ABSTRACT Nurse turnover is a central driver of the growing care deficits that characterise contemporary capitalism. In Sweden, despite policy efforts to improve retention, nurse shortages persist – destabilising care provision and intensifying workplace strain. This article explores how turnover and employer responses in the Swedish healthcare sector reflect the contradictory dynamics of market culture. Drawing on document and media analysis, and informed by feminist-Polanyian theories of care and Hirschman’s exit-voice framework, the study shows that nurses respond to deteriorating conditions through exit, while regional authorities adopt market-based strategies selectively. Market logics are embraced when they enhance managerial control but resisted when nurses act as autonomous market agents. This ambivalence reveals deeper tensions in the governance of care work under neoliberalism. The article contributes to scholarship on the care crisis, marketisation, and the transformation of professional subjectivities in human service organisations.

This study aimed to examine the effects of personality features and attitudes toward the nursing profession on job motivation and intention to quit among male nurses within the framework of the Job Demands-Resources (JD-R) model. In this framework, personality traits and perceptions of the profession were conceptualized as personal resources, while job motivation represents a motivational process that may influence turnover intention. A cross-sectional design was employed with 303 male nurses actively working in different regions of Turkey. Data were collected via an online survey using non-probability sampling methods. The measurement tools included the Attitude Scale Toward the Nursing Profession, Job Motivation Scale, Personality Features Scale, and the Nurse Turnover Intention Scale. Data were analyzed using descriptive statistics, confirmatory factor analysis, and structural equation modeling. Structural equation modeling revealed that attitudes toward the nursing profession (β = -0.90, p < 0.001), personality features (β = -0.10, p < 0.001), and job motivation (β = -0.14, p < 0.001) had significant and negative effects on intention to quit. Attitudes toward the profession emerged as the strongest predictor, explaining 49% of the variance in intention to quit. Attitudes toward the nursing profession, personality features, and job motivation were found to have significant and negative effects on intention to quit among male nurses. Consistent with the JD-R model, the findings suggest that personal resources (personality and professional perception) and motivational processes (job motivation) may play an important role in shaping turnover intentions among male nurses. Accordingly, professional identity-strengthening initiatives, role model-based mentoring, and motivation-enhancing training programs may help support the retention of male nurses in the profession.

Background: Emergency department nurses face a high risk of burnout due to high-intensity workloads, long working hours and workplace violence, which is associated with the quality of care and increases nurse turnover. Traditional interventions often lack dynamic adjustment capabilities. Methods: This narrative review integrates research on burnout monitoring and prediction, system-level interventions, and individual-level interventions. Results: Machine learning models trained on questionnaire data can tell whether it is a risk when burning out. Wearable devices enable real-time monitoring to prevent burnout at the early stage of detection. But the problem also needs to be resolved with attention to compliance and measurement sensitivity. The problem also needs to be addressed in terms of compliance and recognition of sensitivity. AI-assist scheduling and prediction make system less unequal and lessen work burden. In terms of individuals, modules and digital psychological interventions through the just in time adaptive intervention framework with algorithm matching and the hybrid model of self-selection is to improve the user's interaction. Conclusions: AI-driven interventions for burnout among emergency department nurses provide evidence for the feasibility of proactive, closed-loop intervention programs. It is better to pay more attention to predicting the results of prediction. Translating this into concrete actions and sustaining it over the long term can effectively reduce burnout and maintain a good nursing turnover rate.

Work-life balance is the ability to manage professional and personal responsibilities effectively. A study was undertaken by seventh semester B.Sc. nursing students to assess the work-life balance of nurses working in tertiary care hospitals in Ernakulam district, Kerala, aiming to improve their well-being and quality of care. This research aimed to determine the prevalence of work-life balance, job satisfaction, work engagement and turnover intentions among nurses. It examined the influence of work-life balance on these workplace factors and its association with socio-demographic characteristics. The research approach adopted for the study was descriptive correlational. A total of 330 registered nurses were selected using convenience sampling from a private Medical College hospital in Ernakulam district. The outcome variables in this study were work-life balance, work engagement, job satisfaction and turnover intention. Data were collected using standardized tools including the work-life balance scale, Utrecht work engagement scale, satisfaction of employees in healthcare survey and turnover intention scale. Statistical analysis was carried out using EZR software, with significance set at p<0.5. The results revealed that although many nurses had moderate to high levels of engagement, a large number struggled with poor work-life balance and moderate satisfaction with their jobs. A noticeable portion indicated intentions to leave their roles. A slight positive link was found between work-life balance and engagement, with a non-significant moderate link to job satisfaction. No clear correlation was seen between work-life balance and intent to leave. Significant links were observed between work-life balance and variables like transportation mode, health conditions and family support. The conclusion drawn from the study has shown that nurses turnover intentions are influenced by multiple factors beyond work-life balance. Enhancing work conditions, providing family support and promoting well-being through flexible shifts and mental health services are crucial for improving job satisfaction and retention in tertiary healthcare settings.

