Nurse characteristics, leadership, safety climate, emotional labour and intention to stay for nurses: a structural equation modelling approach

Aim: The aim of this study was to propose a theoretical model and apply it to examine the structural relationships among nurse characteristics, leadership characteristics, safety climate, emotional labour and intention to stay for hospital nurses. Background: Global nursing shortages negatively affect the quality of care. The shortages can be reduced by retaining nurses. Few studies have independently examined the relationships among leadership, safety climate, emotional labour and nurses’ intention to stay; more comprehensive theoretical foundations for examining nurses’ intention to stay and its related factors are lacking. Design: Cross-sectional. Methods: A purposive sample of 414 full-time nurses was recruited from two regional hospitals in Taiwan. A structured questionnaire was used to collect data from November 2013–June 2014. Structural equation modelling was employed to test the theoretical models of the relationships among the constructs. Results: Our data supported the theoretical model. Intention to stay was positively correlated with age and the safety climate, whereas working hours per week and emotional labour were negatively correlated. The nursing position and transformational leadership indirectly affected intention to stay; this effect was mediated separately by emotional labour and the safety climate. Conclusion: Our data supported the model fit. Our findings provide practical implications for healthcare organizations and administrators to increase nurses’ intent to stay. Strategies including a safer climate, appropriate working hours and lower emotional labour can directly increase nurses’ intent to stay. Transformational leadership did not directly influence nurses’ intention to stay; however, it reduced emotional labour, thereby increasing intention to stay.