Nurse turnover might occur due to personal reasons, or job offers from other organizations or working conditions. The relevance of this study is to focus on the nurse turnover pattern at King Abdullah Medical City. The methodology of this study will be based on a cross-sectional questionnaire-based survey. It will deploy multistage sampling to recruit 200 registered nurses with over three years of experience in the profession. It will also be imperative to use a chi-square test and multi-factor logistic regression to attain comparisons relevant to the study. Data will be collected using stratified sampling at the institution with the directors of every department who will approve and sign a form of consent. The study will deploy a questionnaire that will be administered to each of the respondents upon acceptance to take part in the survey. The consequences of nurse turnover in the organization should be considered because nurses are relevant in the lives of patients as determinants of medical outcomes.
The demand for Certified Endocrinology Nurses, Certified Dialysis Nurses, Certified Registered Nurse Anaesthetists, and certified nurse midwives is growing. Notably, nursing shortage is a costly phenomenon within a medical care facility. It results in the loss of valuable employees who may be hard to replace, considering the high cost of employing and training new nurses. It also culminates in critical issues in the medical facility because nurses are the primary source of patient care. As such, they play a crucial role in providing high-quality medical care services to patients under the jurisdiction. They also play a vital role in ensuring that the health promotion of patients can be actualized. Nursing shortage implies that staff retention of nurses is of invaluable benefit to an organization that operates in the health care industry.
Nurse turnover might occur due to personal reasons, or job offers from other organizations or working conditions. Workers who need moving into a different profession because of getting tired of working in a specific organization may decide to leave the company without prior notice. Those who get job offers from other organizations in the same or different industry may feel that they do not have to continue toiling in a medical facility. The job offers they get may have less work or more pay when compared to the current job. It means that such nurses find it easy to relocate to another organization where conditions are more favorable to them. Finally, pathetic working conditions may motivate nurses to decide to quit their current job and find another place where they can work.
Purpose and Rationale
The relevance of this study is to focus on the nurse turnover pattern at King Abdullah Medical City. The usefulness of surveying the hospital is to understand the implications of nurse turnover within the hospital and in the country. The consequences of nurse turnover in the organization should be considered because nurses are relevant in the lives of patients as determinants of medical outcomes. It is for this reason that this study will examine empirical literature on nurse turnover rates and related to King Abdullah Medical City by surveying 200 participants from the health care facility.
The study has the following research questions:
- What is the correlation between demographic variables such as years of critical care experience, marital status, educational level, years of nursing experience, gender, and age on nursing turnover intention?
- What is the correlation between turnover intention and relational coordination has mediated by nurses’ affective commitment and job satisfaction?
- What is the relationship between the level of education and professional and organizational turnover in the medical care environment?
- What is the role of nurse leaders in ensuring that they can reduce nurse turnover rates at King Abdullah Medical City?
Park, Gass, & Boyle (2016) conduct a study on the reasons for nurse turnover in non-Magnet and Magnet hospitals. The research utilizes a correlational, descriptive study that analyzes unit-level organizations where 497 are hospitals and 2958 are units. The researchers deploy a Wilcoxon-Mann-Whitney test method and Poisson regression. Results from the study show that turnover rates of Registered Nurses are due to environment-related factors. As such, they are high in non-magnet hospitals than units in Magnet medical centers with a rate as high as 4.68 due to workload and staffing. The rate is also 1.44 times higher than Magnet hospitals due to work schedules. The relevance of this research to the current study is to determine how administrators can strive to improve unit work environments, especially work scheduling, workload conditions, and staffing. These issues are critical because they influence decisions that nurses make when opting to remain in an organization or leave.
Yang et al. (2017) conduct a cross-sectional study on factors that influence nurse turnover at work by focusing on the validation of work pressure. The researchers conducted a cross-sectional survey of 800 registered nurses with more than one year of experience in the working environment. The research finds out that the classification of turnover retention is 19% – very weak and 62% – weak. However, it is 19% – very strong or strong. Factors that influence work stress include workload, experience, and age. On the contrary, nurses intend to leave an organization that is not affected by the scale of income. The department that has the highest rate of nurse turnover is pediatrics. Nurses in this section experience a significant level of stress that makes it indispensable to leave the organization. A strong intention to leave the organization is found in nurses aged between 30 and 39. The research is relevant to the current study because it depicts the correlation between nurse turnover intentions with career commitment and job duty as well as age and stress. It is imperative to note that the intention to leave an organization is multifactorial. These factors should be considered in nurse retention incentives that are imperative in making sure that an organization can achieve the required level of success with existing professionals. The study also shows that effective support strategies and management are essential to reduce stress in the working environment, which can help the organization retain nurses for an extended time.
