Investigating the Effect of Nurse–Team Communication on Nurse Turnover: Relationships Among Communication Processes, Identification, and Intent to Leave

Abstract

Enhanced team communication may strengthen nurses' attachment to their organizations and teams and improve nurse retention. This study examines the relationships among nurse–team communication, identification (organizational and team), and intent to leave. Hospital nurses (N = 201) completed surveys measuring 3 nurse–team communication processes: promoting team synergy, ensuring quality decisions, and individualizing communication. Hierarchical regression analyses revealed that promoting team synergy was a significant predictor of intent to leave, whereas ensuring quality decisions and individualizing communication did not account for significant additional variance in intent to leave. Separate analyses showed that the relationship between promoting team synergy and intent to leave was partially mediated by team identification or by organizational identification. Further analyses were conducted on the 7 communication practices for promoting team synergy. Mentoring emerged as the only significant predictor of intent to leave; however, its relationship to intent to leave was fully mediated by organizational identification or partially mediated by team identification. Pragmatic suggestions are offered to improve nurse identification and reduce turnover.

ACKNOWLEDGMENTS

This project was supported by a grant from Bronson Healthcare Group, Kalamazoo, Michigan. An earlier version of this article was presented at the 2006 National Communication Association conference, San Antonio, TX

Notes

¹Nurses had previously completed a similar-version of the questionnaire, which may have led to this lower than expected response rate.

²Instructions were as follows, “Nurses may engage in a variety of communication practices in their interactions with other team members that ultimately affect patient outcomes. This survey asks you to provide your reactions to nurse-team interactions and respond to other issues that impact teamwork at ___. Please rate the importance of each communication practice.” Participants were given the phrase, “How important is it for nurses to …” and asked to respond by circling one number on a scale ranging from 1 (not at all important) to 10 (extremely important), with a midpoint over 5 and 6 (somewhat important).

³The letter identified the hospital and stated, “The goal of this survey is to identify the most important communication practices for hospital nurses when interacting with members of the healthcare team. We are asking doctors, nurses, and PCAs [patient-care assistants] to participate.”

⁴Participants were instructed to “Please rate how much nurses with whom you work at ___ using each communication practice” and asked to respond by circling one number on a scale ranging from 1 (never) to 10 (always), with a midpoint over 5 and 6 (sometimes).

⁵Initially, this study used a four-item Organizational Identification Questionnaire scale, which proved to be problematic with a Cronbach's alpha of .64 for organizational identification and .47 for team identification. The item, “I feel very little loyalty to ___ (hospital name),” was dropped from both identification scales due to failure to correlate highly with the other items.

⁶At each stage in the series of regression analyses, the lowest nonsignificant predictor variable was eliminated to ensure that other variables did not reach significance in its absence.