The Influence of Perceived Same-Status Nurse-to-Nurse Coworker Exchange Relationships, Quality of Care Provided, Overall Nurse Job Satisfaction, and Organizational Commitment on Intent to Stay and Job Search Behavior of Nurses in the Acute Care Nurse Work Environment

Abstract

ABSTRACT THE INFLUENCE OF PERCEIVED SAME-STATUS NURSE-TO-NURSE COWORKER EXCHANGE RELATIONSHIPS, QUALITY OF CARE PROVIDED, OVERALL NURSE JOB SATISFACTION, AND ORGANIZATIONAL COMMITMENT ON INTENT TO STAY AND JOB SEARCH BEHAVIOR OF NURSES IN THE ACUTE CARE NURSE WORK ENVIRONMENT by Madonna M. Kubichka The University of Wisconsin-Milwaukee, 2016 Under the Supervision of Dr. Karen Morin The nurse turnover rate continues to rise; currently 17.2%. The challenges of the acute care environment are multifaceted and contribute to nurse turnover. Stressful working conditions may contribute to negative relationships among colleagues; subsequently quality of care can suffer, as well as, job satisfaction and nurse intent to stay. A cross-sectional, correlational study, guided by the Coworker Exchange Theory (Sherony & Green, 2002), used data obtained through a printed survey from a sample of 427 registered nurses. The purpose of this dissertation was to investigate the influence of perceived same-status nurse-to-nurse coworker exchange relationships, quality of care provided, overall nurse job satisfaction, and organizational commitment on intent to stay and job search behavior of nurses in the acute care nurse work environment. Study variables were made operational using six instruments. Results from path analysis showed that same-status nurse-to-nurse coworker exchange relationships explained 43% of variance in nurse perceived quality of care provided, 21% of variance in overall nurse job satisfaction, and 8% of variance in nurse intent to stay. Overall nurse job satisfaction accounted for 25% of the effect of same-status nurse-to-nurse coworker exchange relationships on nurse perceived quality of care provided and 68% of same-status nurse-to-nurse coworker exchange relationships on nurse intent to stay. Nurse perceived quality of care provided accounted for 71% of same-status nurse-to-nurse coworker exchange relationships on nurse intent to stay. Findings provide beginning evidence that coworker exchange relationships influence the nurse work environment and nurse turnover. Strategies to address same-status nurse-to-nurse coworker exchange relationships warrant being identified. Organizational leaders may wish to consider allocating resources to build, develop, and maintain improved coworker exchange relationships within the nurse work environment to aid in discouraging nurse job search behavior.