Is satisfactiona direct predictor of nursing turnover

The theory of planned behaviour states that attitudinal variables (e.g. job satisfaction) only have an indirect effect on retention, whereas intentions have a direct effect.

This study uses secondary data from a longitudinal cohort of newly qualified nurses to test for the direct and indirect effects of job satisfaction (client care, staffing, development, relationships, education, work-life interface, resources, pay) and intentions to nurse on working as a nurse during the three years after qualification.

Methods: A national sample (England) of newly qualified (1997/98) nurses (n=3669) were surveyed at six months, eighteen months and three years . ANOVA and MANOVA were used for comparison of mean job satisfaction scores between groups; intentions to nurse (very likely, likely vs.

unlikely, very unlikely and unable to say at this stage); working (or not working as a nurse) at each time-point. Indirect and direct effects were tested using structural equation and logistic regression models.

Results: Intentions expressed at six months to nurse at eighteen months were associated with higher scores on pay and relationships, and intentions at three years were associated with higher scores on care, development, relationships, work-life interface, resources, and pay respectively.

Intentions expressed at eighteen months to nurse at three years were associated with higher scores on development, relationships, education and work-life interface. Associations with actual nursing were fewer.

Those working as a nurse had higher satisfaction scores for development (eighteen months) and relationships (three years). Regression models found significant associations between the pay and staffing factors and intentions expressed at six months to nurse at eighteen months, and between pay and intentions to nurse at three years.

Many of the associations between intentions and working as a nurse were significant. Development was the only job satisfaction factor significantly associated with working as a nurse and just at eighteen months.



Conclusions: Results partially support the theory of planned behaviour. Intentions expressed by nurses are stronger predictors of working as a nurse than job satisfaction.

Retention strategies should focus on identifying nurses showing early signs of departure with emphasis on developmental aspects, mentoring and support.

Author: Trevor Murrells, Sarah Robinson and Peter Griffiths
Credits/Source: Human Resources for Health 2008, 6:22