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A qualitative study of the determinants for nurse turnover Analyzed from the theoretical perspective of the psychological contract
KTH, School of Industrial Engineering and Management (ITM), Industrial Economics and Management (Dept.), Organization and management.
KTH, School of Industrial Engineering and Management (ITM), Industrial Economics and Management (Dept.), Organization and management.
2017 (English)Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
Abstract [en]

Job turnover amongst nurses is a current issue not only in Sweden but globally. Not only is it expensive and inefficient for hospitals and employers to have a high employee turnover, but the turnover might also result in vacant nursing positions which force patient slots to shut down, resulting in that fewer patients receive treatment and that the patient safety decreases. In order to cope with the issues that spring from a high turnover, retention measures has to be taken within the organization. By conducting ten observations at an infectious disease department at a Swedish university hospital in combination to an extensive meta-analysis of existing turnover models, a model for nurse turnover was developed. By understanding the dynamics of the healthcare industry and the department under study, four themes were identified that contributed to intentions to stay or leave an employment: “Contextual setting”, “Culture and norms”, “Personal factors”, and “Critical events”. The model was later used as a foundation for the analysis and synthesis of eight in-depth interviews with nurses and two in-depth interviews with nurse managers. The nurses’ work environment was studied in regard to the theoretical concept “Psychological contract”. Findings showed that prosocial motives laid the ground when nurses chose their profession, and that strong affective commitment such as group coherence was highly emphasized as the most motivating factor to remain within the organization. It was also shown that breaches to the psychological contract limited the nurses’ organizational commitment levels. Discrepancy between expectations and fulfilment of educational opportunities and specialized job roles caused breaches to the relational psychological contract, and consequently caused reasons for turnover. Findings also imply that nurses are governed by professional commitment rather than organizational commitment.

Place, publisher, year, edition, pages
2017. , p. 95
Keywords [en]
job turnover, nurses, employee retention, job embeddedness, organizational commitment, professional commitment, psychological contract, healthcare.
National Category
Engineering and Technology
Identifiers
URN: urn:nbn:se:kth:diva-214803OAI: oai:DiVA.org:kth-214803DiVA, id: diva2:1143415
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Available from: 2017-09-21 Created: 2017-09-21 Last updated: 2017-09-21Bibliographically approved

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CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf