Advertisement

A concept analysis of turnover intention: Implications for nursing management

      Summary

      This paper provides a review and concept analysis of turnover intention. The aim was to promote Nurse Managers’ understanding of the meanings and mechanisms of turnover intention, which could help them counteract nurse turnover. Sixty-six papers published between January 1998 and August 2007 were collected from CINAHL, PubMed, and PsycINFO databases, and were subjected to Rogers’ concept analysis. The results showed that turnover intention is a multi-stage process involving the voluntary departure of employees from their current position, and is triggered by negative psychological responses to internal/external job context. These psychological responses evolve into withdrawal cognition and behaviours, and lead to actual turnover. To prevent nurse turnover, Nurse Managers should closely observe the internal and external causes of turnover, and the stage of nurses’ turnover intention.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Collegian
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References
      The literature with asterisks was included in the concept analysis.

        • *Alexander J.A.
        • Lichtenstein R.
        • Oh H.J.
        • Ullman E.
        A causal model of voluntary turnover among nursing personnel in long-term psychiatric settings.
        Research in Nursing & Health. 1998; 21: 415-427
        • *Alexandrov A.
        • Babakus E.
        • Yavas U.
        The effects of perceived management concern for frontline employees and customers on turnover intentions: Moderating role of employment status.
        Journal of Service Research. 2007; 9: 356-371
        • *Allen D.G.
        • Weeks K.P.
        • Moffitt K.R.
        Turnover intentions and voluntary turnover: The moderating roles of self-monitoring, locus of control, proactive personality, and risk aversion.
        Journal of Applied Psychology. 2005; 90: 980-990
      1. American Organisation of Nurse Executives. (2002). Acute care hospital surveys of RN vacancy and turnover rates in 2000. Available at: http://www.wha.org/workForce/pdf/aone-surveyrnvacancy.pdf.

