Nursing theory and concept development: a theoretical model of clinical nurses’ intentions to stay in their current positions

Abstract

We describe a theoretical model of staff nurses' intentions to stay in their current positions. The global nursing shortage and high nursing turnover rate demand evidence-based retention strategies. Inconsistent study outcomes indicate a need for testable theoretical models of intent to stay that build on previously published models, are reflective of current empirical research and identify causal relationships between model concepts. Two systematic reviews of electronic databases of English language published articles between 1985-2011. This complex, testable model expands on previous models and includes nurses' affective and cognitive responses to work and their effects on nurses' intent to stay. The concepts of desire to stay, job satisfaction, joy at work, and moral distress are included in the model to capture the emotional response of nurses to their work environments. The influence of leadership is integrated within the model. A causal understanding of clinical nurses' intent to stay and the effects of leadership on the development of that intention will facilitate the development of effective retention strategies internationally. Testing theoretical models is necessary to confirm previous research outcomes and to identify plausible sequences of the development of behavioral intentions. Increased understanding of the causal influences on nurses' intent to stay should lead to strategies that may result in higher retention rates and numbers of nurses willing to work in the health sector.