Perceived stress, sickness presenteeism, job burnout, and turnover intention among nurses: A cross-sectional survey.

Elderly care nursing has problems such as staffing shortages, stress and limited career opportunities, which are prompting nurses to leave. The aims of this service evaluation were to explore the factors contributing to high turnover of nurses in elderly care and propose retention strategies. A qualitative design was used. Seven semi-structured interviews were conducted with nurses from six wards within the elderly care division. Three main themes emerged: staff and patient safety; lack of career progression; and training needs. Nurses in elderly care face both personal and organisational challenges. Prioritising their development, safety and recognition is crucial for retention. Trusts should acknowledge and support these nurses' hard work and commitment. Recommendations include flexible working patterns, providing adequate skill mix on the wards and opportunities for career progression in elderly care.

Operationalizing the RETAIN Framework: Calculating the cost of nurse turnover in practice.

Employee affective commitment is a critical factor for workforce retention and service quality in healthcare organizations, particularly among nurses who represent the largest professional group in hospitals. Kemayoran X Hospital has experienced persistently high nurse turnover rates, indicating potential deficiencies in affective commitment. This study aimed to examine the influence of perceived organizational support and organizational justice on nurses’ affective commitment, with work engagement serving as an intervening variable. A quantitative cross-sectional design was employed, involving 125 staff nurses at Kemayoran X Hospital selected through purposive sampling. Data were collected using structured self-administered questionnaires distributed via Google Forms and analyzed using Structural Equation Modeling–Partial Least Squares (SEM-PLS). The results demonstrated that perceived organizational support, organizational justice, and work engagement simultaneously exerted a significant effect on affective commitment. Furthermore, perceived organizational support and organizational justice showed significant positive effects on work engagement, which in turn significantly influenced affective commitment. Mediation analysis confirmed that work engagement partially mediated the relationships between perceived organizational support and affective commitment, as well as between organizational justice and affective commitment. These findings indicate that nurses who perceive fair treatment and strong organizational support are more likely to be engaged in their work and emotionally committed to their organization. In conclusion, strengthening organizational support systems, ensuring fairness in decision-making processes, and fostering work engagement are essential managerial strategies to enhance nurses’ affective commitment and reduce turnover in hospital settings.

The stability of healthcare around the world is seriously threatened by nurse turnover intention, which is a primary predictor of actual turnover. The necessity to comprehend contributing elements is highlighted by the 47.7% new nurse turnover rate in Korea, which costs over USD 33,733 per nurse. This comprehensive review synthesizes quantitative, qualitative, and mixed-methods evidence to map factors that influence nurse turnover intention across hospital settings. Using a PRISMA-ScR approach, a literature search for "factors of nurse turnover" in Scopus produced 2,274 articles; 13 of these met inclusion criteria and were subjected to thematic analysis. Four primary areas were identified: leadership style (transformational, toxic, bullying), psychosocial aspects (work-life balance, job satisfaction, distress, and social support), and organizational factors (work environment, mentorship). Work-life balance and job satisfaction reduce risk by 30–40%, while a supportive work environment and adequate resources reduce turnover by 10–20%. While toxic or bullying leadership significantly raises turnover intention (β=0.51), transformational leadership enhances retention by 0.082 per unit. There are significant regional differences; for instance, 81.4% of Kenyan nurses plan to quit because their pay is less than $500 USD, which increases the probability of turnover three to five times. The use of cross-sectional research (76.9%) and the lack of worldwide representation are examples of gaps in the literature. To increase retention, holistic approaches that incorporate transformational leadership training, mental health assistance, healthy workplaces, and equitable pay are crucial.