Lyu et al. (2016) discuss the rights of nurse turnover in China from 2000 to 2015. The study includes 206 journal articles and 33 Master’s dissertations. The results show that there has been an increase in the number of publications concerning nurse turnover from 2000 to 2015. The number of articles has increased significantly from 2007 onward. The articles published in 2010 and 2011 were less than those published in 2015. Several journals have been publishing information concerning nurse turnover. The information is relevant to the current study because it depicts the use of research funding in promoting the application of scientific theory and innovation to strengthen the normative use and rigor of scientific research in developing its ability to inform issues like nurse turnover rates. Research is expected to help give theoretical exploration and influential factors as well as assessment tools that can help understand the consequences of nurse turnover rates. Saudi Arabia requires studies that are imperative in informing the rates of nurse turnover to ensure that associated issues can be mitigated.
Falatah & Salem (2018) discuss nurse turnover rates in the Kingdom of Saudi Arabia. The researchers evaluate primary sources using the Whittemore and Knafl’s integrative review method. The findings show that there are variations in reported turnover rates across the studies. The specific determinants of nurse turnover rates in the Kingdom of Saudi Arabia include job-related factors, leadership, and management. Satisfaction and nurse demographics are also critical factors to consider. The research is essential to the current study because it shows that there is a need to focus on costs and outcomes of nurse turnover and other factors that have a significant influence on turnover intention in the Kingdom. The alarming rate of nurse turnover in the Kingdom of Saudi Arabia makes it all the more relevant to analyze existing factors. The intention is to ensure that nurse turnover rates can be understood well within the Kingdom to arrive at expected conclusions that consider retaining nurses using evidence-based practice approaches.
Chang et al. (2018) examine the impact of nurse burnout on career interest and outcome expectations as well as self-efficacy and the intention to leave the organization and profession. Nurse burnout has a significant relationship with nurse turnover within a medical care organization. The study is based on proportionate stratified sampling and a cross-sectional design. The results show that burnout has a negative correlation with outcome expectations and self-efficacy. Outcome expectations have a positive association with career interest and self-efficacy. However, career interest and self-efficacy lack a relationship. There is a negative correlation between career interest and the intention to leave an organization. The latter factor is related to the intention to leave the profession. The information from the study is vital for the current research because it confirms that nurses leaving the profession have a significant negative impact on patient outcomes. Policymakers need to evaluate if the medical care system can instill expectations in nurses for adequate compensation and satisfaction among them. Using this information is relevant in helping organizations to understand how they can retain nurses through adequacy in compensation plans and overall job satisfaction in Saudi Arabia.
Antwi, Y. A., & Bowblis (2018) conduct a study aimed at understanding the effect of nurse turnover on patient mortality and the quality of care in nursing homes. The researchers use a conceptual model of nurse turnover retention within the nursing home. The results show that a systematic underestimation of the impact of nursing turnover on the quality of care and mortality may result from ignoring endogeneity. Nurse turnover results in a diminished quality of care and an increase in mortality within the medical care environment. The study is relevant to the current research because it helps understand the impact of turnover on the procyclicality of mortality rates in Saudi Arabia. Nursing turnover has a significant negative effect on the mortality rate and the quality of care that patients receive. It means that it is relevant for medical care organizations to find definitive ways through which they can reduce the rates of nurse Turnover.
Mazurenko, Gupte, & Shan (2015) discuss nursing turnover in the United States. The essence of the document is to examine and compare issues that result in a professional turnover and organizational turnover. The former means nurses leaving the profession while the latter means nurses vacating a specific job. They collect data from 8796 registered nurses and perform an analysis using source software. The results show that there is a need for policymakers and medical care managers to be aware of various factors associated with the decision of nurses to leave the profession or organization. Medical care managers need to understand the usefulness of nursing retention strategies and develop comprehensive programs to build the careers of nurses. The document is related to the topic because it shows methods that can be used to ensure that nothing retention has been actualized from the organizational perspective.
Farahani, Oskouie, & Ghaffari (2016) conduct a study on factors that affect nursing turnover in Iran. The country is facing a nursing shortage with a high rate of nurse turnover among nurses who have been working for three years or less in the country. It points out that there is a need to focus on employing new individuals in the working environment because the turnover of employees is costly. The coordination of training and employment of new nurses is also expensive to the organizations that are taking part in this incentive. The writers point out that the shortage of nurses typically results in a reduction of motivation and stress during shifts. Organizations may require them to work beyond the expected hours, and the overtime might be compulsory and excessive. These individuals experience task interference and extreme pressure in the working environment. They may also face unwanted fatigue and frustration in addition to a reduction in motivation. It means that medical care organizations incur significant financial and human resource costs because of excessive working hours. The phenomenon is associated with a decrease in productivity and fatigue in addition to absenteeism and sick leave. The document is relevant to the topic because it represents factors that are critical to gaining an understanding of the critical factors that result in a nursing turnover.
