Moderating role of relationships between workloads, job burnout, turnover intention, and healthcare quality among nurses.

BACKGROUND: In Jordan, nurses consider a primary providers of direct patient care, and play a multifaceted role in ensuring healthcare quality. The study aimed to examines the moderating effect of job satisfaction in the relationship between workload and healthcare quality, job burnout and healthcare quality, and turnover intention and healthcare quality. METHODS: A cross-sectional research approach was adopted among 311 from Registered Nurses (RN) across Jordanian hospitals. Job satisfaction, workload scale and job burnout scale were shared between March and April 2023. RESULTS: The overall findings indicate that workload, job burnout, and turnover intention are negatively and significantly related to healthcare quality, and that job satisfaction moderates the relationship between workload and healthcare quality, job burnout and healthcare quality, and turnover intention and healthcare quality. These findings have broad implications for healthcare organizations, emphasizing the pivotal role of job satisfaction in mitigating the negative effects of workload, burnout, and turnover intentions among nurses. CONSULSION: Strategies to enhance job satisfaction, such as reducing work-related stress and fostering supportive work environments, should be prioritized by healthcare policymakers and institutions to ensure the delivery of high-quality patient care.

Unveiling the Exodus: A scoping review of attrition in allied health.

BACKGROUND: Efficient utilisation of allied health workforce may help address the predicted shortfall of 18 million health workers estimated by 2030. Knowledge about allied health professionals' attrition, or intention to leave, and factors influencing attrition can assist in developing evidence-informed strategies to mitigate this issue. The review aimed to map attrition and attrition intention rates, and its attributing factors for allied health professions worldwide. METHODS: Adhering to the PRISMA-ScR guidelines, a comprehensive search was conducted across academic databases (PsycINFO, MEDLINE, Embase, Emcare, CINAHL, Scopus, and the Cochrane Library database) and grey literature (Google, Google Scholar, organisational websites). Two reviewers independently undertook a two-stage screening process along with data extraction using customised data extraction forms. A narrative synthesis was used to synthesise the data. RESULTS: Thirty-two studies published between 1990 and 2024 were included. Attrition rates ranged from 0.5% to 41% across allied health disciplines. Pharmacists demonstrated the lowest attrition rates, while audiologists reported the highest. Radiographers reported the lowest intent to leave at 7.6%, while occupational therapists showed highest intent to leave, ranging from 10.7% to 74.1%. The analysis revealed three recurring themes contributing to attrition: profession-centric factors (e.g., career progression, job satisfaction, support, and professional growth), systemic-centric factors (e.g., compensation, staffing challenges, clinical practices, patient care, workload), and individual-centric factors (e.g., recognition, the need for change, and burnout). CONCLUSION: Attrition in allied health remains a significant challenge. Addressing this issue requires a systemic, nuanced, and evidence-based approach, given the complex, interlinked, and multifaceted factors contributing to attrition. The younger workforce, characterized by changing generational values, necessitates innovative thinking, intersectoral collaboration, and the potential for co-created solutions with, for, and by the allied health workforce.

The Role of Negative Age Stereotypes and Sociodemographic Factors in the Intention to Leave Among German University Hospital Nursing Staff.

Staff shortages are a global problem in the nursing profession. Negative beliefs about older workers may have detrimental effects on the development and performance capacity of an aging workforce. To date, little is known about the impact of age stereotypes and potential factors on nurses' intent to leave (ITL). Therefore, the aim of our study was to assess intention to leave and potential predictors (eg, sociodemographic characteristics and age stereotypes) in a large representative sample of nurses in a German university hospital setting. A total of 423 nurses at the University Hospital of Heidelberg participated in a cross-sectional questionnaire study assessing sociodemographic data, age stereotypes using the "Beliefs About Older Workers" questionnaire, and participants' intentions to leave and give up their profession. Questionnaires were returned by 423 nurses (13.7% response rate). The results revealed that negative age stereotypes were highly prevalent. Significant correlations between age and negative age stereotypes were found, indicating that the younger the nurses were, the more negative their age stereotypes were. Most nurses with negative age stereotypes had no intention to leave their profession; however, the majority of nurses could not imagine working in the profession until they retired. Despite the low response rate, the results of the current study suggest that organizational and societal measures to reduce age stereotypes should be directed at newcomers and young nurses to retain them in the profession in the long term.

Why are healthcare professionals leaving NHS roles? A secondary analysis of routinely collected data.

BACKGROUND: Much policy attention focuses on increasing the supply of workers in the English NHS but there has been less attention paid to the rise in leavers. This paper seeks to explore how existing data sets can illuminate the decision-making of leavers and inform actions that could mitigate this. METHOD: Secondary analysis of routinely collected data from 79 workforce projects in the UK (n = 46 339 participants) over a 4-year (2019-2023) period was undertaken. Free text data we extracted and analysed using content analysis, sentiment analysis and text mining. Inclusion criteria were those who stated they had resigned, had confirmed retirement date, and had secured employment elsewhere either within or without the sector but had not yet resigned. Exclusion criteria were those who had not indicated they were leaving or indicated intention to leave. These findings were then compared with themes from Herzberg's work hygiene theory and Hoffat and Woods's professional practice environment theory. RESULTS: Multiple reasons were given for leaving. Findings were congruent with Herzberg's two factor work hygiene theory and demonstrate that leavers are driven by the inability to meet their intrinsic motivation to practice according to their professional standards as much as by terms and conditions. Leavers describe suboptimal professional practice environments which produce obstacles to achieving their work objectives and leaving their intrinsic motivation frustrated. CONCLUSION: Whilst reasons for leaving differ between people, there is a relationship between intrinsic motivation (why they want to do the job) and the conditions in which they try to do the job. This study suggests that looking beyond the primary reason for leaving given in the national dataset could identify how the practice environment influences the decision.

A questionnaire on the current situation of resignation intention of nurses in intensive care units in China - A descriptive quantitative study.

AIM: This study analysed and summarized the correlation between various indicators of ICU nurses' personal lives, hospital work situation, social opinion, psychological assessment, and their intention to resign. DESIGN: A descriptive quantitative study. METHODS: This study was a multicentre questionnaire on factors influencing intensive care unit (ICU) nurses' intention to resign. This study was completed through the Critical Care E Institute (CCEI) and China Calm Therapy Research Group Academic Organization (CNCSG) by contacting ICU nurses in three hospitals in 34 provinces in China. The questionnaire was in the form of a cell phone WeChat scan code. The survey included 22 indicators, including basic information about nurses (marital and child status, personal income, etc.), hospital work (weekly working hours, night shift, hospital environment, etc.), and psychological symptoms. RESULTS: A total of 1904 nurses were included in this study. Among them, 1060 (55.67%) had the intention to resign. In this study, among the 22 indicators involved, 16 factors, including hospital work hours, job title, satisfaction with current income, having children, and evaluation of the hospital, significantly impact nurses' intentions to resign (all p < 0.05). Logistic regression analysis showed that six indicators influenced nurses' choice of resignation intention (all p < 0.05), including hospital work time, professional title, income satisfaction, hospital work pride, satisfaction of nurses with the compassion and care given to them by their hospitals, and career vision score. The ROC curve showed that all six indicators were <0.70, but the model receiver operating characteristic (ROC) curve constructed for the indicators was 0.756. In China, increasing the income of ICU nurses, fostering pride in hospital work, reducing working hours, ensuring smooth promotion processes, and enhancing career prospects can all decrease their likelihood of choosing to resign. Absorbing practical nursing management and work experience from other countries will help decrease the intention to resign within this group. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Work Environment, Burnout, and Intent to Leave Current Job Among Cardiologists and Cardiology Health Care Workers: Results From the National Coping With COVID Survey.

BACKGROUND: Little is known about factors contributing to burnout and intent to leave in cardiologists and other cardiology health care workers. METHODS AND RESULTS: The Coping With COVID survey assessed work conditions, burnout, and intent to leave among physicians, nurses, advanced practice providers, and other clinical staff (OCS) from April 2020 to December 2020. Single-item measures assessed work conditions, burnout (emotional exhaustion), and intent to leave. Multilevel logistic regression examined work life variables' relationships to burnout among role types and feeling valued as a mediator. Open-ended comments analyzed via grounded theory contributed to a conceptual model. Coping With COVID was completed by 1199 US cardiology health care workers (354 physician/520 nurses/198 advanced practice providers/127 OCS). Nurses were most likely to report burnout (59% nurses, 57% OCS, 46% advanced practice providers, 40% physicians, P<0.0001). Workload correlated with burnout in all groups (adjusted odds ratios [aORs], 4.1-17.4; Ps<0.005), whereas anxiety/depression related to burnout in all except OCS (aORs, 3.9-8.3; Ps≤0.001). Feeling valued was related to lower burnout in most groups. Intent to leave was common (23%-45%) and was lower in physicians and advanced practice providers who felt valued (aORs, 0.26 and 0.22, respectively; Ps<0.05). Burnout was highest for nurses in practice 16 to 20 years, and intent to leave was highest for OCS in practice 16 to 20 years. Themes contributing to burnout included personal and patient safety, leadership, and financial issues. CONCLUSIONS: Burnout was prevalent among cardiology health care workers and highest in nurses and OCS. Addressing factors associated with burnout in different role types may improve work life sustainability for all cardiology health care workers.

