Caribbean Nurse Turnover
A Scoping Review
DOI:
https://doi.org/10.15362/ijbs.v30i1.561Keywords:
Nurse retention, Nurse turnover, Intention evaluation, Personnel turnover, Caribbean, Nurse attitudes, Work environmentAbstract
Nurse turnover in the Caribbean has resulted in continuous shortages and chronic understaffing, jeopardizing the ability of health systems to provide essential services and negatively impacting patient care and outcomes. Despite extensive global research on nurse turnover over the past 40 years, the Caribbean has been largely overlooked by researchers. This study maps and summarizes the existing empirical and grey literature, identifying key themes and knowledge gaps concerning nurse turnover in the Caribbean. We employed Arskey and O’Malley’s methodological approach and collaborated with a health sciences research librarian to develop a search strategy. We searched 12 electronic databases and used Google and Google Scholar to locate relevant literature. Two reviewers independently screened and extracted data, compiling it into qualitative and numerical thematic summaries. The study uncovered a significant scarcity of literature, with only five articles published between 1999 and 2017, mostly quantitative and using cross-sectional methods. Two major themes emerged: mental health challenges and the need for supervisory and organizational support. This review highlights specific predictive factors of turnover intentions among nurses in English-speaking countries of the Caribbean. It also reveals the limited research available on this topic, demonstrating the need to prioritize nursing research on retention and turnover. This study concludes that future researchers should use a multi-disciplinary, geographically wide approach to develop tailored interventions, enhance nurse well-being and promote health system resilience.
References
Arksey H., & O’Malley L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology. 8(1), 19–32. https://doi.org/10.1080/1364557032000119616
Azad, M. M., & Ali, S. M. (2024). A systematic review on how the nursing work environment, job burnout, and turnover intention affect patient safety. Educational Administration: Theory and Practice, 30(1), 1916–1925. https://doi.org/10.53555/kuey.v30i1.6752
Baba, V. V., Galperin, B. L., & Lituchy, T. R. (1999). Occupational mental health: A study of work-related depression among nurses in the Caribbean. International Journal of Nursing Studies, 36(2), 163-169. https://doi.org/10.1016/s0020-7489(99)00002-4
Bae, S. H. (2022). Noneconomic and economic impacts of nurse turnover in hospitals: A systematic review. International Nursing Review, 69(3), 392–404. https://doi.org/10.1111%2Finr.12769
Chênevert, D., Jourdain, G., & Vandenberghe, C. (2016). The role of high-involvement work practices and professional self-image in nursing recruits’ turnover: A three-year prospective study. International Journal of Nursing Studies, 53, 73–84. https://doi.org/10.1016/j.ijnurstu.2015.09.005
Colquhoun, H. L., Levac, D., O'Brien, K. K., Straus, S., Tricco, A. C., Perrier, L., Kastner, M., & Moher, D. (2014). Scoping reviews: Time for clarity in definition, methods, and reporting. Journal of Clinical Epidemiology, 67(12),1291–4. https://doi.org/10.1016/j.jclinepi.2014.03.013
Cosgrave, C. (2020). Context matters: Findings from a qualitative study exploring service and place factors influencing the recruitment and retention of allied health professionals in rural Australian public health services. International Journal of Environmental Research and Public Health, 17(16), 5815 https://doi.org/10.3390%2Fijerph17165815
Dewanto A., & Wardhani V. (2018). Nurse turnover and perceived causes and consequences: A preliminary study at private hospitals in Indonesia. BMC Nursing, 17(2),52. https://doi.org/10.1186/s12912-018-0317-8
Galanis, P., Moisoglou, I., Papathanasiou, I. V., Malliarou, M., Katsiroumpa, A., Vraka, I., Siskou, O., Konstantakopoulou, O. & Kaitelidou, D. (2024). Association between organizational support and turnover intention in nurses: A systematic review and meta-analysis. Healthcare, 12(3), 291. https://doi.org/10.3390/healthcare12030291
Halter, M., Boiko, O., Pelone, F., Beighton, C., Harris, R., Gale, J., Gourlay, S., & Drennan, V. (2017). The determinants and consequences of adult nursing staff turnover: A systematic review of systematic reviews. BMC Health Services Research, 17, 1–20. https://doi.org/10.1186/s12913-017-2707-0
Hamilton, N. E., & Kiger, A. M. (2022). Exploring the complexities of nurse turnover through mixed methods: A call for qualitative approaches. Journal of Nursing Management, 30(5), 1102–1110. https://doi.org/10.1111/jonm.13411
International Organization for Migration Regional Office for Central America, North America and the Caribbean. (2023). Data report: Trends in Caribbean migration and mobility. https://rosanjose.iom.int/
sites/g/files/tmzbdl1446/files/documents/2023-07/data-report-trends-in-caribbean-migration-and-mobility.pdf
Jacobson, J. (2015). The complexities of nurse migration. American Journal of Nursing, 115(12), 22-23. https://doi.org/10.1097/01.naj.0000475284.07793.69
Kerr, V. O. (2005). Influence of perceived organizational support, organizational commitment, and professional commitment on turnover intentions of healthcare professionals in Jamaica. (Publication No. 3197584). [Doctoral Dissertation, Nova Southeastern University]. ProQuest Dissertations Publishing.