Determinants of Nurse Turnover in Psychiatric Hospitals in Makkah Region, Saudi Arabia

Background: Globally, healthcare systems struggle to retain critical care nurses (CCNs) due to high turnover intentions. The mediating roles of emotional intelligence and sense of belonging in mitigating moral distress, stress, and fatigue are insufficiently explored. Objective: This study investigates how moral distress, work stress, and fatigue influence CCNs’ turnover intentions through the mediating pathways of emotional intelligence and a sense of belonging. Study design and methods: A multicentre, cross-sectional survey was conducted across eight public and private hospitals. The study enrolled 432 CCNs between May 20 and July 31, 2024. Each participant completed a validated, structured questionnaire that was self-administered and paper based. Descriptive statistics, ANOVA, independent samples t-tests, and path analysis were utilised for data analysis. Results: CCNs reported high mean scores for fatigue (21.50), moral distress (65.10), and turnover intention (14.75). Path analysis indicated a direct significant positive effect of moral distress on fatigue (β= .69), work stress (β= .38), and indirectly on turnover intention (β= .12). Fatigue further intensified work stress (β=.40). Notably, significant moral distress was inversely associated with emotional intelligence (β=-.24) and positively with sense of belonging (β= .24). In turn, both emotional intelligence (β=-.31) and a sense of belonging (β= -.27) were negatively associated with turnover intentions. Conclusions: This study elucidates the significant influence of adverse workplace factors, specifically moral distress, fatigue, and work stress, on the CCNs' turnover intentions. Such stressors erode core nursing competencies and present a tangible risk to patient care standards. Importantly, the results underscore the protective functions of emotional intelligence and a strong sense of belonging, which appear to attenuate the negative impact of these occupational stressors. Implications for research, policy, and practice: By mitigating the impact of moral distress and cultivating a more supportive work environment, healthcare organisations can foster environments that reduce occupational stress, alleviate fatigue, and consequently decrease nurses' turnover intentions. Addressing these detrimental workplace dynamics is essential for enhancing the work environment for nurses and ensuring the provision of optimal patient care within healthcare settings.

Nurse turnover poses a significant challenge to healthcare systems worldwide, affecting care quality, continuity, and operational costs. This study examines the effects of individual and organizational characteristics on nurse turnover, with work stress as a mediating factor. A cross-sectional survey was conducted among 74 inpatient nurses at St. Elisabeth Hospital Semarang. Individual characteristics included Type A personality, locus of control, and self-efficacy, while organizational characteristics encompassed structure, policies, processes, and work environment. Work stress was measured across physiological, psychological, and behavioral dimensions, and turnover was assessed via intention to resign, job alternative search, and actual resignation. Findings revealed moderate levels of work stress and personal/organizational factors, but low turnover intention. Structural equation modeling (SmartPLS) confirmed that both individual and organizational characteristics significantly influenced turnover, mediated by work stress. Type A personality, external locus of control, and lower self-efficacy were linked to higher stress and turnover, while supportive organizational practices mitigated these effects. This study highlights the importance of strengthening nurse resilience and optimizing organizational support to reduce stress and turnover. Interventions targeting personal development, stress management, and organizational efficiency are critical for sustaining a stable and effective nursing workforce.

Although the nursing profession remains in high demand globally, nurse turnover rates continue to rise. The transition from student nurse to licensed professional is a critical phase in a nurse’s development, during which individuals are particularly vulnerable to stress and workplace challenges. The Philippines, widely recognized for producing nurses who serve healthcare systems worldwide, has limited local research examining transition experiences within domestic healthcare settings. This study explored challenges encountered by newly hired nurses as they moved from students to licensed professionals. It examined gaps in knowledge, skills, and attitudes, and identified support systems and coping strategies that facilitated adjustment to clinical practice. A phenomenological design was employed using semi-structured interviews with newly hired nurses from two private hospitals in Candelaria, Quezon Province. Ten participants were selected through purposive sampling. Data were analyzed using thematic analysis supported by NVivo 15 software, generating nine themes: Navigating Role Transition, Professional Adaptation, Reality Shock, Adaptive Communication, Clinical Preparedness Deficit, Decision-Making Hesitancy, Institutional Support, Peer Support, and Personal Resilience. Findings revealed challenges related to psychological adjustment, inadequate clinical skills, and gaps between theoretical education and practice. These challenges underscore the need for structured transition programs and institutional support. Based on the findings, the study proposed Pathway to Care, an Information, Education, and Communication material designed to prepare licensed nurses for professional realities. The insights may inform educators, administrators, and policymakers in strengthening transition initiatives.