Workplace violence and turnover intention among Chinese nurses: the mediating role of compassion fatigue and the moderating role of psychological resilience.

BACKGROUND: Workplace violence is a global public health issue and a major occupational hazard cross borders and environments. Nurses are the primary victims of workplace violence due to their frontline roles and continuous interactions. OBJECTIVE: The present study aimed to investigate the status of workplace violence, turnover intention, compassion fatigue, and psychological resilience among Chinese nurses, and explore the mediating role of compassion fatigue and the moderating role of psychological resilience on relationship between workplace violence and turnover intention among Chinese nurses. METHOD: A cross-sectional study was conducted among a convenience sample of clinical registered nurses from public hospitals in Changsha, Hunan, China. Data was collected through an online questionnaire, which included a demographic information form, the Workplace Violence Scale (WVS), the Turnover Intention Questionnaire (TIQ), the Compassion Fatigue Scale (CF-CN), and the Connor-Davidson Resilience Scale (CD-RISC). Descriptive statistics and correlation analysis were employed to examine the relationships among the main variables. A moderated mediation analysis was further conducted using the PROCESS macro for SPSS (Model 4 and Model 8) to examine the mediating role of compassion fatigue and the moderating role of psychological resilience. RESULT: The present survey recruited a convenience sample of 1,141 clinical registered nurses, who reported experiencing multiple types of workplace violence during the past year. Correlation analysis revealed significant positive correlations between workplace violence and turnover intention (r = 0.466, P < 0.01) as well as compassion fatigue (r = 0.452, P < 0.01), while negative correlation between workplace violence and psychological resilience (r=-0.414, P < 0.01). Moderated mediation analysis revealed that compassion fatigue mediated, while psychological resilience moderated, the positive relationship between workplace violence and turnover intention (all P < 0.05). CONCLUSION: This study underscores the mediating effect of compassion fatigue and the moderating role of psychological resilience in the relationship between workplace violence and turnover intention among Chinese nurses. Future efforts should be undertaken to develop effective preventive measures and intervention strategies at individual, organizational, and national levels to mitigate workplace violence and foster supportive work environment. CLINICAL TRIAL NUMBER: Not applicable.

Novel solutions to the midwifery retention crisis in England: an organisational case study of midwives' intentions to leave the profession and the role of retention midwives.

PROBLEM/BACKGROUND: Midwifery retention is a global issue, but less is known regarding what motivates midwives' intention to stay or leave within individual organisations. In 2021, NHS England funded maternity organisations to employ retention midwives. To date, the impact of these roles has not been evaluated. AIM: To explore the views of midwives regarding their intentions to leave or stay within one English organisation and to provide insights into the perceived impact of the role of retention midwives. METHODS: An instrumental case study was carried out in one organisation. Data a mixed methods survey (n=67/91) and interview data (n=7). Quantitative data was analysed using descriptive and inferential statistics; qualitative data using thematic analysis. All data was synthesised together. FINDINGS: The three themes included 'Values-based tensions: The eroding role of the midwife'; 'Discerning differences: Intentions to leave or stay'; 'Retention midwives: Activities and impact'. DISCUSSION: We found that there was a clear link between midwives' intention to leave or stay and their workplace roles; specialist midwives were more likely to stay, report satisfaction, autonomy, and feel a sense of contribution or effectiveness in their role compared to those in other roles. The retention midwives were making a positive difference to midwives' experience of the workplace. CONCLUSION: Midwives working within the same organisation have different experiences of their role and job satisfaction. Future work should consider applying the positive elements of the specialist roles to the wider midwifery workforce to enhance retention. The retention midwife role shows promise, but further evaluation is required.

Factors associated with early-career GPs' retention as independent specialists in former training practices.