Kohnen, D., De Witte, H., Schaufeli, W. B., Dello, S., Bruyneel, L., & Sermeus, W. (2024). Engaging leadership and nurse well-being: The role of the work environment and work motivation—a cross-sectional study. Human Resources for Health, 22(1), 8. https://doi.org/10.1186/s12960-023-00886-6
Labrague, L. J., McEnroe–Petitte, D. M., Tsaras, K., Cruz, J. P., Colet, P. C., & Gloe, D. S. (2018). Organizational commitment and turnover intention among rural nurses in the Philippines: Implications for nursing management. International Journal of Nursing Sciences, 5(4), 403–408. https://doi.org/10.1016/j.ijnss.2018.09.001
Lansiquot, B. A., Tullai‐McGuinness, S., & Madigan, E. (2012). Turnover intention among hospital‐based registered nurses in the Eastern Caribbean. Journal of Nursing Scholarship, 44(2), 187–193. https://doi.org/10.1111/j.1547-5069.2012.01441.x
Laschinger, H. K. S., Cummings, G., Leiter, M., Wong, C., MacPhee, M., Ritchie, J., Grinspun, D., Gurnham, M. E., Foster, B., Huckstep, S., Ruffolo, M., Shamian, J., Burkoski, V., & Read, E. (2016). Starting out: A time-lagged study of new graduate nurses’ transition to practice. International Journal of Nursing Studies, 57, 82–95. https://doi.org/10.1016/j.ijnurstu.2016.01.005
Leineweber, C., Chungkham, H. S., Lindqvist, R., Westerlund, H., Runesdotter, S., Alenius, L. S., & Tishelman, C. (2016). Nurses’ practice environment and satisfaction with schedule flexibility is related to intention to leave due to dissatisfaction: A multi-country, multilevel study. International Journal of Nursing Studies, 58, 47–58. https://doi.org/10.1016/j.ijnurstu.2016.02.003
Levac, D., Colquhoun, H., & O’Brien, K. K. (2010). Scoping studies: Advancing the methodology. Implementation Science, 5(1), 69. https://doi.org/10.1186/1748-5908-5-69
Liu, Y., Duan, Y., & Guo, M. (2023). Turnover intention and its associated factors among nurses: A multi-center cross-sectional study. Frontiers in Public Health, 11, 1141441. https://doi.org/10.3389/fpubh.2023.1141441
Maharaj, S., Lees, T., & Lal, S. (2018). Prevalence and risk factors of depression, anxiety, and stress in a cohort of Australian nurses. International Journal of Environmental Research and Public Health, 16(1), 61. https://doi.org/10.3390/ijerph16010061
Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry, 15(2), 103–111. https://doi.org/10.1002/wps.20311
Moher D., Liberati A., Tetzlaff J., Altman D. G., & The PRISMA Group. (2009). Preferred reporting items for systematic reviews and metaanalyses: The PRISMA statement. PLoS Med, 6(6), e1000097. https://doi.org/10.1136/bmj.b2535
Morrison, M. F., Lindo, J. M. L., Aiken, J., & Chin, C. R. (2017). Lateral violence among nurses at a Jamaican hospital: A mixed methods study. International Journal of Advanced Nursing Studies, 6(2), 85–91. https://doi.org/10.14419/ijans.v6i2.8264
Mosadeghrad, A. M., Ferlie, E., & Rosenberg, D. (2022). Differentiating between organizational and professional turnover intentions among healthcare professionals. Health Services Management Research, 35(1), 21–30. https://doi.org/10.1177/0951484821993704
Park, B., & Ko, Y. (2020). Turnover rates and factors influencing turnover of Korean acute care hospital nurses: A retrospective study based on survival analysis. Asian Nursing Research, 14(5), 293–299. https://doi.org/10.1016/j.anr.2020.09.001
Pressley, C., & Garside, J. (2023). Safeguarding the retention of nurses: A systematic review on determinants of nurse's intentions to stay. Nursing Open, 10(5), 2842–2858. https://doi.org/10.1002%2Fnop2.1588
Rolle-Sands, S., Ingraham, K., & Salami, B. O. (2020). Caribbean nurse migration—a scoping review. Human Resources for Health, 18, 1–10. https://doi.org/10.1186/s12960-020-00466-y
Shan, G., Wang, S., Wang, W., Guo, S., & Li, Y. (2021). Presenteeism in nurses: Prevalence, consequences, and causes from the perspectives of nurses and chief nurses. Frontiers in Psychiatry, 11, 584040. https://doi.org/10.3389%2Ffpsyt.2020.584040
Sheng, H., Tian, D., Sun, L., Hou, Y., & Liu, X. (2023). Nurse practice environment, perceived organizational support, general well‐being, occupational burnout and turnover intention: A moderated multi‐mediation model. Nursing Open, 10(6), 3828–3839. https://doi.org/10.1002/nop2.164
Tourigny, L., Baba, V. V., & Lituchy, T. (2016). On the retention of younger nurses. Journal of Nursing and Care, 5(350), 1–6. https://doi.org/10.4172/2167-1168.1000350
Yildiz, B., Yildiz, H., & Ayaz Arda, O. (2021). Relationship between work–family conflict and turnover intention in nurses: A meta‐analytic review. Journal of Advanced Nursing, 77(8), 3317–3330. https://doi.org/10.1111/jan.14846
Yun, M. R., & Yu, B. (2021). Strategies for reducing hospital nurse turnover in South Korea: Nurses' perceptions and suggestions. Journal of Nursing Management, 29(5), 1256–1262. https://doi.org/10.1111/jonm.13264
Zhang, Y., Yin, R., Lu, J., Cai, J., Wang, H., Shi, X., & Mao, L. (2022). Association between horizontal violence and turnover intention in nurses: A systematic review and meta-analysis. Frontiers in Public Health, 10, 964629. https://doi.org/10.3389%2Ffpubh.2022.964629