The need to manage employee turnover in the healthcare industry is urgent, according to recent data. The World Health Organization (2023) projects that by 2030, there would be a shortfall of 10 million healthcare workers worldwide, with significant rates of burnout and resignation following COVID-19. In 2022, the average annual hospital turnover rate in the United States was 22.7%, while the turnover rate for registered nurses was 27.1% (NSI Nursing Solutions, 2023). A 2022 study in China found an average nurse turnover rate of 15% across tertiary hospitals, while the NHS in the United Kingdom reported an 18% turnover rate, particularly among early-career personnel (Zhao et al., 2022; NHS Digital, 2023). These trends mirror a global pattern of talent insecurity, which jeopardizes patient outcomes and raises operational costs. This research presents a complete model of employee retention using a mixed-methods approach that includes case studies, theoretical integration, and policy analysis. It provides a strategic roadmap for healthcare administrators and policymakers by connecting scientific findings to real-world implementations across diverse healthcare systems. The study closes with an integrated research design and a conceptual framework to inform future research and practice.

Racial segregation is believed to play a critical role in enforcing racial disparities in nursing home quality. In this study, we test whether segregation exacerbates racial disparities in nursing home quality. We used data from the 2023 Minimum Data Set (MDS) and 2025 public use files on nursing home quality from the Center for Medicare and Medicaid Services to compare the quality of nursing homes with a high versus low proportion of Black residents and assess whether that relationship varied depending on the level of racial segregation among nursing homes in the county. Racial segregation was measured based on how Black and non-Hispanic White nursing home residents were distributed across nursing homes in a county. Nursing home quality measures included: star ratings, nursing turnover rates, adjusted staffing hours, and inspection deficiency scores. Racial disparities existed at all levels of segregation. Nursing home segregation was associated with widening disparities in inspection deficiency scores; no statistically significant association was found between segregation and racial disparities in star rating, nursing turnover rates, or adjusted staffing hours. Racial disparities in nursing home quality are stark, with disparities in inspection deficiency scores exacerbated in counties with more segregated nursing home markets. These findings highlight the need for targeted policies to mitigate the impact of systemic disinvestment on nursing homes that serve a high proportion of Black residents.

Psychiatric Mental health hospital in Saudi Arabia suffer fundamental problem of increased rates of mental health nurses turnover that seriously affect the quality of psychiatric patients’ care.Objective: This study aimed to examine the Impact of Compassion Support Program ( CSP) on Compassion Fatigue, Job Satisfaction, and Turnover of Psychiatric Nurses at El Taif Mental Hospital, Makkah city, SAUDI ArabiaMethod: A quasi-experimental (pre-post one-group) research design is used to evaluate the impact of Compassion Support Programs on compassion fatigue, job satisfaction, and turnover of psychiatric nurses in Taif Mental hospital, Makkah province of Saudi Arabia. The sample: consisted of all nurses who accepted to voluntary participate in the study, their number amounted to 40 nurses out of total 80 nurses after following the procedure of sampling size and G. power analysis. They represented different age groups, fluent in Arabic or English languages and represented the different hospital departments. Tools of data collection were four self-rating questionnaires (Arabic &amp; English). Three of them were administrated pre and post implementation of the CSP program to evaluate its efficacy on the three specified variables. Results: statistical analysis using paired-samples t-test revealed significant differences at p. &lt;0.05 between pre and post program implementations regarding all three variables. Pearson correlation test also showed significant correlation at (p˂ 0.05) among nationality, education, income, intention to leave, job satisfaction, and compassion fatigue. Multiple Regression analysis confirmed that lack of job satisfaction is the most highly correlated factor to the intention to leave work among Psychiatric nurses in this hospital.Conclusion: Compassion Support Program proved a significant impact on reducing psychiatric nurses’ compassion fatigue, turn over as well as significantly improved job satisfaction

