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Predicting Registered Nurse Job Satisfaction and Intent to Leave

Larrabee, June H. PhD, RN; Janney, Michelle A. PhD, RN, CNAA; Ostrow, C Lynne EdD, RN; Withrow, Mary Lynne MSN, RN; Hobbs, , Gerald R. Jr PhD; Burant, Christopher MA, MACTM

Journal of Nursing Administration: May 2003 - Volume 33 - Issue 5 - pp 271-283

Background: Nurse job dissatisfaction has been the primary predictor of intent to leave; however, although many predictors of job satisfaction have been identified, little is known about the influence of variable nurse attitudes, such as psychological empowerment and hardiness, on job satisfaction.

Objective: The purpose of this study was to investigate the relative influence of nurse attitudes, context of care, and structure of care on job satisfaction and intent to leave.

Methods: A nonexperimental, predictive design evaluated these relationships in a nonrandom sample of 90 registered staff nurses using instruments with known psychometric properties.

Results: The major predictor of intent to leave was job dissatisfaction, and the major predictor of job satisfaction was psychological empowerment. Predictors of psychological empowerment were hardiness, transformational leadership style, nurse/physician collaboration, and group cohesion.

Conclusions: Results supported the influence of nurse attitude on job satisfaction relative to other contributing factors.

This nonexperimental, predictive study investigated the relative influence of registered nurse (RN) attitudes, context of care, and structure of care on RNs’ job satisfaction and intent to leave (see Table 1 for concept definitions). Minimizing turnover is a priority for executives, especially in times of nurse shortage, as in today’s healthcare climate. 1,2 In the United States, the national turnover rate for hospital nurses was 12% in 1996, 15% in 1999, 1 and 26.2% in 2000. 3 This escalation of turnover has occurred simultaneously with a 20% decline in nursing school graduations since 1996 4 and the lowest unemployment rate (1%) of RNs in a decade. 1 Furthermore, in mid-2001, there were approximately 126,000 unfilled RN jobs in the United States, about a 11% vacancy rate. 4 Multiple factors contribute to staff shortage, including high turnover.

Authors’ affiliations: Associate Professor, School of Nursing (Dr Larrabee), Associate Professor and Chair, Department of Health Restoration (Dr Ostrow), Associate Professor, Department of Statistics (Dr Hobbs), West Virginia University, Morgantown, WVa; Clinical Investigator (Dr Larrabee), Director for Medical Units (Ms Withrow), West Virginia University Hospitals, Morgantown, WVa; Vice President and Chief Nurse Executive (Dr Janney), Northwestern Memorial Hospital, Chicago, Ill; Research Data Analyst (Mr Burant), Department of Bioethics, Case Western Reserve University, Cleveland, Ohio.

Corresponding author: June H. Larrabee, PhD, RN, West Virginia University, School of Nursing, PO Box 9610, Morgantown, WV 26506-9610 (

© 2003 Lippincott Williams & Wilkins, Inc.