Staff Nurses’ Intention to Remain Employed in Small- and Medium-Sized Hospitals, with a Focus on Their Working Conditions

Staff Nurses' Intention to Remain Employed in Small- and Medium-Sized Hospitals, with a Focus on Their Working Conditions

ETSUKO NAKAMURA,¹ NAOHITO TANABE,² AKIKO SEKII,² AKIKO HONDA,² EMIKO HOSHINO,¹ NAO SEKI,³ AKIHIKO SUMIDA⁴, AKIYOSHI SEKIYA¹ and HIROSHI SUZUKI¹

¹Division of Public Health, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
²Division of Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
³School of Health Sciences, Faculty of Medicine, Niigata University, Niigata, Japan
⁴ Niigata Seiryo University Junior College, Niigata, Japan

Retaining experienced nurses is an indispensable part of securing the safety and reliability of medical care. In this study, we investigate how the working conditions affect staff nurses' intention to remain in their current employment positions (intention to remain employed). A total of 319 staff nurses working for three private hospitals were given a questionnaire in order to evaluate their working conditions. A stepwise multiple logistic regression analysis selected 5 out of 44 question items as significant independent variables for their intention to remain employed; they were assumed to directly affect their intentions (direct modulators). From the remaining 39 items, seven meaningful factors were extracted via factor analysis. We constructed a path network model so that these factors would indirectly affect the intention to remain employed via any of the five direct modulators (indirect modulators). In this network, the factor, “Rapport with coworkers” had the strongest positive effect on three of the five direct modulators (β = 0.28-0.55, p < 0.05). According to factor loadings, positive teamwork together with appropriate supervision and recognition from superiors and colleagues seems to characterize this factor, and therefore, may play a key role in retaining staff nurses in their current positions. Two indirect modulators related to “Management by Objectives” (MBO)—“Understanding MBO” and “Clear personal objectives” also played negligible roles in this path model. These findings could be helpful in improving management systems of the nursing sections of hospitals, which could contribute to retaining staff nurses in their current employment positions.

keywords —— working environment; nurse; job satisfaction; management by objectives; path analysis

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Tohoku J. Exp. Med., 2010, 220, 191-198

Correspondence: Naohito Tanabe, M.D., Ph.D., Division of Health Promotion, Niigata University Graduate School of Medical and Dental Science, 1-757 Asahimachi-dori, Chuo Ward, Niigata 951-8510, Japan.

e-mail: tanabe@med.niigata-u.ac.jp