        • *Arnold J.
        • Davey K.M.
        Graduates’ work experiences as predictors of organisational commitment, intention to leave, and turnover: Which experiences really matter?.
        Applied Psychology: An International Review. 1999; 48: 211-238
        • *Bigliardi B.
        • Petroni A.
        • Dormio A.I.
        Organisational socialisation, career aspirations and turnover intentions among design engineers.
        Leadership & Organisation Development Journal. 2005; 26: 424-441
        • *Blau G.
        • Lunz M.
        Testing the incremental effect of professional commitment on intent to leave one's profession beyond the effects of external, personal, and work-related variables.
        Journal of Vocational Behaviour. 1998; 52: 260-269
        • *Blau G.
        • Ward-Cook K.
        • Edgar L.C.
        Testing for the impact of correlates on medical technologists’ intent to leave their jobs.
        Journal of Allied Health. 2006; 35: 95-100
        • *Brough P.
        • Frame R.
        Predicting police job satisfaction and turnover intentions: The role of social support and police organisational variables.
        New Zealand Journal of Psychology. 2004; 33: 8-16
        • *Byrne Z.S.
        Fairness reduces the negative effects of organisational politics on turnover intentions, citizenship behaviour and job performance.
        Journal of Business and Psychology. 2005; 20: 175-199
        • *Carmeli A.
        • Weisberg J.
        Exploring turnover intentions among three professional groups of employees.
        Human Resource Development International. 2006; 9: 191-206
        • *Castle N.G.
        • Engberg J.
        • Anderson R.
        • Men A.
        Job satisfaction of nurse aides in nursing homes: Intent to leave and turnover.
        The Gerontologist. 2007; 47: 193-204
        • *Chan E.-Y.
        • Morrison P.
        Factors influencing the retention and turnover intentions of registered nurses in a Singapore hospital.
        Nursing and Health Sciences. 2000; 2: 113-121
        • *Chandrashekaran M.
        • McNeilly K.
        • Russ F.A.
        • Marinova D.
        From uncertain intention to actual behaviour: A threshold model of whether and when salespeople quit.
        Journal of Marketing Research. 2000; 37: 463-479
        • *Chang C.-S.
        • Du P.-L.
        • Huang I.-C.
        Nurses’ perceptions of severe acute respiratory syndrome: Relationship between commitment and intention to leave nursing.
        Journal of Advanced Nursing. 2006; 54: 171-179
        • *Chang E.
        Career commitment as a complex moderator of organisational commitment and turnover intention.
        Human Relations. 1999; 52: 1257-1277
        • *Chang H.-T.
        • Chi N.-W.
        • Miao M.-C.
        Testing the relationship between three-component organisational/occupational commitment and organisational–occupational turnover intention using a non-recursive model.
        Journal of Vocational Behaviour. 2007; 70: 352-368
        • *Chen Z.X.
        • Francesco A.M.
        Employee demography, organisational commitment, and turnover intentions in China: Do cultural differences matter?.
        Human Relations. 2000; 53: 869-886
        • *Chiu C.-K.
        • Chien C.S.
        • Lin C.-P.
        • Hsiao C.Y.
        Understanding hospital employee job stress and turnover intentions in a practical setting: The moderating role of locus of control.
        Journal of Management Development. 2005; 24: 837-855
        • *Chiu C.-K.
        • Lin C.-P.
        • Tsai Y.H.
        • Hsiao C.-Y.
        Modelling turnover intentions and their antecedents using the locus of control as a moderator: A case of customer service employees.
        Human Resource Development Quarterly. 2005; 16: 481-499
        • *Crossley C.D.
        • Bennett R.J.
        • Jex S.M.
        • Burnfield J.L.
        Development of a global measure of job embeddedness and integration into a traditional model of voluntary turnover.
        Journal of Applied Psychology. 2007; 92: 1031-1042
        • *Cunningham G.B.
        • Sagas M.
        Occupational turnover intent among assistant coaches of women's teams: The role of organisational work experiences.
        Sex Roles. 2003; 49: 185-190
        • *Cunningham G.
        • Sagas M.
        • Ashley F.
        Coaching self-efficacy, desire to become a head coach, and occupational turnover intent: Gender differences between NCAA assistant coaches of women's teams.
        International Journal of Sport Psychology. 2003; 34: 125-137
        • *DeConinck J.B.
        • Stilwell C.D.
        Incorporating organisational justice, role states, pay satisfaction and supervisor satisfaction in a model of turnover intentions.
        Journal of Business Research. 2004; 57: 225-231
        • *Egan T.M.
        • Yang B.
        • Bartlett K.R.
        The effects of organisational learning culture and job satisfaction on motivation to transfer learning and turnover intention.
        Human Resource Development Quarterly. 2004; 15: 279-301
        • *Firth L.
        • Mellor D.J.
        • Moore K.A.
        • Loquet C.
        How can managers reduce employee intention to quit?.
        Journal of Managerial Psychology. 2004; 19: 170-186
        • *Flinkman M.
        • Laine M.
        • Leino-Kilpi H.
        • Hasselhorn H.M.
        • Salanterä S.
        Explaining young registered Finnish nurses’ intention to leave the profession: A questionnaire survey.
        International Journal of Nursing Studies. 2008; 45: 727-739
        • *Freund A.
        Commitment and job satisfaction as predictors of turnover intentions among welfare workers.
        Administration in Social Work. 2005; 29: 5-21
        • *Geurts S.
        • Schaufeli W.
        • De Jonge J.
        Burnout and intention to leave among mental health-care professionals: A social psychological approach.
        Journal of Social and Clinical Psychology. 1998; 17: 341-362
        • *Geurts S.A.
        • Schaufeli W.B.
        • Rutte C.G.
        Absenteeism, turnover intention and inequity in the employment relationship.
        Work & Stress. 1999; 13: 253-267
        • Goodin H.J.
        The nursing shortage in the United States of America: An integrative review of literature.
        Journal of Advanced Nursing. 2003; 43: 335-350
        • *Hang-yue N.
        • Foley S.
        • Loi R.
        Work role stressors and turnover intentions: A study of professional clergy on Hong Kong.
        International Journal of Human Resource Management. 2005; 16: 2133-2146
        • *Harris K.J.
        • James M.
        • Boonthanom R.
        Perceptions of organisational politics and cooperation as moderators of the relationship between job strains and intent to turnover.
        Journal of Managerial Issues. 2005; 17: 26-42
        • *Harris K.J.
        • Kacmar K.M.
        • Witt L.A.
        An examination of the curvilinear relationship between leader-member exchange and intent to turnover.
        Journal of Organisational Behaviour. 2005; 26: 363-378
        • *Hart S.E.
        Hospital ethical climates and registered nurses’ turnover intentions.
        Journal of Nursing Scholarship. 2005; 37: 173-177
        • *Herrbach O.
        • Mignonac K.
        • Gatignon A.-L.
        Exploring the role of perceived external prestige in managers’ turnover intentions.
        International Journal of Human Resource Management. 2004; 15: 1390-1407
        • Hom P.W.
        • Kinicki A.J.
        Toward a greater understanding of how dissatisfaction drives employee turnover.
        The Academy of Management Journal. 2001; 44: 957-987
        • *Houkes I.
        • Janssesn P.P.M.
        • de Jonge J.
        • Bakker A.B.
        Specific determinants of intrinsic work motivation, emotional exhaustion and turnover intention: A multiple longitudinal study.
        Journal of Occupational and Organisational Psychology. 2003; 76: 427-450
        • *Houkes I.
        • Janssesn P.P.M.
        • de Jonge J.
        • Nijhuis F.J.N.
        Specific relationships between work characteristics and intrinsic work motivation, burnout and turnover intention: A multi-sample analysis.
        European Journal of Work and Organisational Psychology. 2001; 10: 1-23
        • *Huang I.-C.
        • Chuang C-H.J.
        • Lin H.-C.
        The role of burnout in the relationship between perceptions of organisational politics and turnover intention.
        Public Personnel Management. 2003; 32: 519-531
        • *Huffman A.H.
        • Adler A.B.
        • Dolan C.A.
        • Castro C.A.
        The impact of operations tempo on turnover intention of army personnel.
        Military Psychology. 2005; 17: 175-202
      2. Japan Nursing Association. (2006). Nurse demand–supply survey in hospitals in 2005: Overall results (a prompt report). News Release. Available at: http://www.nurse.or.jp/home/opinion/newsrelease/2006pdf/20060602.pdf (in Japanese).

