The Relationship between Work Environments and Intention to Leave in Nursing: A Cross-sectional and Correlational Study

Year 2022, , 629 - 635, 28.09.2022

Saliha Aydoğmuş Bilgen Özlük

https://doi.org/10.33808/clinexphealthsci.991808

Abstract

Objective: Unfavorable work environments are among the factors that affect nurses’ intention to leave. This study was explored to examine the relationship between nurses’ work environments and their intention to leave.

Methods: This cross-sectional and correlational design study was carried out with 547 nurses working in a university, a private hospital, and a teaching hospital between November 2016 and February 2017. The Practice Environment Scale of the Nursing Work Index and a question about intention to leave was used. Descriptive statistics, Pearson correlation and multiple linear regression analysis were used in the analysis of the data.

Results: The mean total score of scale was found to be M= 2.30±0.56 and nurses' perceptions of work environments to be unfavorable. It was found that; 13.9% of the nurses did not intend to leave, 35.5% had a low, and 50.8% had a high intention to leave. It was determined that unfavorable work environments increases intention to leave (R= .370, R2= .137, p<0.001).

Conclusion: This study found that it was nurses’ intention to leave was negatively affected by their work environments. Hospital and nurse managers should be aware of the need to create positive work environments in order to prevent nurses from leaving the profession.