INTRODUCTION: Retention of general practice registrars in their training practices is important for addressing the GP workforce deficit and maldistribution of GPs. Given that rural and remote general practices are disproportionately affected by low retention, identifying the factors that promote retention may be as important as developing recruitment strategies in these areas. Quantifying the impact of relevant factors on registrar retention will enable a better understanding of how to incentivise retention and attenuate the loss of the rural workforce to other areas. We sought to establish the prevalence and associations of retention of general practice registrars in their training practices. METHODS: This analysis was a component of the New alumni Experience of Training and independent Unsupervised Practice (NEXT-UP) study: a cross-sectional questionnaire-based study of early-career GPs in conjunction with evaluation of data contemporaneously recorded as part of vocational training. Participants were former registrars of three regional training organisations delivering general practice training in New South Wales, Tasmania, the Australian Capital Territory and Eastern Victoria, who had attained Fellowship of the Royal Australian College of General Practitioners or the Australian College of Rural and Remote Medicine between January 2016 and July 2018. The outcome measured was whether the registrar had previously worked at their current practice during vocational training. Multivariable logistic regression was used to estimate the association between relevant explanatory variables and the outcome. RESULTS: A total of 354 alumni responded (response rate 28%), of whom 322 provided data regarding previous training practice retention, with 190 (59%) having previously worked at their current practice as registrars. Among respondents who reported currently working in a regional-rural practice location (n=100), 69% reported having previously worked at their current practice during training. GPs were more likely to be retained by a practice they had trained at if it was of lower socioeconomic status (adjusted odds ratio (aOR) 0.82 (95% confidence interval (CI) 0.73-0.91), p<0.001 for each decile of socioeconomic status) and if the practice provided two or more of home visits, nursing home visits or after-hours services (aOR 4.29 (95%CI 2.10-8.75), p<0.001). They were less likely to be retained by the practice if training was completed in a regional-rural area (aOR 0.35 (95%CI 0.17-0.72), p=0.004). CONCLUSION: Regional-rural training location is associated with reduced odds of subsequent retention of general practice registrars. This is occurring despite significant government investment in expansion of general practice training in regional and rural areas. The practice factor most strongly associated with GP retention was the provision of out-of-practice and after-hours care. There may be altruistic, rather than monetary, reasons that explain this finding. Such training opportunities, if provided to all trainees, especially in regional and rural areas, would be a learning opportunity, a way of promoting holistic community-based care and an incentive for subsequent retention within the practice and community as an established GP.

Analysis of turnover intention and influencing factors among female nurses with two children in Grade A tertiary public hospitals in Sichuan province: a cross-sectional study.

Objective: This study aims to examine the current status of turnover intention among female nurses with two children and explore the factors influencing their decision to resign, ultimately providing a basis for reducing nurses' turnover intention and stabilizing the nursing workforce. Methods: A convenience sampling method was used to select 1,370 in-service female nurses with two children from 65 Grade A tertiary public hospitals in Sichuan Province from September to December 2023. Data was collected through a general information questionnaire, work-family behavioral role conflict scale, regulatory emotional self-efficacy, and turnover intention scale. Results: This study revealed that the average score for turnover intention among female nurses with two children was (13.11 ± 3.93). There was a positive correlation between work-family behavioral role conflict and turnover intention (r = 0.485, p < 0.01), while regulatory emotional self-efficacy showed a negative correlation with turnover intention (r = -0.382, p < 0.01). The main influencing factors for resignation among these nurses included age, number of night shifts per month, average monthly income, primary caregiver for children, work-to-family conflict and family-to-work conflict, and the ability to express positive emotions (POS), the capacity to regulate negative emotions such as despondency/distress (DES), and the skill to manage anger/irritation (ANG). Collectively, these factors explained 29.5% of the total variance in turnover intention scores. Conclusion: Turnover intention among female nurses with two children is relatively high. To address this issue, hospital managers shall implement effective measures through various channels to settle work-family conflict, enhance nurses' regulatory emotional self-efficacy, and reduce turnover intention resulting from work-family conflict. Together, these efforts will reduce nurse turnover and foster a stable nursing workforce.

The Role of Work-Life Balance, Work Stress, and Work-Family Conflict in Creating Job Satisfaction and Their Impact on Turnover Intention in Nurses at Level I Health Facilities Hospital in Karawang.

Turnover intention research with the addition of independent variables of work-life balance and work stress in nurses with health backgrounds is rarely found in type c public hospitals in Karawang city, where literature about this research needs to explain it. This research aims to ascertain how work-life balance, workplace stress, and work-family conflict affect nurses' intentions to quit their jobs by using job satisfaction as a mediator. The sampling for this study was carried out using the probability sampling method known as proportionate stratified random sampling. A total of 550 nurses from 4 schools submitted responses. Work-life balance, work-related stress, and job happiness all significantly influence the likelihood of turnover. The desire to increase or reduce hospital turnover is significantly influenced by work-life balance, stress at work, and work-family conflict. This study has limitations that can lead to imperfect conclusions because the sample used is only the nurse division, so this study can only be generalized to some other districts. The variables studied still need to be reviewed to affect turnover intention by mediating job satisfaction.

