Antecedents of hospital nurses\u2019 intention to leave the organization: A cross sectional survey

Background: Leadership and perceived organizational support inspire trust in the leader and in the organization. Consequently, these aspects may contribute to a reduction in job burnout among nurses and, in the end, of the intention on their part to leave the hospital. It is crucial to develop models in order to simultaneously test the correlations between these relevant psychosocial variables, so that complexity of the nursing work environment may be better understood. Objectives: We expected to give support to and to further corroborate results in the literature linking perceived leadership style \u2013 and particularly servant leadership \u2013 perceived organizational support, trust in the leader and in the organization, job burnout among nurses and their subsequent intention to leave the hospital. Design: Cross-sectional study. Setting: Two Italian large size public hospitals. Participants: Two samples including both graduates and non-graduates members of the nursing staff. Overall mean age was equal to 42.06 years while the general mean for tenure was 12.99 years. Data were collected in 2012. Methods: A regression model with latent variables was tested via structural equation modeling using LISREL. The multi-sample procedure was also applied in order to test invariance of results between the two samples. Results: Servant leadership was positively associated with trust in the leader and perceived organizational support was positively associated with trust in the organization. Trust in the leader and trust in the organization displayed a negative correlation with the emotional exhaustion and cynicism factors of job burnout, and a positive correlation with the professional efficacy factor. Furthermore, trust scores mediated the effects of servant leadership and perceived organizational support on job burnout factors. The cynicism factor was negatively associated with intention to leave the organization and it also mediated the effects of both trust in the leader and servant leadership on intention to leave. On the other hand, trust in the organization turned out to be directly and negatively related to intention to leave. Conclusions: Servant leadership and perceived organizational support showed their relevance in the nursing setting. The role of trust in the leader, trust in the organization and job burnout factors as mediating variables received support. Interestingly enough, the higher the cynicism score the higher the intention to leave the hospital. The results achieved may have practical implications not only for recruitment and training of nurse managers but also for hospital management