Bruyneel et al. (2017) conduct an analysis aimed at exploring the correlation between turnover intentions with emotional exhaustion and job satisfaction in addition to job characteristics and the working environment. Evidence is gathered from 294 registered nurses, and results show that nurses with more years of experience are less likely to indicate intentions of turnover. The information is imperative to the analysis because it shows that organizations can minimize turnover intentions in emergency departments by targeting early career nurses in addition to job characteristics and the work environment. There is also a need for increased social support by supervisors for all nurses, especially females.
Dewanto & Wardhani (2018) discuss nursing turnover in addition to the perceived causes and consequences. They deploy a thematic analysis of the literature, and the results depict nurse turnover between 12 and 34%. The three common causes of nurse turnover include unsuitable working conditions and external attractions, along with personal reasons. Nursing turnover results in a disruption of operations that can further complicate the costs and revenue of the medical care organization. The information is vital to the topic because it shows that nursing turnover can be predicted by job tenure and marital status as well as age in a medical care facility. Understanding this information helps develop the best ways through which nursing turnover can be reduced significantly within the organization.
Labrague et al. (2018) carry out a study to understand factors that influence the intention of nursing turnover in the Philippines. The researchers conducted 166 nurses using a descriptive and cross-sectional approach. The results show that job satisfaction and work stress have a significant impact on the decision that nurses make to leave a specific organization. Nurses who have a Baccalaureate degree and a few years’ of experience have high scores of turnover intentions. Similarly, young nurses have high intentions to leave the current organization when compared to older individuals. The research is critical to the present study because it depicts predictors of turnover intention by pointing out that job stress, as well as job satisfaction and the age of nurses, entail the most influential factors that regulate nurse turnover.
Kim & Lee (2016) conduct a study on the turnover rate among new nurses. They deploy a survey on 323 participants to determine the reasons for nurse turnover. The results show that 24.5% of new nurses leave the job within a year of beginning working. The predictors of turnover include the number of nurses per hundred beds and the number of hospitals in a given area. Job satisfaction and a monthly income, as well as job status, are critical factors to consider that concern the last turnover. The document is relevant to the study because it shows that new graduate nurses are the most vulnerable to turnover. The researchers recommend policy changes and additional studies to be conducted concerning the reduction of nurse turnover among fresh graduates.
Takase, Teraoka, & Yabase (2016) conduct a study to determine the impact of the fulfillment of psychological contract on the perception of advanced fulfilment achievement and age in reducing the intentions of turnover among nurses in Japan. The researchers use 1337 registered nurses and midwives with a participation rate of 57% and deploy moderated regression analysis to analyze the results. The results show that perceived advancement opportunity fulfillment and fulfilling the psychological contract jointly and independently contribute to reducing the turnover intention in nurses. The results are imperative in the study because they show that advancing opportunities as a way of career development and fulfilling the psychological contract are critical issues that reduce turnover intentions, especially among newly graduated nurses.
Hudgins (2016) conduct a study on the correlation between anticipated turnover with job satisfaction and resilience. The review uses a sample of 89 nurse leaders from several hospitals in southwestern Virginia. The results depict a correlation between the three factors tested. It is also found that anticipated turnover and job satisfaction overlap significantly in meaning, and they create new constructs of the intention to remain in the organization. They have a statistical significance with resilience. The research is essential to the current study because it shows that stable nursing teams have positive effects on the improvement of patient outcomes. It means that nurse leaders can enhance their resilience and recruit individuals whom they can hire and retain to improve the intention to remain within the medical care organization.
Chen et al. (2015) conduct a study investigating the correlation between turnover intention and job satisfaction as mediated by work-life balance. The research is a cross-sectional mailed survey of 200 nurses from 25 nursing homes in Taiwan. The results show that dissatisfaction in the job indirectly influences the intention of turnover through the increased conflict between work and life. It is also essential pointing out that turnover intention is negatively and significantly associated with work-life balance and job satisfaction. The findings of the research are imperative in the current study because they show the correlation between nurse turnover and work-life balance.
Park & Boyle (2015) carry out a study on the quality of unit-level data concerning nurse turnover. They surveyed178 hospitals and analyze the data using descriptive statistics. The results show that most medical care organizations agree with the quality of data collection incentives for unit-level turnover among nurses. The study is relevant to the current research because it shows the usefulness of units level nurse turnover information that can be used in improving the quality of care and workforce stability in addition to nurse retention.
Feng et al. (2017) analyze nurse turnover as one of the primary reasons for the shortage of nurses worldwide. They deploy a cross-sectional study of 581 nurses from 10 hospitals. The results show that job satisfaction is a critical factor to consider in nurse retention within medical care organizations. The results are critical for the current study because they depict the youthfulness of efforts to improve the subjective social status of nurses, such as job satisfaction.
