Work environment issues and intention-to-leave in Portuguese nurses: A cross-sectional study

- Predicted health-workforce shortages across Europe emphasise the need for robust retention policies.
- We modelled effects of nurse workload, work environments, individual characteristics on intention-to-leave.
- Four out of ten nurses would leave their organisation due to dissatisfaction.
- A lack of opportunities for advancement is the strongest predictor of intention-to-leave.
- Having opportunities for advancement reduces the effect of individual characteristics on intention-to-leave.

This study extends the Registered Nurses Forecasting (RN4CAST) study evidence base with newly collected data from Portuguese nurses working in acute care hospitals, in which the measurement of the quality of work environment, workload and its association with intention-to-leave emerge as of key importance. Data included surveys of 2235 nurses in 144 nursing units in 31 hospitals via stratified random sampling. Multilevel multivariate regression analysis shows that intention-to-leave is higher among nurses with a specialty degree, nurses aged 35-39, and in nursing units where nurses are less satisfied with opportunities for career advancement, staffing levels and participation in hospital affairs. Analysis with moderation effects showed the observed effect of age and of having a specialty degree on intention-to-leave during the regression analysis is reduced in nursing units where nurses are more satisfied with opportunities for career advancement. The most important finding from the study suggests that promoting retention strategies that increase satisfaction with opportunities for career advancement among Portuguese nurses has the potential to override individual characteristics associated with increased turnover intentions.