        • Karsh B.
        • Booske B.C.
        • Sainfort F.
        Job and organisational determinants of nursing home employee commitment, job satisfaction and intent to turnover.
        Ergonomics. 2005; 48: 1260-1281
        • *Kidd J.M.
        • Green F.
        The careers of research scientists: Predictors of three dimensions of career commitment and intention to leave science.
        Personnel Review. 2006; 35: 229-251
        • *Kirschenbaum A.
        • Weisberg J.
        Employee's turnover intention and job destination choices.
        Journal of Organisational Behaviour. 2002; 23: 109-125
        • *Knudsen H.K.
        • Ducharme L.J.
        • Roman P.M.
        Counsellor emotional exhaustion and turnover intention in therapeutic communities.
        Journal of Substance Abuse Treatment. 2006; 31: 173-180
        • *Krausz M.
        • Koslowsky M.
        • Eiser A.
        Distal and proximal influences on turnover intentions and satisfaction: Support for a withdrawal progression theory.
        Journal of Vocational Behaviour. 1998; 52: 59-71
        • *Lambert E.G.
        • Hogan N.L.
        • Barton S.M.
        The impact of job satisfaction on turnover intent: A test of a structural measurement model using a national sample of workers.
        The Social Science Journal. 2001; 38: 233-250
        • *Larrabee J.H.
        • Janney M.A.
        • Ostrow C.L.
        • Withrow M.L.
        • Hobbs G.R.
        • Burant C.
        Predicting registered nurse job satisfaction and intent to leave.
        Journal of Nursing Administration. 2003; 33: 271-283
        • *Layne C.M.
        • Hohenshil T.H.
        • Singh K.
        The relationship of occupational stress, psychological stain, and coping resources to the turnover intentions of rehabilitation counsellors.
        Rehabilitation Counselling Bulletin. 2004; 48: 19-30
        • *Lichtenstein R.
        • Alexander J.A.
        • McCarthy J.F.
        • Wells R.
        Status differences in cross-functional teams: Effects on individual member participation, job satisfaction, and intent to quit.
        Journal of Health and Social Behaviour. 2004; 45: 322-335
        • *Lou J.-H.
        • Yu H.-Y.
        • Hsu H.-Y.
        • Dai H.-D.
        A study of role stress, organisational commitment and intention to quit among male nurses in southern Taiwan.
        Journal of Nursing Research. 2007; 15: 43-53
        • *Lum L.
        • Kervin J.
        • Clark K.
        • Reid F.
        • Sirola W.
        Explaining nursing turnover intent: Job satisfaction, pay satisfaction, or organisational commitment?.
        Journal of Organisational Behaviour. 1998; 19: 305-320
        • *McCarthy G.
        • Tyrrell M.P.
        • Lehane E.
        Intention to ‘leave’ or ‘stay’ in nursing.
        Journal of Nursing Management. 2007; 15: 248-255
        • *McDuff E.M.
        • Mueller C.W.
        The ministry as an occupational labour market: Intentions to leave an employer (church) versus intentions to leave a profession (ministry).
        Work and Occupations. 2000; 27: 89-116
        • Mitchell T.R.
        • Lee T.W.
        The unfolding model of voluntary turnover and job embeddedness: Foundations for a comprehensive theory of attachment.
        Research in Organisational Behaviour. 2001; 23: 189-246
        • Mrayyan M.
        Jordanian nurses’ job satisfaction ans intent to stay: Comparing teaching and non-teaching hospitals.
        Journal of Professional Nursing. 2007; 23: 125-136
        • *Mulki J.P.
        • Jaramillo F.
        • Locander W.B.
        Effects of ethical climate and supervisory trust on salesperson's job attitudes and intentions to quit.
        Journal of Personal Selling & Sales Management. 2006; 26: 19-26
        • Mullen C.
        Commentary: An English perspective.
        Journal of Advanced Nursing. 2003; 43: 335-350
        • *Poon J.M.L.
        Effects of performance appraisal politics on job satisfaction and turnover intention.
        Personnel Review. 2004; 33: 322-334
      3. PricewaterhouseCoopers’ Health Research Institute. (2007). What works: Healing the Healthcare Staffing Shortage. Available at: http://dwd.wisconsin.gov/healthcare/pdf/what_works.pdf.

