The psychological contracts of National Health Service nurses.

AIMS: Following the psychological contract model of the employee-employer exchange relationship is offered as a means of understanding the expectations of a UK sample of 223 National Health Service (NHS) nurses in association with their leaving intentions. DESIGN AND METHODS: A pilot study involving 21 NHS nurses, using the repertory grid technique was conducted to elicit contract expectations. Twenty-nine categories of expectation were identified through content analysis. The study proper, employed a survey developed on the basis of results from the pilot study to identify contract profiles among 223 nurses from three London/South-east NHS hospitals, using the Q-sort method. Type of contract held (relational/transactional), satisfaction (job and organization), and leaving intentions were also examined. RESULTS: Q-analysis yielded four contract profiles among the nurses sampled: 'self-development and achievement'; 'belonging and development'; 'competence and collegiality' and 'autonomy and development'. Correlation analysis demonstrated that leaving intentions were associated with a need for personal autonomy and development, and the violation of expectations for being appreciated, valued, recognized and rewarded for effort, loyalty, hard-work and achievement, negative endorsement of a relational contract, positive endorsement of a transactional contract, and job and organizational dissatisfaction. CONCLUSION: Findings illustrate the diagnostic utility of the term psychological contract for understanding the expectations of NHS nurses. The potential significance of these findings for managing nurse retention is highlighted