FACTORS IMPACTING ACUTE CARE NURSES’ INTENTIONS TO LEAVE THEIR POSITIONS: POST COVID-19 ERA

Abstract

Background: The nursing profession is currently experiencing an acute workforce shortage, with turnover rates reaching critical levels. In the light of this fragility, this study aimed to examine factors influencing turnover intentions among U.S hospital nurses in the post-pandemic era. Methods: An exploratory cross-sectional design was implemented using a national convenience sample of nurses (n=406) who worked during the COVID-19 pandemic and currently work in an acute care setting. Instruments included the Moral Injury Event Scale (MIES), the Hospital Ethical Climate Scale (HECS), the Satisfaction of Employees in Health Care (SEHC), and the Roodt's Turnover Intention scale (TIS). To fully understand nurses’ experiences, open-ended questions were inserted to allow nurses to share their experiences and recommendations for organizational support strategies to enhance their intent to stay. Data were analyzed using correlation, multiple regression, hierarchical regression, and content analysis. Results: Findings revealed high levels of exposure to morally injurious events (M = 30.5, SD = 12.5) and a strong desire to leave current positions (M = 20.12, SD = 5.4). Turnover intention was negatively correlated with job satisfaction and perceptions of the ethical climate. Moral injury (MI) was positively correlated with turnover intentions and negatively correlated with job satisfaction and the ethical climate. Further analysis showed the job satisfaction and ethical climate fully mediated the relationship between MI and turnover intentions. Content analysis of qualitative responses identified four key themes: 1) Feeling unsupported/overworked, 2) Inadequate organizational preparedness/resources during the pandemic, 3) Reasons for remaining in role, and 4) Desired forms of organizational support. Conclusion: The study underscores the urgent need for targeted interventions to retain nurses in the workforce. Enhancing job satisfaction and fostering a positive ethical climate may significantly reduce turnover intentions. Further research should investigate additional mediating factors, such as post-traumatic growth, to better understand and address nurse retention.