Keywords

Favorable, intention to leave, nursing, shortage, work environment

References

• [1] Kocaman G, Yurumezoglu HA, Uncu S, Turkmen E, Goktepe N, Intepeler SS. The development of healthy work environment standards for nurses in Turkey. Journal of Education and Research in Nursing. 2018; 15(1):30-39. http://dx.doi. org/10.5222/HEAD.2018.030
• [2] Copanitsanou P, Fotos, N, Brokalaki, H. Effects of work environment on patient and nurse outcomes. Br J Nurs. 2017; 26(3):172-176. https://doi.org/10.12968/bjon.2017.26.3.172
• [3] Albashayreh A, Al Sabei SD, Al-Rawajfah OM, Al-Awaisi H. Healthy work environments are critical for nurse job satisfaction: Implications for Oman. Int Nurs Rev. 2019; 66(3):389-395. https://doi.org/10.1111/inr.12529
• [4] Samur M, Intepeler SS. Factors influencing nurses’ perceptions of occupational safety. Arch Environ Occup Health. 2017; 72(1):45-52. https://doi.org/10.1080/19338.244.2016.1156045
• [5] International Council of Nurses (ICN). Sustain and Retain in 2022 and Beyond, 2022. Available from https://www.icn.ch/ publications
• [6] Dans, M., Lundmark, V. The effects of positive practice environments: Leadership must-knows. J Nurs Manag. 2019; 50(10):7-10. https://doi.org/10.1097/01. NUMA.000.058.0624.53251.29
• [7] Dilig-Ruiz A, MacDonald I, Varin MD, Vandyk A, Graham ID, Squires JE. Job satisfaction among critical care nurses: A systematic review. Int J Nurs Stud. 2018; 88:123-134. https:// doi.org/10.1016/j.ijnurstu.2018.08.014
• [8] Özlük B, Baykal Ü. Organizational citizenship behavior among nurses: The influence of organizational trust and job satisfaction. Florence Nightingale J Nurs. 2020; 28(3):333-340. https://doi.org/10.5152/FNJN.2020.19108
• [9] Al-Hamdan Z, Manojlovich M, Tanima B. Jordanian nursing work environments, intent to stay, and job satisfaction. J Nurs Scholarsh. 2017; 49(1):103-110. https://doi.org/10.1111/ jnu.12265
• [10] Leineweber C, Chungkham HS, Lindqvist R, Westerlund H, Runesdotter S, Alenius L. S, Tishelman C. Nurses’ practice environment and satisfaction with schedule flexibility is related to intention to leave due to dissatisfaction: A multi- country, multilevel study. Int J Nurs Stud. 2016; 58: 47-58. https://doi.org/10.1016/j.ijnurstu.2016.02.003
• [11] Hayes LJ, O’Brien-Pallas L, Duffield C, Shamian J, Buchan J, Hughes F, Laschinger H. K, North N. Nurse turnover: A literature review-an update. Int J Nurs Stud. 2012; 49(7):887- 905. https://doi.org/10.1016/j.ijnurstu.2011.10.001
• [12] International Council of Nurses (ICN). Positive practice environments: Quality workplaces = Quality patient care: information and action tool kit, 2007. Available from https:// www.twna.org.tw/frontend/un16_commission/webPages_4/ IND/1.pdf
• [13] Registered Nurses’ Association of Ontaria. Pilot evaluation of implementation and update of healthy work environment best practice guidelines: Final report, 2003. Available from https:// rnao.ca/sites/rnao-ca/files/HWE_Evaluation_Final_Report. pdf
• [14] American Organization of Nurse Executives. Policy statement on mandated staffing ratios, 2003. Available from http://www. aone.org/resources/mandated-staffing-ratios.pdf
• [15] American Association of Critical-Care Nurses. AACN standards for establishing and sustaining healthy work environments: A journey to excellence, 2005. Available from http://ajcc. aacnjournals.org/conten /14/3/187.full.pdfhtml
• [16] Tambağ H, Can R, Kahraman Y, Şahpolat M. The effect of the work environment on job satisfaction among nurses. Medical Journal of Bakırköy. 2015; 11(4):143-149. https://doi. org/10.5350/BTDMJB201511402
• [17] Bilazer FN, Konca GE, Uğur S, Uçak H, Erdemir F, Çıtak E. 7 gün-24 saat/ hasta başında: Türkiye’de hemşirelerin çalışma koşulları. Ankara: Türk Hemşireler Derneği, 2008. Available from: http://www. turkhemsirelerdernegi.org.tr/menu/ hemsirelik-yayinlari/yayinlar/ turkiyede-hemsirelerin-calisma- kosullari.aspx.
• [18] Sağlık Bakanlığı. Sağlıkta Kalite standartları – Hastane (Versiyon-5; Revizyon-01), 2016. Available from https://www. saglikaktuel.com/d/file/sks_hastane_versiyon_5_1.pdf
• [19] Çaylak E, Altuntas S. Organizational silence among Nurses: The Impact on organizational cynicism and intention to leave work. J Nurs Res. 2017; 25(2):90-98. https://doi.org/10.1097/ jnr.000.000.0000000139