Patterns of health workforce turnover and retention in Aboriginal Community Controlled Health Services in remote communities of the Northern Territory and Western Australia, 2017-2019.

BACKGROUND: Aboriginal Community Controlled Health Services (ACCHSs) in Australia aim to optimise access to comprehensive and culturally safe primary health care (PHC) for Aboriginal populations. Central to quality service provision is the retention of staff. However, there is lack of published research reporting patterns of staff turnover and retention specific to ACCHSs. This study quantified staff turnover and retention in regional and remote ACCHSs in the Northern Territory (NT) and Western Australia (WA), and examined correlations between turnover and retention metrics, and ACCHSs' geographical and demographic characteristics. METHODS: The study used 2017-2019 payroll data for health workers in 22 regional and remote PHC clinics managed by 11 ACCHSs. Primary outcome measures included annual turnover and 12-month stability rates, calculated at both clinic and organisation levels. RESULTS: There was a median of five client-facing (Aboriginal health practitioners, allied health professionals, doctors, nurses/midwives, and 'other health workers' combined) and two non-client-facing (administrative and physical) staff per remote clinic, at any timepoint. Mean annual turnover rates for staff were very high, with 151% turnover rates at the clinic level and 81% turnover rates at the organisation level. Mean annual turnover rates for client-facing staff were 164% and 75%, compared to 120% and 98% for non-client-facing staff, at clinic and organisational levels, respectively. Mean 12-month stability rates were low, with clinic-level stability rates of only 49% and organisation-level stability rates of 58%. Mean annual clinic-level turnover rates were 162% for non-Aboriginal staff and 81% for Aboriginal staff. Both workforce metrics were moderately to highly correlated with the relative remoteness of clinics, size of regular clients serviced, and average annual headcount of employees in each clinic (p values < 0.01). CONCLUSIONS: Participating ACCHSs in remote NT and WA have very high turnover and low retention of healthcare staff. Overall, clinic-level turnover rates increase as distance from regional centres increases and are lower for Aboriginal staff, suggesting that greater employment of Aboriginal staff could help stabilise staffing. Improved retention could reduce burden on ACCHSs' resources and may also support quality of service delivery due to improved cultural safety and continuity of care.

Factors associated with the non-retention of health sector employees recruited in Iran: a survival analysis.

BACKGROUND: Health staff are an essential component of the health system and a significant factor in improving health outcomes. As a result, without a suitable number of trained and supported workforces, health-related goals will not be achieved. As a result, one of the most significant tasks of the government and healthcare human resource management in healthcare organizations is focusing on development and maintenance of personnel. METHOD: This study was a longitudinal and historical cohort study. Data was collected on the 40 medical universities and healthcare organizations under the jurisdiction of Iran Ministry of Health and Medical Education from 2008 to 2018 from the human resources database. In this study the COX regression and survival analysis was used to assess the factors of staff maintenance, retention rate, and the risk of turnover. RESULT: 46,939 health workforces were included in the study, of which 13,328 (28.4%) were men and 33,611 (71.6%) were women. Based on the finding of cox regression model, the retention of staff were statistically different between male and female. Employees whose current work place and birthplace were similar had a significantly higher probability of retention. Accordingly, the cox regression result showed, the risk of employee turnover for single personnel was higher than the married ones. CONCLUSION: an applicable policy for increasing maintenance among workforce recruitment, could be considering the native born professionals instead of non-natives born which reduce the costs of employee turnover, including re-hiring, initial and on-the-job training, housing, and other extra living expenses away from home and family.

The Impact of Transitional Shock on Newer Nurses in a Contemporary Healthcare Environment.

OBJECTIVE: The aim of this study was to understand newer nurses' perception and expectations of their work environment, professional and institutional satisfaction, and motivating/decision-making factors around nursing and intent to leave their positions. BACKGROUND: Studies have shown newly graduated nurses face many challenges transitioning from a student to an independently practicing nurse. The COVID pandemic complicated this transition and created new stressors resulting in discouragement and turnover for newer nurses. METHODS: This study used a qualitative approach through purposive sampling, semistructured qualitative interviews, and content analytic techniques. Transitional Shock Theory was used as the theoretical framework. RESULTS: Four themes emerged from the study: 1) confronting the reality; 2) betrayal/mistrust; 3) relational integrity; and 4) enablers of clinical competence. CONCLUSIONS: The findings will help nurse leaders understand the importance of organizational-level supports to improve the transition of newer nurses in typical periods and in times of additional stress.

