Exploring the key predictors of retention in emergency nurses

Journal of Nursing Management

Volumn 20, Issue 5, 2012, Pages 696-707

  Sawatzky, Jo Ann V ^a   Enns, Carol L ^a  

^a UNIVERSITY OF MANITOBA   (Canada)

Author keywords

Burnout; Engagement; Job satisfaction; Retention

Indexed keywords

ADAPTIVE BEHAVIOR; ADULT; AGED; ARTICLE; BURNOUT; CANADA; CONFIDENCE INTERVAL; CROSS-SECTIONAL STUDY; EMERGENCY NURSING; FEMALE; HEALTH CARE SURVEY; HUMAN; JOB SATISFACTION; MALE; MENTAL STRESS; MIDDLE AGED; NURSE; PERSONNEL MANAGEMENT; PSYCHOLOGICAL ASPECT; PSYCHOMETRY; QUESTIONNAIRE; STATISTICS;

ADAPTATION, PSYCHOLOGICAL; ADULT; AGED; BURNOUT, PROFESSIONAL; CONFIDENCE INTERVALS; CROSS-SECTIONAL STUDIES; EMERGENCY NURSING; FEMALE; HEALTH CARE SURVEYS; HUMANS; JOB SATISFACTION; MALE; MANITOBA; MIDDLE AGED; NURSES; PERSONNEL TURNOVER; PSYCHOMETRICS; QUESTIONNAIRES; STRESS, PSYCHOLOGICAL; YOUNG ADULT;

EID: 84864300694     PISSN: 09660429     EISSN: 1365263X     Source Type: Journal    
DOI: 10.1111/j.1365-2834.2012.01355.x     Document Type: Article

References (78)

