The Process From Turnover Intention to Turnover Decision in Chinese Nurses With Master’s Degree: A Grounded Theory Study

Abstract

Aim: This study explores the stages from turnover intention to turnover decision-making among Chinese nurses with a master’s degree, aiming to identify the enablers and barriers influencing turnover decisions. Design: A constructivist grounded theory approach was adopted to develop a theoretical framework for understanding turnover decision-making among master’s degree nurses. Methods: Through purposive and theoretical sampling, nurses with a master’s degree who had either left their positions or expressed a high turnover intention within the past 2 years were selected. Semistructured interviews were conducted face to face or online from May to August 2023. Participants were employed or had previously worked in tertiary hospitals across Chinese provincial capitals. Theoretical sampling and constant comparative analysis were employed to achieve theoretical saturation. Data collection and analysis occurred concurrently, with Charmaz’s constructivist grounded theory applied for continuous comparison to identify core categories. Results: A total of 18 nurses with master’s degrees were recruited from tertiary hospitals in regions including Shanxi, Shaanxi, Shanghai, Shandong, and Tianjin. The process from turnover intention to decision is influenced by four key factors: triggers, fuels, retardants, and accelerants. This progression spans four stages: intention generation, turnover latency, turnover deliberation, and final decision. Conclusions: Nursing managers can identify and track the progression of turnover intention through the four stages from intention to decision. Tailored management strategies should focus on key influencing factors, strengthening protective factors that impact turnover decisions, helping nurses rebuild confidence in continued employment, and reducing both turnover intention and overall turnover rates.