The impact of workplace relationships on engagement, well-being, commitment and turnover for nurses in Australia and the USA.

AIMS: We examined the impact of workplace relationships (perceived organizational support, supervisor-nurse relationships and teamwork) on the engagement, well-being, organizational commitment and turnover intentions of nurses working in Australian and USA hospitals. BACKGROUND: In a global context of nurse shortages, knowledge about factors impacting nurse retention is urgently sought. We postulated, using the Social Exchange Theory, that nurses' turnover intentions would be affected by several factors and especially their relationships at work. DESIGN: Based on the literature review, data were collected via a self-report survey to test the hypotheses. METHODS: A self-report survey was used to gather data in 2010-2012 from 510 randomly chosen nurses from Australian hospitals and 718 nurses from US hospitals. A multi-group structural equation modelling analysis identified significant paths and compared the impact between countries. RESULTS: The findings indicate that this model was more effective in predicting the correlations between variables for nurses in Australia compared with the USA. Most paths predicted were confirmed for Australia, except for the impact of teamwork on organizational commitment and turnover, plus the impact of engagement on turnover. In contrast, none of the paths related to supervisor-subordinate relationships was significant for the USA; neither were the paths from teamwork to organizational commitment or turnover. CONCLUSION: Our findings suggest that well-being is a predictor of turnover intentions, meaning that healthcare managers need to consider nurses' well-being in everyday decision-making, especially in the cost-cutting paradigm that pervades healthcare provision in nearly every country. This is important because nurses are in short supply and this situation will continue to worsen, because many countries have an ageing population.

The importance of supervisor-nurse relationships, teamwork, wellbeing, affective commitment and retention of North American nurses.

AIM: Using Social Exchange Theory, this study examines links between supervisor-nurse relationships, teamwork, psychological wellbeing and turnover intentions for nurses in the USA. BACKGROUND: Nurses in the USA comprise the biggest workforce of any country in the world. However, nurses continue to be in short supply even with an aggressive campaign to attract foreign nurses. The shortage of qualified registered nurses has negative implications for patient care and mortality because it affects problem-solving and teamwork as a result of poor communication among nurses. METHODS: The study uses a cross-sectional design and 730 completed surveys were obtained using a self-report strategy. RESULTS: The findings indicate that supervisor-nurse relationships, teamwork and wellbeing explain almost half of nurses' commitment to their hospital and their intentions to leave. Further, there was evidence of a generational effect in that Baby Boomer nurses perceived higher levels of wellbeing and commitment, and lower intention to leave. IMPLICATIONS FOR NURSING MANAGEMENT: These findings suggest that management must focus on improving the quality of workplace relationship as a first step in retaining skilled nurses. It may be time for management to embed performance indicators for all levels of management, linked to ensuring effective workplace relationships.