1. Aiken L.H., Clarke S.P., Sloane D.M., Sochalski J. & Silber J.H. (2002) Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. Journal of the American Medical Association288 (16), 1987-1993.
2. Alspach G. (2007) Facilitating the retention of experienced critical care nurses: a survey report of what matters most. Critical Care Nurse27 (5), 12-19.
3. Andrews D.R. & Dziegielewski S.F. (2005) The nurse manager: job satisfaction, the nursing shortage and retention. Journal of Nursing Management13 (4), 286-295.
4. Arch M. & Graetz B. (1989) Work satisfaction, unionism and militancy amongst nurses. Community Health Studies13 (2), 177-185.
5. Bayley E.W., Maclean S.L., Desy P. & McMahon M. (2004) ENA's Delphi study on national research priorities for emergency nurse in the United States. Journal of Emergency Nursing, 30 (1), 12-21.
6. Bell L. (2006) Respect and workplace options help retain aging nurses. Nursing Management37 (11), 56.
7. Bogaert P.V., Meulemans H., Clarke S., Vermeyen K. & Van de Heyning P. (2009) Hospital nurse practice environment, burnout, job outcomes and quality of care: test of a structural equation model. Journal of Advanced Nursing65 (10), 2175-2185.
8. Boyle D.K., Bott M.J., Hansen H.E., Woods C.Q. & Taunton R.I. (1999) Managers' leadership and critical care nurses' intent to stay. American Journal of Critical Care8 (6), 361-371.
9. Browning L., Ryan C.S., Thomas S., Greenberg M. & Rolniak S. (2007) Nursing specialty and burnout. Psychology, Health & Medicine12 (2), 248-254.
10. Buerhaus P.I. (2002) Shortages of hospital registered nurses: causes and perspectives on public and private sector actions. Nursing Outlook50, 4-6.
11. Buerhaus P.I., Staiger D.O. & Auerbach D.I. (2000) Why are shortages of hospital RNs concentrated in specialty care units?Nursing Economics18 (3), 111-116.
12. Buerhaus P.I., Auerbach D.I. & Staiger D.O. (2007) Recent trends in the registered nurse labor market in the US: short-run swings on top of long-term trends. Nursing Economics25 (2), 59-66.
13. Burston P.L. & Stichler J.F. (2010) Nursing work environment and nurse caring: relationship among motivational factors. Journal of Advanced Nursing66 (8), 1819-1831.
14. Burt C.W. & McCaig L.F. (2006) Staffing, capacity, and ambulance diversion in emergency departments: United States, 2003-04. Advanced Data from Vital and Health Statistics376, 1-23.
15. Canadian Institute of Health Information (2005) Understanding Emergency Department Waiting Times. Canadian Institute of Health Information, Ottawa.
16. Canadian Institute of Health Information (2009). Registered Nurses Database. Canadian Institute of Health Information, Ottawa.
17. Carlbom D.J. & Rubenfeld G.D. (2007) Barriers to implementing protocol-based sepsis resuscitation in the emergency department: results of a national survey. Critical Care Medicine35 (11), 2525-2532. Available at:, accessed 1 March 2011.
18. Choi J., Bakken S., Larson E., Du Y. & Stone P.W. (2004) Perceived nursing work environment of critical care nurses. Nursing Research53 (6), 370-378.
19. Coetzee S.K. & Klopper H.C. (2010) Compassion fatigue within nursing practice: a concept analysis. Nursing & Health Sciences12, 235-243.
20. Coomber B. & Barriball K.L. (2007) Impact of job satisfaction components on intent to leave and turnover for hospital-based nurses: a review of the research literature. International Journal of Nursing Studies44, 297-314.
21. Coombs M. & Ersser S.J. (2004) Medical hegemony in decision-making - a barrier to interdisciplinary working in intensive care?Journal of Advanced Nursing46 (3), 245-252.
22. Cowan M., Shapiro M., Hays R. & Afifi A. (2008) The effect of a multidisciplinary hospital/physician and advanced practice nurse collaboration on hospital costs. Journal of Nursing Administration36 (2), 79-85.
23. Ekstedt M. & Fagerberg I. (2005) Lived experiences of the time preceding burnout. Journal of Advanced Nursing9 (1), 59-67.
24. Enns C. & Gregory D. (2007) Lamentation and loss: expressions of caring by contemporary surgical nurses. Journal of Advanced Nursing58 (4), 339-347.
25. Erikson L. & Williams S. (2000) Attitudes of emergency nurses regarding patient assaults. Journal of Emergency Nursing26 (3), 210-215.
