Factors that contribute to anticipated turnover among civilian registered nurses employed in United States Army hospitals

Abstract

<p>In this study, selected factors believed to influence anticipated turnover among civilian registered nurses employed in Army hospitals were examined. Based on a theoretical model developed from existing models of nursing turnover, independent variables were clustered into three groups: individual factors (age, education, tenure, kinship responsibility); growth need strength, initial expectations of tenure, and career intentions; and perceptions of contextual factors (workload, group cohesion, instrumental communication, job characteristics, external and internal labor market, and pay satisfaction). The theoretical model proposed that independent variables influenced the dependent variable which was anticipated turnover, either directly or indirectly through job satisfaction. The sample consisted of 470 civilian registered nurses employed full-time in the in-patient setting in nine Army hospitals in the U.S. Hospital selection was based on crude separation rate, location, and size to form a representative sample. Questionnaires were sent to 470 nurses, and the response rate was 54%. Multivariate analysis revealed that the most effective variables for predicting anticipated turnover included job satisfaction and age. The most effective variables for predicting job satisfaction included group cohesion, satisfaction with compensation, career intentions, growth need strength, and instrumental communication. Structural equation modeling (SEM) revealed that group cohesion, satisfaction with compensation, career intentions, growth need, instrumental communication, and task identity had direct effects on job satisfaction and indirect effects on anticipated turnover. SEM revealed that both age and job satisfaction had direct effects on anticipated turnover. Future research should include examination of group cohesion as a potentially powerful source for fostering job satisfaction among civilian nurses. Implications of this study for nurse administrators include the need for attention to unit level group dynamics and recognition that younger civilian nurses who have not made a career commitment may have higher turnover intentions and may need special interventions which convey that they are valued by the Army hospital in which they work.</p>