Principal Advisor, Operations Group, Community Health Systems

Dissertation Title

The Effects of Nurse-Manager Relationships and Nurse-Physician Collaboration on Nurse Intent to Leave

Dissertation Abstract

Aim. The aim of this study was to determine whether two relational aspects of the nurse work environment—perceived quality of the nurse-supervisor relationship and nurse-physician collaboration—might reduce nurse intent to leave the hospital.

Background. There is a documented global shortage of nurses which is a pressing issue in U.S. hospitals. The nursing shortage has been exacerbated by a high rate of voluntary nursing turnover in U.S. hospitals which is costly and has previously been found to negatively impact patient care. Factors associated with the nursing work environment have been found to be important predictors of nurse intent to leave. There is an increasing need to better understand the nursing work environment and its impact on nurse intent to leave.

Design. The study was a cross-sectional design with nurses from 16 hospitals in six states completing self-administered surveys.

Methods. A questionnaire including sections devoted to leader-member exchange, physician collaboration, and intent to leave, at the individual level, was administered to over 4,000 nurses in hospitals ranging from 15 beds to 800 beds.

Results. Over 500 nurses completed the survey. More positive perceptions of the nurse-supervisor relationship were associated with lower nurse intent to leave. Additionally, more positive perceptions of nurse-physician collaboration were associated with lower nurse intent to leave. Both associations were statistically significant, even when controlling for job satisfaction.

Conclusion. Results highlight the importance of a supportive nursing work environment in the retention of qualified nursing staff.