Factors Influencing Intention to Leave Among Nurse Managers: A Cross-Sectional Study

To estimate the proportion of Italian nurse managers (NMs) intending to leave (ITL) their positions and to identify associated socio-demographic, job-related, and psychosocial factors.

Cross-sectional study.

Between September and November 2023, 464 NMs from 19 public hospitals completed a case-report form and the short version of the Copenhagen Psychosocial Questionnaire II (COPSOQ II). Latent Class Analysis (LCA) identified ITL profiles, and multiple logistic regression assessed factors associated with ITL.

284 NMs (61.2%; 95% CI 57-66) reported an intention to leave within 12 months. LCA identified two classes: (1) Low-ITL (54%)-mainly outpatient NMs from Central regions with strong relationships with management, good support, work-life balance, and autonomy (55.9% probability of being unlikely to leave). (2) High-ITL (46%)-mainly surgical or critical-care NMs, often from Northern regions, marked by poor management relations, low support and high work-family conflict (80.9% probability of being likely to leave). Multiple regression confirmed that stronger management relations reduced ITL (OR 0.60, 95% CI 0.46-0.79) whereas high job demands and work-health conflict increased it (OR 1.56, 95% CI 1.19-2.04). Northern location also predicted higher ITL (OR 1.58, 95% CI 1.03-2.44). Demographics, education, and clinical setting were not significantly associated.

These findings suggest that healthcare organizations should prioritize managerial and organizational strategies targeting modifiable work-related factors to reduce nurse managers' intention to leave. Interventions aimed at improving organizational support, work environment, and job satisfaction may contribute to workforce retention at the managerial level. Future research should evaluate the effectiveness of targeted organizational interventions in sustaining nurse manager retention.