Nurses That Stay.

The 2024 NSI National Health Care Retention & RN Staffing Report published by NSI Nursing Solutions, Inc, was released early this year and indicated hospitals' average turnover and vacancy rates for RNs nearly returned to their 2019 levels in 2023 after peaking in the middle of that timeframe. Simultaneously, healthcare organizations continue to struggle with nurse retention. As nurses begin to return or enter the nursing profession, the time is here to ask why nurses are leaving your organization. In 1983, the original study, "Magnet Hospitals: Attraction and Retention of Professional Nurses," identified hospital characteristics that were able to "attract and retain a staff of well-qualified nurses and are therefore consistently able to provide quality care."

The Impact of Patient Assaults and Aggressive Behaviors on Nursing Personnel's Stress, Well-being, and Intention to Leave Post-COVID-19 Pandemic.

AIM: To describe and compare the prevalence of assaults and aggressive patient behavior among frontline staff in behavioral health (BH), medical-surgical (MS), and emergency department (ED) settings and examine the impact on staff health, work stress, work engagement, and intent to leave their position. BACKGROUND: Patient verbal and physical assaults have significant staff consequences, including decreased work productivity, increased burnout, job dissatisfaction, absenteeism, turnover, and intentions to leave. METHODS: Using a descriptive cross-sectional design, data were collected from a sample of 432 frontline staff working in ED, BH, and MS settings across 3 healthcare systems. RESULTS: The majority of frontline staff (74%) reported experiencing verbal aggression often/frequently, significantly impacting their mental health, work engagement, stress levels, and intent to leave. All 3 specialty groups reported a significant increase in verbal/psychological assaults and physical assaults since the pandemic's onset. CONCLUSION: The COVID-19 pandemic had a significant impact on assaultive/aggressive behaviors. Nurse leaders must strategize on methods to decrease the normalization of violence against healthcare workers and support research aimed at evidence-based interventions to reduce such incidences of violence and ensure the well-being of healthcare workers.

The Effect of Nursing Moral Distress on Intent to Leave Employment.

OBJECTIVE: This study explored the impact of moral distress (MD) and respondent characteristics on intent to leave employment. BACKGROUND: Managing patient care, within organizational constraints, may create physical discomfort or mental peace disturbances such as MD, negatively impacting RN retention. METHODS: Responses from 948 RNs were collected using an anonymous online survey. The impact of MD on intent to leave employment was explored. RESULTS: MD was significantly higher among RNs intending to leave employment. System-level and team-level integrity attributes were significant factors predicting intent to leave, controlling for potential confounders. The odds of intending to leave were 147% higher for new graduate RNs, 124% higher for direct care RNs, and 63% higher for 2nd-career RNs. Gender and race were not significant predictors. CONCLUSION: Exploring root causes contributing to MD frequency and severity is critical to maintain a healthy work environment. Mitigating MD in the work environment may enhance nursing practice and improve patient care. Support for new graduate and 2nd-career RNs can be realized, further reducing turnover for these vulnerable populations of the nursing workforce.

Establishing a Sustainable Workforce Via Nursing Pipelines.

COVID-19 escalated the already challenged nursing workforce, causing hospitals to address their unstable staffing. This report details the journey of a large rural level 1 academic healthcare market postpandemic to stabilize their nursing workforce and create a sustainable pipeline of nurses. The results demonstrated reductions in turnover rates, vacancy rates, and days to fill nursing positions.

Understanding the impact of abusive leadership on third-party observers' turnover intentions: Insights from organizational identification and authority orientation.

This study proposes and tests a conceptual model including three predictors (observed abusive leadership, workplace identification, and authority orientation) of third-party observers' turnover intentions. Analyzing responses from of 367 sales employees from Chinese hotels suggests that organizational identification partially mediates the relationship between observed abusive leadership and observer turnover intention. Also, observed abusive leadership is negatively associated with observers' workplace identification. Finally, authority orientation is negatively associated with observers' turnover intentions. This study contributes theoretically to understanding the repercussions of abusive leadership and offers managerial insights for hospitality firms to mitigate high turnover rates.