Beyond Individual Resilience: A Social-Ecological Perspective on Sustaining the NICU Nursing Workforce

Area of Science:

• Nursing
• Healthcare Management
• Organizational Psychology

Background:

• Workforce stability in neonatal intensive care units (NICUs) is crucial for neonate care quality.
• Job dissatisfaction and turnover are significant challenges in high-acuity NICU settings.
• The ecological model provides a framework for understanding workforce sustainability.

Purpose of the Study:

• To examine resilience, communication competence, and the nursing work environment as multilevel factors influencing nursing workforce sustainability in NICUs.
• To assess the association of these factors with job satisfaction as a proxy for workforce retention.

Main Methods:

• A descriptive cross-sectional survey was conducted with 145 NICU nurses in South Korea.
• Data were analyzed using descriptive statistics, t-tests, ANOVA, correlation, and multiple regression analyses.
• The study considered intrapersonal, interpersonal, and organizational factors.

Main Results:

• Job satisfaction positively correlated with resilience (r=0.67), communication competence (r=0.52), and the nursing work environment (r=0.57).
• Resilience (β=0.43), nursing work environment (β=0.30), communication competence (β=0.15), and tertiary hospital employment (β=0.12) significantly predicted job satisfaction.
• These factors explained 55.1% of the variance in job satisfaction.

Conclusions:

• Job satisfaction in NICU nurses is associated with multilevel factors including resilience, communication, and work environment.
• Resilience demonstrated the strongest association with job satisfaction.
• Integrated strategies addressing intrapersonal, interpersonal, and organizational domains are needed to support NICU nursing workforce sustainability.