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The Relationship Between Hospital Unit Culture and Nursesʼ Quality of Work Life
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2002
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Quality Of LifeNursesʼ QualityOrganizational CultureHuman Resource ManagementWorker Well-beingOrganizational BehaviorHospital MedicineManagementWork AttitudeNurse RetentionWorkplace CultureTurnover RatesUnit Organizational CultureNursingCultureHospital EnvironmentBusinessNursing ResearchCulture ChangeWork Life
Turnover among hospital nurses has risen as productivity demands grow, yet the bureaucratic, hierarchical culture of hospitals may undermine efforts to improve nurse job satisfaction and retention. This study examines how unit‑level organizational culture relates to key job‑related factors influencing nurse retention in labor‑and‑delivery units across seven hospitals. Results show that a human‑relations culture boosts organizational commitment, job involvement, empowerment, and satisfaction while reducing turnover intent, indicating that enhancing quality of work life offers a more sustainable retention strategy than recruitment or pay increases.
Turnover rates for hospital nurses have been increasing in recent years, which is partially a result of increasing pressure on nurses from higher productivity expectations in a managed care environment. Improving nurse retention is a difficult challenge to managers since the bureaucratic cultural norm of hospitals, with its hierarchical structures, rules, and regulations, and heavy emphasis on measurement of outcomes and costs, may not be the culture most conducive to enhancing nurses' job satisfaction and commitment. Accordingly, this study investigates the relationships between unit organizational culture and several important job-related variables for nurse retention in the labor and delivery units of seven hospitals. Data analysis shows that unit organizational culture does affect nurses' quality of work life factors and that human relations cultural values are positively related to organizational commitment, job involvement, empowerment, and job satisfaction, and negatively related to intent to turnover. These findings suggest that although increasing recruitment of nurses and improved compensation and benefits strategies may offset hospital nurse shortages in the short term, improving quality of work life may be a more practical and long-term approach to improving hospital nurse retention.