Understanding clinical nurses' intent to stay and the influence of leadership practices on intent to stay

Background: High nursing turnover and early nursing career exit rates evidenced by the current global nursing shortage is the impetus for effective strategies aimed at retaining nurses in their current positions. Nurses' behavioral intentions to leave or stay are not well understood.;Aim: This thesis aims to increase understanding of why clinical nurses choose to remain in their current positions and to assess the influence that nursing leaders have on staff nurses' intent to stay.;Methods: Two systematic literature reviews were conducted; one to synthesize current research on clinical nurses' intentions to stay and the influence of leadership practices on those intentions; the other to determine the appropriateness of conceptualizing intentions to stay and leave as opposite ends of a continuum. Building on two published conceptual models (Boyle et al. 1999; Tourangeau & Cranley (2006), a new theoretical model of nurses' intent to stay was developed and tested as a structural equation model using LISREL 8.8 and a subset of the QWEST study data provided by 415 nurses working in nine hospitals in one Canadian province.;Results: The systematic reviews identified positive relationships between relational leadership practices and nurses' intentions to stay, supporting the assertion that managers influence the behavioral intentions of nurses and their intentions to stay and leave. Intentions to stay and leave were found to be separate but correlated concepts. Model testing results, chi 2=169.9, df=148 and p=0.105, indicated a fitting model that explained 63% of the variance in intentions to stay. Concepts with the strongest direct effects on intent to stay were empowerment, organizational commitment, and desire to stay. Leadership had strong total effects and indirectly influenced intent to stay through empowerment.;Conclusions: Findings suggested that intent to stay or leave should be investigated as separate but correlated concepts. Relational leadership that focuses on individual nurses and supports empowering work environments will likely affect nurses choosing to remain in their current positions.