Metrics details. Turnover intention is a probability of an employee to leave the current institution within a certain period due to various factors. It is the strongest predictor of actual turnover expected to increase as the intention increases. Emergency Department ED nurses are especially vulnerable to high turnover because of their increased risk of developing burnout and compassion fatigue associated with the work environment. Institutional based cross-sectional study was conducted on nurses in three selected governmental hospitals, Addis Ababa from February 19 to March 31, , using a structured pre-tested self-administered questionnaire. A total of respondents were involved with a response rate of Among them, 79 Peer Review reports. Reasons include dissatisfaction with salary, carrier development opportunity, work environment condition, work overload, and personal factors [ 1 , 2 ]. In the nursing profession, the turnover of nursing job or professional resigning remains a serious problem associated with the crisis. It resulted in a loss of a trained and qualified employee as transfer, termination, or resignation [ 3 ]. Turnover intention is the best actual turnover predictor as expectation increase with intention increases [ 4 ]. It is associated with multiple factors including psychological, cognitive, and behavioral components. It is claimed that turnover intention starts as psychological responses to negative aspects of organizations or jobs. The cognitive component involves the decision to leave from the job. Finally, the withdrawal behavior is acted to leave from the current job or actions oriented to future opportunities [ 5 ].. The magnitude of nursing turnover intention is a rapidly-growing global problem affecting the healthcare sector. It is a major worldwide problem especially in developing countries, including Ethiopia. Turnover of employees is a matter of concern for organizations. It has an impact on the organization including loss of knowledge gained by the employee while on the job, understaffing which in turn leads to decreased effectiveness and productivity of the remaining staff. It has also additional costs related to recruitment and selection, training of new employees, personnel process, and induction [ 11 ].. Emergency nurses are the key components from the emergency team to understand the criticality and breadth of patient care needs to address most efficiently. Thus, emergency nurse turnover has a significant impact on the organization and emergency department leaders who desire to preserve a seasoned and competent nursing workforce [ 12 ]. However, they are entering and leaving the emergency department in higher than average numbers, which subjected to cost higher for hospitals to replace staff. The cost for replacement of trained and specialized emergency nurses is higher for advanced training and education of critical competencies needed to provide advanced care for high-acuity patients by the hospital. One in five Registered Nurses within 1 year of hire and one-third within 2 years is estimated to leaves the profession [ 13 ]. Studies showed that multiple factors influence the decision of emergency nurses to stay in or leave their workplace. They reported that control over these four main factors had direct effects on nurse intention to remain employed [ 14 ]. Among these; job satisfaction, job stress, work experience, pay and benefit, long shifts, and work-family conflict were identified as variables that could force nurses to leave their workplace [ 15 , 16 , 17 , 18 ]. It has three sub-components; affective commitments, normative commitment, and continuance commitment which was widely used for researchers to study organizational factors [ 20 , 21 ]. In this model, employees are remained in the organization to achieve the values and goals of the organization is affective commitment. Feeling to have an obligation is normative commitment and lose a lot if they left the organization is continuance commitment. Organizational commitment is an important predictive variable to assess intention to leave the organization [ 22 ]. Lower professional title, working in the emergency department, and length of time in the workplace were the factors for turnover intention [ 23 , 24 ]. A similar study conducted in Indonesia identified factors as workload, schedule and personal reasons were determinants for turnover intention [ 24 ]. The ability of hospitals to retain trained and experienced emergency nurses in a cost-prohibitive healthcare environment requires action on behalf of hospital administrators [ 25 ]. Emergency Departments ED are highly acute patient care environments that are often unpredictable [ 12 ]. Nurses working in the Emergency department are highly vulnerable to turnover because of their workload and may have a potential for developing burnout and compassion fatigue [ 26 ]. ED nurses with invaluable experience and mentoring capacity may consider leaving the ED for less stressful and physically demanding working conditions. Also, while ED patient volume continues to increase, patient boarding decreases the number of available treatment spaces [ 27 ].
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