Hospital Organizational Climates and Nurses' Intent to Stay: Differences between Units and Wards

Article excerpt

ABSTRACT

Purpose: To assess variables of hospitals' organizational climates and nurses' intent to stay in intensive care units and wards. Also, this study aims at studying the relationship between hospital organizational climate and nurse intention to stay.

Methods: A descriptive comparative design was used to collect the data from a convenience sample of 349 nurses who were working in 7 hospitals in Jordan, with a response rate of 70%. Farley's Nursing Practice Environment Scale (NPES) was used to measure hospitals' organizational climates (Farly & Nyberg 1990). McCain's Behavioral Commitment Scale was used to measure nurses' intent to stay (McCloskey 1990).

Results: Quality of care and professionalism were the most important variables that influence hospitals' organizational climates. Nurses reported that they will stay at their jobs even if these jobs did not meet their expectations. Based on the total scores, there were no significant differences between intensive care units and wards. Intensive care units and wards were different in nurses' gender, average daily census, and model of nursing care. Nurses were also different in their perceptions about some aspects of administrative support, leadership, and professionalism. Nurses in units differed from those in wards in their decisions to retain their jobs. Hospitals' organizational climates and nurses' intent to stay were significantly correlated for the whole sample and intensive care units but not for wards.

Conclusions: Managerial actions should be used by nursing and hospitals' administrators to enhance hospitals' organizational climates and nurses' intent to stay. These interventions include but are not limited to increasing salaries, maintaining supportive relationships between nurses and physicians, sharing nurses in policy-making and administrative decisions, creating quality assurance measures, maintaining open communication and mutual trust between nurse managers and staff, and allowing autonomy about patient care and work environments.

Received 10 March 2007 Accepted 16 October 2007

KEY WORDS

organizational climates; intent to stay; hospitals; nurse

INTRODUCTION

The Organizational climate' is a favorable concept to nurses, who are less likely to leave their work if they work in supportive work environments. These environments would influence the quality of nursing care and the patients' satisfaction. There is an increasing need to improve quality of care with fewer resources, which requires changes throughout healthcare organizations. These changes influence administrators' abilities to manage changes and the acceptance of employees who are experiencing these changes. These massive and repetitive changes would influence nurses' perceptions about the organizational climates at workplace. Thus, nurses may leave their jobs to take up other jobs or change their careers. In order to manage change effectively, nursing administrators must understand social variables that influence nurses' work-related attitudes, particularly by providing climates conducive to nurses' retention (Mok & Au-Yeung 2002).

In the current challenging work environments, nurses can be retained if they are involved in their patients and work-related decisions. Participative management is a key strategy to create a positive sense of an organizational climate. This type of management would enable nurses to exercise their autonomy and sense their value of work (Kane 2000).

In some countries as Jordan, nurses' retention became a research priority as a result of the ongoing nursing shortage (Abualrub 2007; Coomber & Barriball 2007). Nurses' turnover is escalating; recent figures about hospital nurses' turnover rates ranged 15%-21% per year (Advisory Board Company 2000). The estimated cost of replacing a nurse ranged $42,000 to $64,000 (Strachota et al. 2003), which is an increasing figure over the time. …