26. Fang Y. (2001) Turnover propensity and its causes among Singapore nurses: an empirical study. International Journal of Human Resource Management12 (5), 859-871.
27. Figley C.R. (1995) Compassion Fatigue; Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized, Brunner Mazel, New York, NY.
28. Finfgeld-Connett D. (2007) Meta-synthesis of caring in nursing. Journal of Clinical Nursing17, 196-204.
29. Force M.V. (2005) The relationship between effective nurse managers and nursing retention. Journal of Nursing Administration35 (7/8), 336-341.
30. Forsyth S. & McKenzie H. (2006) A comparative analysis of contemporary nurses' discontents. Journal of Advanced Nursing56 (2), 209-216.
31. Freeman R. & Medoff J. (1984) Are They Satisfied? What do Unions do?, pp 136-149. Basic Books, New York, NY.
32. Herrin D. & Spears P. (2007) Using nurse leader development to improve nurse retention and patient outcomes: a framework. Nursing Administration Quarterly31 (3), 231-243.
33. Hewitt Associates (2008) The Hewitt Engagement Model. Available at:, accessed 7 July 2008.
34. Hills R.M. & Kristjanson L. (2004) A Delphi study on research priorities for emergency nurses in Western Australia. Journal of Emergency Nursing, 30 (2), 117-125.
35. Holtom B.C. & O'Neill B.S. (2004) Job embeddedness: a theoretical foundation for developing a comprehensive nurse retention plan. Journal of Nursing Administration34 (5), 216-227.
36. Hooper C., Craig J., Janvrin D.R., Westsel M.A. & Reimels E. (2010) Compassion satisfaction, burnout, and compassion fatigue among emergency nurses compared with nurses in other selected inpatient specialties. Journal of Emergency Nursing, 36 (5), 420-427.
37. Joinson C. (1992) Coping with compassion fatigue. Nursing22, 116-121.
38. Kleinman C.S. (2004) Leadership: a key strategy in staff retention. Journal of Continuing Education in Nursing, 35 (3), 128-132.
39. Kovner C.T., Brewer C.S., Fairchild S., Poornima S., Kim H. & Djukic M. (2007) Newly licensed RNs' characteristics, work attitudes, and intentions to work. American Journal of Nursing107 (9), 58-70.
40. Kramer M. & Hafner L.P. (1989) Shared values: impact on staff nurse job satisfaction and perceived productivity. Nursing Research38 (3), 172-177.
41. Larrabee J.H., Janney M.A., Ostrow C.L., Withrow M.L., Hobbs G.R. & Burant C. (2003) Predicting registered nurse job satisfaction and intent to leave. Journal of Nursing Administration33 (5), 271-283.
42. Lu H., While A.E. & Barriball L. (2005) Job satisfaction among nurses: a literature review. International Journal of Nursing Studies42, 211-227.
43. Maslach C. & Leiter M.P. (1997) The Truth About Burnout: How Organizations Cause Personal Stress And What To Do About It. Jossey-Bass, San Francisco, CA.
44. Maslach C., Jackson S. & Leiter M. (1996) Maslach Burnout Inventory Manual, 3rd edn. Consulting Psychologists Press, Palo Alto, CA.
45. Mohr D.C., Burgess J.F. & Young G.J. (2008) The influence of teamwork culture on physician and nurse resignation rates in hospitals. Health Service Management Research21 (1), 23-31.
46. Nagy M.S. (2002) Using a single-item approach to measure facet job satisfaction. Journal of Occupational and Organizational Psychology75, 77-86.
47. Najjar N., Davis L.W., Beck-Coon K. & Doebbeling C.C. (2009) Compassion fatigue: a review of the research to date and relevance to cancer-care providers. Journal of Health Psychology14 (2), 267-277.
48. Newsom R. (2010) Compassion fatigue: nothing left to give. Nursing Management41 (4), 43-45.
49. Nursing Organizations Alliance (2004). Principles and Elements of a Healthful Practice/Work Environment. American Organization of Nurse Executives, Washington, DC. Available at:, accessed 9 October 2011.
50. O'Brien-Pallas L.L., Doran D.I., Murray M. et al. (2001) Evaluation of a client care delivery model, part I: variability in nursing utilization in community home nursing. Nursing Economics19 (6), 267-276.
51. O'Brien-Pallas L., Duffield C. & Hayes L. (2006a) Do we really understand how to retain nurses?Journal of Nursing Management14, 262-270.
