Differential Predictors of Turnover Intention Among Registered Nurses and Nursing Assistants: A Cross-Sectional Study in South Korea

Abstract

Aim To examine the differential predictors of turnover intention among registered nurses (RNs) and nursing assistants (NAs).Background High turnover among RNs and NAs challenges healthcare systems worldwide. Although factors influencing RN turnover have been widely studied, those affecting NAs remain underexplored. Methods A cross-sectional survey was conducted between July and August 2024 with 386 participants (193 RNs and 193 NAs) from various healthcare settings. Data were collected on demographics, work-related characteristics, and study variables, including burnout (exhaustion and cynicism), emotional labor, job stress, resilience, stress response, and turnover intention. Multiple regression analyses were performed separately for each group to identify significant predictors. Results For RNs, exhaustion (beta = 0.368, p < .001) was the strongest predictor of turnover intention, followed by stress response (beta = 0.322, p < .001) and cynicism (beta = 0.196, p = .005). For NAs, cynicism (beta = 0.277, p < .001) and stress response (beta = 0.244, p = .002) were the most influential factors. Other predictors for NAs included working in hospitals with fewer than 100 beds compared to those with over 500 beds (beta = 0.180, p = .015), having a diploma versus a bachelor's degree (beta = 0.142, p = .009), and shorter working experience (beta = -0.138, p = .036). Discussion Turnover among RNs mainly arises from exhaustion related to heavy responsibility, whereas among NAs it reflects cynicism stemming from limited recognition and hierarchical inequities. Conclusion To reduce turnover, interventions should address exhaustion in RNs and cynicism and stress responses in both RNs and NAs. Implications for nursing Tailored, role-specific interventions are needed to address these differing occupational stressors and enhance workforce retention. Implications for nursing policies Policies should prioritize reducing exhaustion among RNs through workload adjustment, adequate staffing, and addressing cynicism and stress among NAs, particularly novices in smaller hospitals, through mentoring, supportive leadership, and stress management.