title: Nurse retention and satisfaction in Ecuador: implications for nursing administration.
abstract: OBJECTIVE
  This study explores the characteristics of professional nursing work environments that may affect nursing turnover and satisfaction within a large Ecuadorian hospital.
  
  
  BACKGROUND
  Nursing turnover is a challenge and may compromise patient care. Work dissatisfaction contributes to high turnover. Improving nurse satisfaction can contribute to better patient outcomes.
  
  
  METHODS
  Eighty-eight nurses participated in a quantitative and qualitative survey focusing on nursing satisfaction, turnover and selected organisation characteristics.
  
  
  RESULTS
  Issues that may affect nurse satisfaction and turnover were identified using questions from the Nursing Work Index: pay, insufficient number of nurses, undervaluing of nurses by public and the medical team, limited advancement opportunities, lack of autonomy and inflexibility in schedule. Other themes identified from qualitative data are reported.
  
  
  CONCLUSIONS
  The top factor of decreased satisfaction was low pay as indicated by the Nursing Work Index. The qualitative results showed that low pay was the factor for nurse turnover. Additional factors related to nursing satisfaction can be addressed to improve nurse retention.
  
  
  CONCLUSIONS
  Along with increasing nursing pay, strategies to consider in decreasing turnover and increasing satisfaction included: providing opportunities for nursing advancement, promoting the value of nursing, creating clinical protocols and enhancing autonomy. This study adds to knowledge about nursing needs and satisfaction in South America.
authors: College of Nursing, Brigham Young University, Provo, Utah, USA.
authors: Sheri P
authors: SP
authors: Palmer
keywords: Ecuador; Nursing Work Index; nurse turnover; retention; satisfaction