• [20] Nantsupawat A, Kunaviktikul W, Nantsupawat R, Wichaikhum OA, Thienthong H, Poghosyan L. Effects of nurse work environment on job dissatisfaction, burnout, intention to leave. Int Nurs Rev. 2017; 64(1):91-98. https://doi.org/10.1111/ inr.12342
• [21] Jo S, Kurt S, Bennett JA, Mayer K, Pituch KA, Simpson V, Skibiski J, Tagagi E, Karaaslan MM, Özlük B, Reifsnider, E. Nurses’ resilience in the face of coronavirus (COVID-19): An international view. Nurs Health Sci. 2021; 23(3):646-657. https://doi.org/10.1111/nhs.12863
• [22] Said RM, El-Shafei DA. Occupational stress, job satisfaction, and intent to leave: Nurses working on front lines during COVID-19 pandemic in Zagazig City, Egypt. Environ Sci Pollut Res Int. 2021; 28(7):8791-8801. https://doi.org/10.1007/ s11356.020.11235-8
• [23] Raso R, Fitzpatrick JJ, Masick K. Nurses’ intent to leave their position and the profession during the COVID-19 pandemic. J Nurs Adm. 2021; 51(10):488-494. https://doi.org/10.1097/ NNA.000.000.0000001052
• [24] Varasteh S, Esmaeili M, Mazaheri M. Factors affecting Iranian nurses’ intention to leave or stay in the profession during the COVID-19 pandemic. Int Nurs Rev. 2021; 69(2):1-11. https:// doi.org/10.1111/inr.12718
• [25] Özlük B, Bıkmaz Z. The experiences of nurses diagnosed with COVID-19 in Turkey: A qualitative study. Nurs Health Sci. 2021; 23(4):916-924. https://doi.org/10.1111/nhs.12881
• [26] Lake ET. Development of the practice environment scale of the Nursing Work Index. Res Nurs Health. 2002; 25(3):176-188. https://doi.org/10.1002/nur.10032
• [27] Türkmen E, Badır A, Balcı S, Topçu SA. The adaptation of the practice environment scale of the nursing work index into Turkish: Reliability and validity study. J Res Dev Nurs. 2011; 13(2):5-20.
• [28] HM, Tackenberg P, Müller B, NEXT-Study Group. Working conditions and intent to leave the profession among nursing staff in Europe. HM. Hasselhorn (Ed.). Stockholm: National Institute for Working Life, 2003. Available from http://citeseerx.ist.psu.edu/viewdoc/ download?doi=10.1.1.622.3322&rep=rep1&type=pdf
• [29] Lee HF, Chiang HY, Kuo HT. Relationship between authentic leadership and nurse‧ intent to leave: The mediating role of work environment and burnout. J Nurs Manag. 2019; 27(1):52-65. https://doi.org/10.1111/jonm.12648
• [30] Lacher S, Geest S, Denhaerynck K, Trede I, Ausserhofer D. The quality of nurses’ work environment and workforce outcomes from the perspective of swiss allied healthcare assistants and registered nurses: A cross-sectional survey. J Nurs Scholarsh. 2015; 47(5):458-467. https://doi.org/10.1111/jnu.12151
• [31] Leone C, Bruyneel L, Anderson JE, Murrells T, Dussault G, de Jesus ÉH., Sermeus W, Aiken L, Rafferty AM. Work environment issues and intention-to-leave in Portuguese nurses: A cross- sectional study. Health Policy. 2015; 119(12):1584-1592. https://doi.org/10.1016/j.healthpol.2015.09.006
• [32] Sağlık Bakanlığı. OECD, Avrupa Birliği Sağlık İstatistikleri ve Türkiye, Hastanelerde Beşeri ve Fiziki Kaynakların İncelenmesi, 2015. Available from https://www.saglikaktuel.com/d/ file/35c966a9f1d343909d4d0858bec69333.pdf
• [33] Greinacher A, Helaß M, Nikendei C, Müller A, Mulfinger N, Gündel H, Maatouk, I. The impact of personality on intention to leave the nursing profession: A structural equation model. J Clin Nurs. 2021; 31(11-12);1570-1579. https://doi. org/10.1111/jocn.16010
• [34] Ying LY, Ramoo V, Ling LW, Nahasaram ST, Lei CP, Leong LK, Danaee, M. Nursing practice environment, resilience, and intention to leave among critical care nurses. Nurs Crit Care. 2021; 26(6):432-440. https://doi.org/10.1111/nicc.12551
• [35] Lee YW, Dai YT, McCreary LL. Quality of work life as a predictor of nurses’ intention to leave units, organisations and the profession. J Nurs Manag. 2015; 23(4):521-531. https://doi. org/10.1111/jonm.12166
• [36] Kloutsiniotis PV, Mihail DM. Linking innovative human resource practices, employee attitudes and intention to leave in healthcare services. Employee Relations. 2017; 39(1):34-53. http://dx.doi.org/10.1108/ER-11-2015-0205
• [37] Lavoie-Tremblay M, Fernet C, Lavigne GL, Austin S. Transformational and abusive leadership practices: impacts on novice nurses, quality of care and intention to leave. J Adv Nurs. 2016; 72(3):582-592. https://doi.org/10.1111/jan.12860
• [38] Arslan YH, Kocaman G. Predictors of nurses’ intentions to leave the organisation and the profession in Turkey. J Nurs Manag. 2016; 24(2):235-43. https://doi.org/10.1111/jonm.12305