The effect of work environment on intent to leave the nursing profession: a case study of bedside registered nurses in rural Florida

Abstract

The purpose of this research was to explore the effect work environment has on the intent to leave the profession for rural hospital bedside registered nurses (RNs). Subscales of autonomy, control over the practice setting, nurse-physician relationship and organizational support were incorporated into the analysis to determine which aspects of work environment directly affect the intent to leave the profession. An explanatory cross-sectional survey was distributed to 259 direct care bedside RNs employed at a rural system-affiliated hospital in Central Florida between February 2007 and June 2007. Anonymity was assured. A questionnaire containing demographic questions, the Nursing Work Index-Revised and Blau's intent to leave scale was distributed to all direct care nurses. A 32.8% response rate was achieved for a total of 85 complete and usable surveys. Data analysis shows that the work environment in general is negatively related to intent to leave. In addition, each of the four subscales was also negatively related to the intent to leave the profession. The results of this study support several recommendations for practice and education, including the promotion of professional practice environments, fostering inter-departmental relationships, and increasing the managerial training of RN managers.

Nurses’ views on hospital organizational characteristics

“…In the current study, nurses reported that they have limited opportunity to take part in policy decisions, a lack of freedom to make important patient care and work decisions, and limited participation in efforts to control costs. All these demonstrate limited or even lack of autonomy of nurses, consistent with other authors . Nurse limited or lack autonomy negatively reflect on nurse job satisfaction and retention .…”

“…The overall mean of the hospital organizational characteristics indicates a low level of nurses’ views on hospital organizational characteristics. This indicates poor work environments as marked by low nurse professional autonomy, consistent with other studies; low nurse satisfaction and high nurse turnover, similar to Kutney‐Lee et al; low quality of work, consistent with Olds et al and Wei et al; and, in turn, low patient satisfaction, similar to Olds et al and Wei et al…”

“…Blake, 1 Shirey, 2 Copanitsanou et al, 4 Aiken and Patrician, 6 Sönmez and Yıldırım, 9 Souesme and Ferrand, 10 Cortelyou-Ward et al, 11 Kutney-Lee et al, 12 and Olds et al 13 Descriptive studies Positive organizational characteristics are essential for healthy work environments and positive various outcomes.…”

“…In nursing, positive hospital organizational characteristics are essential for attractive work environments. These characteristics include, but are not limited to, empowering nurse professional autonomy and collaborative relationships with physicians . Positive hospital organizational characteristics and work environments promote nurse satisfaction and decrease nurse turnover, enhance patient satisfaction and quality of work, and decrease inpatient mortality …”

“…These characteristics include, but are not limited to, empowering nurse professional autonomy and collaborative relationships with physicians. 6,[9][10][11] Positive hospital organizational characteristics and work environments promote nurse satisfaction and decrease nurse turnover, 3,6,12,13 enhance patient satisfaction and quality of work, and decrease inpatient mortality. 3,6,12,13 The healthcare system in Jordan has experienced rapid growth.…”