A causal model of voluntary turnover among nursing personnel in long-term psychiatric settings.
Causal modeling was used to explore the processes by which individual characteristics, job satisfaction, and intention to quit explain turnover among nursing personnel in 29 Department of Veterans Affairs (VA) long-term psychiatric settings. The sample consisted of 1,106 registered nurses (RNs), licensed practical nurses (LPNs), and nurses' aides. We conceptualized turnover as a multistage process linking social and experiential orientations, attitudes toward the job, the decision to quit, and the behavior of actually quitting. Intention to quit was the strongest direct predictor of turnover. Professional growth opportunities and workload were important indirect predictors of turnover. Dissatisfaction with work hazards and relationships with coworkers were both indirect and direct predictors of turnover. Attitudes towards the job varied by nursing group. LPNs and aides were less satisfied than RNs with autonomy and work hazards. RNs were more dissatisfied with workload. We conclude that strategies to promote retention need to address aspects of jobs tailored to specific nursing groups.
University of Michigan, School of Public Health, Department of Health Management and Policy, Ann Arbor 48109, USA.
J A
JA
Alexander
R
R
Lichtenstein
H J
HJ
Oh
E
E
Ullman
D000328:Adult; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000523:psychology*; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D007588:Job Satisfaction; D008134:Long-Term Care; D008297:Male; D008960:Models, Psychological; D015401:Nursing Administration Research; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000600:supply & distribution*; D010563:Personnel Turnover / Q000706:statistics & numerical data*; D011568:Psychiatric Nursing; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs; D000078329:Workforce; D016526:Workload