Falatah & Conway (2019) analyze the correlations between nurse turnover intention with affective commitment and job satisfaction in the Kingdom of Saudi Arabia. The methodology deployed is a cross-sectional online survey with 180 participants. The results show that the relationship between turnover intention and relational coordination. The mediation variable is job satisfaction within the medical care environment. The results also show that the affective commitment of nurses can have a significant mediation role to play between turnover intention and relational coordination. Then research is relevant for the current study because it shows that relational coordination is critical as a factor to consider in turnover intention among nurses. It is imperative to note that high levels of relational coordination imply positive outcomes relevant to patients and nurses as well as associated medical care professionals. The research shows that there is a need to reconfigure job designs to cultivate and build links between several clinical disciplines with nothing to enhance commitment levels and job satisfaction. The intention is to reduce the last turnover rate within the Kingdom of Saudi Arabia by encouraging nurses to understand the role they play in the lives of patients to ensure that they recuperate from a holistic perspective. Ensuring nothing intention should be the definitive objective to help inform positive results within the medical care environment.
Abumayyaleh et al. (2016) conduct a study on the correlation between turnover intention and moral distress among critical-care nurses. They deploy a convenience sample composed of 200 critical care nurses and conduct a cross-sectional study to determine the results of the analysis. The results show that the level of moral distress among critical care nurses is moderate. There is a lack of significant association between the frequency and turnover intention of nurses and moral distress intensity except for a considerable correlation between turnover intention, years of critical care experience, years of nursing, and age. The study is vital to the current research because it shows that critical care nurses experience frequent and intense moral distress. These individuals get distressed because of the provision of aggressive care to patients who would not expect to benefit from critical care as well as end-of-life issues. They experience moral distress regardless of years of experience in a single hospital and work experience as well as gender and age. They have a perception of moral distress that locks the correlation with turnover intention. It means that they may identify its wide-ranging and critical implications of moral distress that can extend beyond retention and job satisfaction. It also implies that policymakers and the administration of a hospital should be guided using such information to deploy policies that help direct the care of significant others and patients in critical care settings that concern end-of-life problems. Moral distress is an essential factor to consider in vital environments of care, and it should take extended urgent attention.
Aljohani & Alomari (2018) conduct a study of nurses turnover rates among Filipino nurses in Saudi Arabia. The research is a cross-sectional study of 124 nurses. The results show that different factors influence nurse turnover. The work environment affects 16%, while the quality of life has an impact on 25% of nurse turnover rates. Administration support affects 25%, while financial motivations influence 34% of nurse turnover rates. Bad accommodations have an influence of 9%, where is discrimination influences 13.5% of the turnover rate of nurses. The end of contract influences 14.5%, while the low ratio of nurses to patients influences about 15% of nurse turnover rates. Finally, 18.3% of nurses point out that reduced salaries make it hard for them to continue working in a specific organization. The results are critical for the study because they show that it is imperative to manage nurse turnover through the implementation in organizations such as the ministry of health in Saudi Arabia. Nurses need to be discouraged using financial benefits and increasing wages. There is a shortage of staff members, and hospitals face issues such as emergencies and an increase in workload. It means that nurses are being questioned to work for extra hours, but none of them are allowed to use these extra hours to benefit themselves. It results in a situation whereby nurse turnover increases significantly in the country. The recommendations given in the article include using temporary staff and decreasing paperwork as well as minimizing understaffing within the medical care environment. It is also essential to use mixed approaches to nursing by delegating the duty to nurse assistants and similar medical care professionals.
The methodology of this study will be based on a cross-sectional questionnaire-based survey. It will deploy multistage sampling to recruit 200 registered nurses with over three years of experience in the profession. It will also be imperative to use a chi-square test and multi-factor logistic regression to attain comparisons relevant to the study. The inclusion criteria will entail working at the organization for at least three years and being actively involved in patient management. The researcher will contact all respondents in person to request their engagement in the study. Data will be collected using stratified sampling at the institution with the directors of every department who will approve and sign a form of consent. The study will deploy a questionnaire that will be administered to each of the respondents upon acceptance to take part in the survey.
Data analysis will be conducted using SPSS software, and the chi-square will be used to test count data for group comparisons. A two-tailed t-test will be used to determine statistical significance in the data. The research will also use subgroup analysis to assess job responsibility and professional titles’ influence on turnover rates. Analyzing the turnover impact factors for turnover intention will need the deployment of multiple factor logistic regression. The data should depict the correlation between demographic variables such as years of critical care experience, marital status, educational level, years of nursing experience, gender, and age on nursing turnover intention. It will also evaluate the correlation between turnover intention and relational coordination has mediated by nurses’ affective commitment and job satisfaction. Further, it will discuss the relationship between the level of education and professional and organizational turnover in the medical care environment. Finally, it will determine the role of nurse leaders in ensuring that they can reduce nurse turnover rates at King Abdullah Medical City.