Turnover in health care: the mediating effects of employee engagement.

AIM: This study aimed to understand the interaction between interpersonal respect, diversity climate, mission fulfilment and engagement to better predict turnover in health care. BACKGROUND: Registered nurse turnover has averaged 14% and current nursing shortages are expected to spread. Few studies have studied employee engagement as a mediator between organisational context and turnover. METHOD: Study participants were employees working within 185 departments across ten hospitals within a large healthcare organisation in the USA. Although a total of 5443 employees work in these departments, employee opinion survey responses were aggregated by department before being linked to turnover rates gathered from company records. RESULT: Engagement fully mediated the relationship between respect and turnover and the relationship between mission fulfilment and turnover. Diversity climate was not related to turnover. CONCLUSION: Turnover in health care poses a significant threat to the mission of creating a healing environment for patients and these results demonstrate that workplace respect and connection to the mission affect turnover by decreasing engagement. IMPLICATIONS FOR NURSING MANAGEMENT: The findings demonstrated that to increase engagement, and improve turnover rates in health care, it would be beneficial for organisations, and nurse management to focus on improving mission fulfilment and interpersonal relationships.

Leading Nursing Into the Future: Development of a Strategic Nursing Platform on a System Level.

Leading and orchestrating the mission-essential work of 47 diverse hospitals toward a common vision with a supporting strategy is a challenge for any health care system. Trinity Health embraced this challenge while reorganizing the pivotal role of nursing in designing the future of health care delivery. This article outlines the roadmap utilized to create a common nursing platform to drive strategy aligned to future viability, strength, and growth across a system.

The nursing incivility scale: development and validation of an occupation-specific measure.

This article describes the development of the Nursing Incivility Scale (NIS), which is designed to assess hospital nurses' experiences with incivility according to specific sources-physicians, coworkers, patients, and direct supervisors. The NIS was developed using focus groups with nurses at a hospital in the midwestern United States and validated during a second survey administered to 163 hospital nurses. Exploratory factor analysis revealed that the NIS items grouped according to a priori scale construction. All subscales showed acceptable reliability and demonstrated acceptable convergent and discriminant validity with other variables. The results indicate that the NIS has good psychometric qualities and can be used by hospitals and health care administrators to assess the prevalence of incivility.

Developing a model of source-specific interpersonal conflict in health care.

Nurses work in complex social environments, and conflict may arise with fellow coworkers, their supervisor, physicians or the patients and family they care for. Although much research has documented the negative effects of conflict on nurses, no research to date has examined the comparative effect that conflict from all four sources can have on nurses. The purpose of this study is to test a model of workplace conflict where the negative effect of conflict on nurses will be experienced via emotional exhaustion. We test the mediator model by analysing the cross-sectional data collected within one hospital (N1=182) and cross-validating those results in a second hospital (N2=161). The pattern of results was largely consistent across the two samples indicating support for a mediated model of workplace conflict for physician, supervisor and patient. Conflict with other nurses, however, did not have a relationship with either emotional exhaustion or other personal and organizational outcomes. The theoretical and practical implications of the current findings, as well as the limitations and future research directions, are discussed.