Leaving the organization or the profession - a multilevel analysis of nurses' intentions.

AIM: This paper is a report of a study of (i) which variables are associated with the intention to leave the profession (ii) which variables are associated with the intention to leave the organization; and (iii) how the related variables differ between intentions in a secondary analysis of data of the German part of the European Nurses' Early Exit Study.

BACKGROUND: Nursing turnover research so far rarely differentiates between leaving the profession or the organization. The identification of specific correlates for different leaving intentions would support better understanding of the turnover process and the development of targeted measures to reduce turnover.

METHODS: A secondary data analysis of the German sample of the European Nurses' Early Exit-Study was performed, using a generalized linear mixed model approach.

RESULTS: Data from 2119 Registered Nurses in 71 departments of 16 hospitals from 2003 were analysed. Models for intentions to leave the profession explained more of the variance (r(2) = 0.46) than models for intentions to leave the organization (r(2) = 0.28). Both leaving intentions were associated with age, professional commitment and job satisfaction. Intentions to leave the profession were strongly associated with variables related to the personal background and the work/home interface whereas intentions to leave the organization were related to organizational leadership and the local context.

CONCLUSION: Retention initiatives should address the work-home interface. Surveys assessing nursing turnover should be based on comprehensive turnover definitions, including different leaving directions.