Don't Go: Examining the Relationships Between Meaning, Work Environment and Turnover Intention Across the Entire Healthcare Team

Introduction: Healthcare workers tend to have a strong sense of altruism in their work, which may be protective against turnover despite poor working conditions. Due to the increased distress noted during the pandemic, the challenges of working in healthcare and changing attitudes about work may have surpassed the protective effect of meaning and purpose in work. This study empirically examines perceived meaning in work, and specific work-related factors that contribute to employees' intent to stay and to recommend working at the organization to others as COVID-19 transitions from a pandemic to endemic phase. Methods: Data from a survey of 4451 clinical and non-clinical healthcare workers were analyzed using regression and dominance analyses to identify specific predictors of turnover intention and net promoter score. Results: The variables that explained the greatest contribution to variance in turnover intention from highest to lowest were burnout, trust and confidence in senior leadership, perceived organizational support, sense of belonging, and sense of recognition. The variables that explained the greatest overall contribution to variance for net promoter score from highest to lowest were perceived organizational support, trust and confidence in senior leadership, resource availability, sense of recognition, and sense of belonging. While meaning in work was associated with turnover intent, organizational and team level factors such as trust and belonging were more predictive of the outcomes. Discussion: While meaning and purpose are important job resources, they are not sufficient to retain employees in the absence of trust, organizational support, belonging, recognition and access to necessary resources. Leaders must seek to foster environments that support trust, belonging and recognition in their retention efforts.