52. O'Brien-Pallas L., Griffin P., Shamian J. et al. (2006b) The impact of nurse turnover on patient, nurse, and system outcomes: a pilot study and focus for a multicenter international study. Policy, Politics, & Nursing Practice7 (3), 169-179.
53. O'Brien-Pallas L., Murphy G.T., Shamian J., Li X. & Hays L.H. (2010) Impact and determinants of nurse turnover: a pan-Canadian study. Journal of Nursing Management18, 1073-1086.
54. Price J.L. & Mueller C.W. (1981) A causal model of turnover for nurses. Academy of Management Journal24 (3), 543-565.
55. Purnell M.J. (2009) Gleaning wisdom in the research of caring. Nursing Science Quarterly22 (2), 109-115.
56. Rafferty A.M., Ball J. & Aiken L.H. (2001) Are teamwork and professional autonomy compatible, and do they result in improved hospital care?Quality in Health Care10 (Suppl 2), ii32-ii37.
57. Ritter D. (2011) The relationship between healthy work environments and retention of nurses in a hospital setting. Journal of Nursing Management19, 27-32.
58. Rivera R.R., Fitzpatrick J.J. & Boyle S.M. (2011) Closing the RN engagement gap: which drivers of engagement matter?Journal of Nursing Administration41 (6), 265-272.
59. Robinson K.S., Jagim M.M. & Ray C.E. (2004) Nursing workforce issues and trends affecting emergency departments. Topics in Emergency Medicine26 (4), 276-286.
60. Robinson K.S., Jagim M.M. & Ray C.E. (2005) Nursing workforce issues and trends affecting emergency departments. Nursing Management36 (9), 46-53.
61. SAS Institute Inc. (20022005) SAS Online Doc 9.1.3. SAS Institute Inc., Cary, NC.
62. Scarpello V. & Campbell J.P. (1983) Job satisfaction: are all the parts there?Personnel Psychology36, 577-600.
63. Schaufeli W.B., Bakker A.B. & Salanova M. (2006) The measurement of work engagement with a short questionnaire: a cross-national study. Educational and Psychological Measurement66, 701-716.
64. Schriver J.A., Talmadge R., Chuong R. & Hedges J.R. (2003) Emergency nursing: historical, current, and future roles. Journal of Emergency Nursing, 29 (5), 431-439.
65. Seago J.A., Spetz J. & Ash M. (2011) Hospital RN job satisfaction and nurse unions. Journal of Nursing Administration41 (3), 109-114.
66. Shobbrook P. & Fenton K. (2002) A strategy for improving nurse retention and recruitment levels. Professional Nurse17 (9), 534-536.
67. Simpson M.R. (2009) Predictors of work engagement among medical-surgical nurses. Western Journal of Nursing Research31 (1), 44-65.
68. Sourdiff J. (2004) Predictors of nurses' intent to stay at work in a university health center. Nursing and Health Science6, 59-68.
69. Stamm B.H. (2005) The Professional Quality of Life Scale. Idaho State University, Pocatello, Idaho. Available at:, accessed 7 July 2008.
70. Stone P.W., Larson E.L., Mooney-Kane C., Smolowitz J., Lin S.X. & Dick A.W. (2006) Organizational climate and intensive care unit nurses' intention to leave. Critical Care Medicine34 (7), 1907-1912.
71. Taunton R.E., Boyle D.K., Woods C.Q., Hansen H.E. & Bott M.J. (1997) Manager leadership and retention of hospital staff nurses. Western Journal of Nursing Research19 (2), 205-226.
72. Tzeng H.M. (2002) The influence of nurses' working motivation and job satisfaction on intention to quit: an empirical investigation in Taiwan. International Journal of Nursing Studies39, 867-878.
73. Van Bogaert P., Meulemans H., Clarke S., Vermeyen K. & Van de Heyning P. (2009) Hospital nurse practice environment, burnout, job outcomes and quality of care: test of a structural equation model. Journal of Advanced Nursing65 (10), 2175-2185.
74. Wagner S.E. (2006) Staff retention: from 'satisfied' to 'engaged'. Nursing Management37 (3), 24-29.
75. Watson J. (2006) Caring theory as an ethical guide to administrative and clinical practices. Nursing Administration Quarterly, 30 (1), 48-55.
76. White D. (2006) The hidden costs of caring: what managers need to know. Health Care Manager25 (4), 341-347.
77. Wieck K.L., Dois J. & Landrum P. (2010) Retention priorities for the intergenerational nurse workforce. Nursing Forum45 (1), 7-17.
78. Wong H.J., Morra D., Caesar M. & Carter M.W. (2010) Understanding hospital and emergency department congestion: an examination of inpatient admission trends and bed resources. Canadian Journal of Emergency Medicine12 (1), 18-26.