        • *Rambur B.
        • Palumbo M.V.
        • McIntosh B.
        • Mongeon J.
        A statewide analysis of RNs’ intention to leave their position.
        Nursing Outlook. 2003; 51: 182-188
      4. Review Body for Nursing and Other Health Professions. (2007). Twenty-second report on nursing and other health professions 2007. Available at: http://www.ome.uk.com/downloads/361072_Cm7029_WEB.pdf.

        • *Robison J.
        • Pillmer K.
        Job satisfaction and intention to quit among nursing home nursing staff: Do special care units make a difference?.
        The Journal of Applied Gerontology. 2007; 26: 95-112
        • Rogers B.L.
        Concept analysis: An evolutionary view.
        in: Rogers B.L. Knafl K.A. Concept development in nursing: Foundations, techniques and applications. Saunders, Philadelphia2000: 77-102
        • *Sablynski C.J.
        • Lee T.W.
        • Mitchell T.R.
        • Burton J.P.
        • Holtom B.C.
        Turnover: An integration of Lee and Mitchell's unfolding model and job embeddedness construct and Hulin's withdrawal construct.
        in: Brett J. Drasgow F. The psychology of work: Theoretical based empirical research. Lawrence Erlbaum, Mahwah, NJ2002: 189-204
        • *Schwepker C.H.
        The relationship between ethical conflict, organisational commitment and turnover intentions in the salesforce.
        Journal of Personal Selling & Sales Management. 1999; 19: 43-49
        • *Schwepker Jr., C.H.
        Ethical climate's relationship to job satisfaction, organisational commitment, and turnover intention in the salesforce.
        Journal of Business Research. 2001; 54: 39-52
        • *Stone P.W.
        • Mooney-Kane C.
        • Larson E.L.
        • Pastor D.
        • Zwanziger J.
        • Dick A.W.
        Nurse working conditions, organisational climate, and intent to leave in ICUs: An instrumental variable approach.
        Health Research and Educational Trust. 2007; 42 (Part I): 1085-1103
        • *Sturges J.
        • Guest D.
        Don’t leave me this way! A qualitative study of influences on the organisational commitment and turnover intentions of graduates early in their career.
        British Journal of Guidance & Counselling. 2001; 29: 447-462
        • *Susskind A.M.
        Downsizing supervisors’ communication networks and reactions: A longitudinal examination of information flow and turnover intentions.
        Communication Research. 2007; 34: 156-184
        • *Takase M.
        • Maude P.
        • Manias E.
        Nurses’ job dissatisfaction and turnover intention: Methodological myths and an alternative approach.
        Nursing and Health Sciences. 2005; 7: 209-217
        • *Van Dick R.
        • Christ O.
        • Stellmcher J.
        • Wagner U.
        • Ahlswede O.
        • Grubba C.
        • et al.
        Should I stay or should I go? Explaining turnover intentions with organisational identification and job satisfaction.
        British Journal of Management. 2004; 15: 351-360
        • *van Vianen A.E.M.
        • De Pater I.E.
        • Van Dijk F.
        Work value fit and turnover intention: Same source or different source fit.
        Journal of Managerial Psychology. 2007; 22: 188-202
        • *Vandenberg R.V.
        • Nelson J.B.
        Disaggregating the motives underlying turnover intentions: When do intentions predict turnover behaviour?.
        Human Relations. 1999; 52: 1313-1336
        • *Vigoda-Gadot E.
        • Ben-Zion E.
        Bright shining stars: The mediating effect of organisational image on the relationship between work variables and army officers’ intentions to leave the service for a job in high-tech industry.
        Public Personnel Management. 2004; 33: 201-223
        • Wickett D.
        • McCutcheon H.
        • Long L.
        Commentary: An Australian perspective.
        Journal of Advanced Nursing. 2003; 43: 343-345