Ethical climate and turnover intention among nurses: A scoping review.

Abstract

Nursing shortages and turnover pose significant challenges for health organizations worldwide, driven by various organizational and individual factors. Ethical climate has emerged as a critical aspect influencing nurses' well-being and retention within healthcare settings, reflecting organizational practices with moral implications. Understanding the relationship between ethical climate and turnover intention among nurses is paramount for practitioners, managers, and policymakers. This review aimed to examine evidence and synthesize findings from prior studies on the association between ethical climate and turnover intention among nurses and identify key variables influencing its dynamics. A scoping review methodology was employed, encompassing studies retrieved up to February 2024 from major scientific databases, including PUBMED/MEDLINE, WEB OF SCIENCE, SCOPUS, and SCIENCE DIRECT. This study was conducted following ethical considerations and sound scientific guidelines. Sixteen articles meeting the inclusion criteria were identified. Overall, a significant association between ethical climate and turnover intention was observed, with theoretical underpinnings demonstrated. Key variables frequently linked to both ethical climate and turnover intention included organizational commitment, job satisfaction, and moral distress, while organizational commitment, organizational cynicism, and organizational trust emerged as mediators. Despite demonstrating a clear association, results underscore the necessity for replication studies, qualitative and longitudinal approaches, and standardized measurement. Enhancing the ethical climate through regular assessments, education, and interprofessional collaboration can improve retention. Future research should focus on theory building, ethical management and leadership, associated factors analysis, and intervention studies to develop comprehensive models and effective strategies for improving the ethical climate and reducing nurse turnover.