The role of nursing work environment, head nurse leadership and presenteeism on job embeddedness among new nurses：A cross-sectional multicenter study

Abstract

Abstract Background Retention of new nurses has become a major challenge for medical institutions. Job embeddedness has been shown to be a good predictor of nurse turnover, but more details of it are rarely disclosed, especially among new nurses. This study aims to investigate the job embeddedness level of new nurses and to reveal the influence of the nursing work environment, head nurse leadership and presenteeism on job embeddedness in this population from a theoretical point of view. Method A cross-sectional multicentre study involving 436 participants from 10 cities and 33 hospitals was conducted over 4 months. Samples were selected using a two-stage convenience sampling method. A sequential mediation model performed with SPSS-PROCESS was used to analyse the relationships among the nursing work environment, head nurse leadership, presenteeism and job embeddedness. Results The job embeddedness of new nurses was moderate (25.33 ± 4.51), which is lower than that of senior nurses (t=-5.441, p < 0.001). The nursing work environment (r = 0.731, p < 0.01) and head nurse leadership (r = 0.632, p < 0.01) positively correlated with job embeddedness. Presenteeism (r=-0.349, p < 0.01) negatively correlated with job embeddedness. Nursing work environment can not only directly affect the job embeddedness of new nurses, but also indirectly affect it through the sequential mediating effect of head nurses' leadership and presenteeism (R2 = 0.535, F = 82.160, p < 0.001). Conclusions We call on managers to focus on the job embeddedness of new nurses within two years of entry. Managers should avoid the "embedding dilemma" when cultivating new nurses' job embeddedness. The pathway to excellence aims to improve nursing work environment, head nurse leadership and to avoid presenteeism to cultivate "active embeddedness" replace "forced embeddedness " in new nurses, so as to stabilize the new nurse team.