Abstract Leadership stability in nursing homes (NHs) plays a critical role in shaping residents’ care experience. However, the impact of nursing home administrator (NHA) and director of nursing (DON) turnover on resident satisfaction has not been thoroughly examined. This study investigates the relationship between NHA/DON turnover and resident satisfaction scores. An aggregate dataset of Ohio NHs in 2017 was constructed (N = 752) by merging five data sources: The Ohio Nursing Home Resident Satisfaction Survey, the Ohio Biennial Survey of Long-Term Care Facilities, the Certification and Survey Provider Enhanced Reports, Medicaid Cost Report, and LTCFocus. The outcome variables were eight resident satisfaction scores: overall satisfaction score and seven individual domain scores. The scores were continuous variables, with higher scores indicating greater resident satisfaction (range: 0-100). Leadership turnover was categorized into four predictors: one NHA turnover, two or more NHA turnover, one DON turnover, and two or more DON turnover over the past three years. Multiple linear regressions, including control variables, were conducted via SAS. Results show that two or more DON turnover is associated with a lower overall resident satisfaction score by 1.14% points (p &amp;lt; .05) and lower scores of Environment and Caregivers domains. However, NHA turnover is not statistically associated with overall resident satisfaction score, while positively associated with two domain scores. The findings of this study highlight the critical role of DON stability in improving resident satisfaction and suggest that having one leadership turnover may not compromise NH quality; however, frequent turnover, particularly among DONs, could be detrimental.

This quality improvement project evaluated a 6-month mentorship program's influence on job satisfaction, burnout, engagement, intent to stay, and turnover/retention for experienced (12 mentors) and newly hired (13 mentees) nurses within 3 health system hospital units. Results showed limited statistical significance for improving job satisfaction, burnout, and engagement. Qualitative participants' feedback indicated the program enhanced their goals, comfort level, and socialization through peer support. No unit participants left, compared with an 18.6% nonparticipant turnover rate.

The persistent shortage and turnover of nurses remain significant challenges within Rwanda’s healthcare system, particularly in district hospitals. This study explored factors influencing nurses’ retention and motivation, aiming to identify effective strategies for sustaining a stable and committed nursing workforce. A descriptive quantitative design was employed with a sample of 83 nurses from Gisenyi District Hospital. Data were collected through structured questionnaires and analyzed using SPSS version 21, with findings presented in frequencies and percentages. Results revealed that the majority of respondents emphasized the need to improve physical working conditions (61.4% agreed; 34.9% strongly agreed), human resource management (51.8% agreed; 43.4% strongly agreed), and transparency (60.2% agreed; 66.3% strongly agreed). Furthermore, opportunities for professional advancement (50.6% strongly agreed) and peer support (50.6% strongly agreed) were highlighted as key motivational factors. Participants also called for enhanced living conditions, increased staffing, and salaries aligned with educational qualifications. The study concludes that improving workplace conditions, leadership practices, and professional development opportunities are critical strategies for nurse retention in Rwanda. It recommends that healthcare managers and policymakers implement targeted retention programs to foster motivation and reduce turnover among nurses.

Nursing home administrator (NHA) and director of nursing (DON) are the 2 key leadership positions in nursing homes (NHs) and play an important role in delivering high-quality long-term care services. However, the impact of DON turnover has not been well investigated compared with that of NHA. This study aims to investigate the association of NHA/DON turnover with 5-star ratings and consumer satisfaction. A cross-sectional analysis of Ohio NHs. An NH-level data set of Ohio NHs was constructed, containing 5-star ratings, consumer satisfaction scores, and NH characteristics. Six data sets were merged from the 2017 Nursing Home Compare Archive, 2017 Ohio Nursing Home Resident Satisfaction Survey, 2018 Ohio Nursing Home Family Satisfaction Survey, the Certification and Survey Provider Enhanced Reports, Payroll-Based Journal, and the 2017 Ohio Biennial Survey of Long-Term Care Facilities. Logistic and linear regressions were performed, controlling for other NH characteristics. Multivariable regressions indicate that DON turnover is consistently associated with lower star ratings by 2.9%-11.5% points and lower consumer satisfaction scores by 0.4%-1.5% points. NHA turnover is associated with lower overall and health inspection star ratings and family satisfaction score, but the effect sizes of NHA turnover diminish when accounting for DON turnover. The Centers for Medicare & Medicaid Services incorporates a specific measure for NHA turnover into the staffing star rating. However, DON turnover is only reported as a part of the turnover of total nursing staff or registered nurse turnover rates. Given its impact on quality outcomes, DON turnover should be incorporated as a standalone measure to enhance accountability and transparency within the NH industry.