Validation of work pressure and associated factors influencing hospital nurse turnover: a cross-sectional investigation in Shaanxi Province, China

Abstract

BackgroundNurses' turnover is a major contributor to nursing shortages, strongly influenced by nurses’ intentions to leave. Several factors influencing the turnover intention have been well identified in Western countries and large cities in China. However, whether these factors also contribute to nurses' work stress in Midwest China are still unclear. The main purpose of this study was to examine the work pressure and associated factors influencing the nurses’ intent to leave.MethodsA cross-sectional questionnaire-based survey with multistage sampling was conducted by recruiting 800 employed registered nurses with >1 year of work experience. Chi-square test and multi-factor logistic regression were applied to attain the relative comparisons. Sub-group analysis was conducted to explore the different turnover intention patterns in different age groups.ResultsThe turnover intention was classified as strong/very-strong (19%), weak (62%), and very-weak (19%). Among the factors influencing the nurses’ desire to leave the profession, work pressure was the most prominent. The predominantly associated factors contributing the work stress were age, experience, and workload. However, the scale of income did not affect the intent to leave decision. Pediatrics was identified to be the highest tormented department with a significant (P < 0.05) turnover of nurses. Among different age sub-groups, 30–39 age group nurses in Secondary hospitals demonstrate a stronger intent to leave.ConclusionNurses’ turnover intentions were associated with stress, age, job duty, and career commitment in Shaanxi Province. The intent to leave is dynamically multifactorial, and effective managements and supportive strategies are needed to reduce the nurses work stress accordingly.

Intention to leave among staff nurses in small‐ and medium‐sized hospitals

“…Organisations provide various forms of rewards to employees in exchange for their contributions. It is reported that nurses perceived whether their organisations were rewarding their efforts monetarily or nonmonetarily, which influenced their decisions to leave or remain (Li, Galatsch, Siegrist, Müller, & Hasselhorn, 2011;Yang et al, 2017). At first, basic monetary rewards, such as salaries, bonuses and incentives through a contract between the organisation and the employee (Williams, Brower, Ford, Williams, & Carraher, 2008), are critically important factors for encouraging employees' retention and motivation (El-Jardali et al, 2009;Tekleab, Bartol, & Liu, 2005).…”

“…There is much interest in the reasons nurses leave their current job and the effective strategies for retaining the nursing workforce internationally (Han, Trinkoff, & Gurses, 2015;Takase, Teraoka, & Yabase, 2016;Yang, Lv, Zhou, Liu, & Mi, 2017). Any turnover rate below 15% annually is considered healthy and not a cause for concern (Kenny, 2007); meanwhile, high turnover rates make major problems in the healthcare system and quality of care.…”

“…Any turnover rate below 15% annually is considered healthy and not a cause for concern (Kenny, 2007); meanwhile, high turnover rates make major problems in the healthcare system and quality of care. High turnover rates of nurses impose an additional burden on healthcare organisations (Takase et al, 2016), causing the quality of medical and nursing services to decline (Duffield, Roche, Homer, Buchan, & Dimitrelis, 2014;O'Brien-Pallas, Murphy, Shamian, Li, & Hayes, 2010), as well as indirectly increasing the workload, work stress and job burnout of the remaining nurses, which is associated with turnover again (Yang et al, 2017). Leaving a hospital is a preceding step to leaving the profession (de Oliveira, Griep, Portela, & Rotenberg, 2017).…”

From job stress to intention to leave among hospital nurses: A structural equation modelling approach

“…The retention of hospital staff nurses has been identified as a key factor to counteract the shortage (Baumann, 2010;International Council of Nurses 2014;Shacklock & Brunetto, 2012). Empirical studies have highlighted the significant effect of job stress on retention and turnover intention among nurses (Wu, Fox, Stokes, & Adam, 2012;Yang, Lv, Zhou, Liu, & Mi, 2017;Zhang, Wu, Fang, Zhang, & Wong, 2017). As the pressure on the healthcare system is rapidly increasing with population ageing, evidence concerning the job stress to turnover pathway is urgently needed to develop effective interventions.…”

Relationship Between Work-Family Conflict and Job Satisfaction of Medical Staff after Implementing the Health System Development Plan

“…Long working hours, high workload, lack of job security, high workplace noise, too much heat or cold at workplace, job hazards and possibility of injury, working methods, inadequate facilities for work, low light and the existence of toxic gases in the workplace, the relationship with superior colleagues and subordinates at work, and work conflicts are of the main factors in stress creation in the hospital spaces (27)(28)(29).…”