The results of this study provide useful guidance for managers, supervisors, and colleagues of nurses to improve the workplace environment. First, managers and supervisors should focus on promoting organizational justice, because this plays a vital role in helping nurses determine whether to remain in their current organization. As indicated by Sulander et al. (2016), justice perception (distributive, procedural, and interactional justice) improves satisfaction with and commitment to the organization. Nurses’ colleagues assistance through information exchange, workload sharing, and mental support can be developed using friendly measures (Campana and Hammoud, 2015). Overall, the results indicate that justice perception is a crucial factor effecting nurses turnover intention. Poor justice perception leads to turnover and increases the frequency of job hopping.
Second, nurses require psychological assistance to address stress and recover from frustration (Feng, 2016; Reyes, Andrusyszyn, Iwasiw, Forchuk, and Babenko-Mould, 2015). Specifically, career adaptability and proactive personality enhance nurses’ ability to manage difficult and stressful situations, whereas a lack of resources and support results in poor justice perception.
Psychological resources can be classified as external and internal. Internal resources such as personality are difficult to change, but other internal resources such as professional identification can be improved by offering personal advancement programs. By contrast, an external resource such as career adaptability requires a supportive work environment. Such an environment should promote support from colleagues, managers, and supervisors. To achieve this, supervisors can arrange additional training programs or counseling about nursing careers for frontline nurses; colleagues can also provide more direct mental support by offering assistance, thus promoting social support in the workplace.
Third, according to Dysvik and Kuvaas (2010), turnover intention has the strongest direct negative relationship with intrinsic motivation, supporting individual fulfilment of the needs for autonomy, competence, and relatedness.
Thus, providing frontline nurses with personal requirement, such as emotional support and professional development, may reduce turnover intention. Our study obtains similar results, in which establishing and maintaining a supporting environment by offering training and rewards, promoting teamwork, and enhancing career opportunities can enable managers to facilitate career satisfaction and reduce turnover intention. Incidentally, this result contradicts most studies that evaluated turnover, burnout, and workload among nurses in Taiwan. Thus, the inwardness of turnover intention among Taiwanese nurses must be better understood.
5.3 Limitations
This study has several limitations. First, the association between research variables was not examined using a rigorous longitudinal design, thus preventing
an exploration of the change effects of the key constructs over time, which is theoretically important yet empirically understudied. Second, although this study has examined directional associations between proactive personality and turnover intention with a time-lagged design, a causal relationship is not unequivocally established between them. Third, the hypotheses were tested among nurses from district hospitals and medical centers in Northern Taiwan.
Although this approach permits the findings to be generalized to Taiwanese nurses, it does restrict the appearance of individual characteristics related to medical centers and district hospitals or wards and intensive care units.
Therefore, researchers should replicate this study in medical centers or at other levels of hospitals for comparative purposes. Fourth, because the National Health Insurance system is implemented in Taiwan, medical personnel may have been influenced by cultural effects such as the compensation system, working pattern, and even professional identity. Thus, the validity of the findings in other cultural contexts should be explored to verify their generalizability. Finally, we focus on three variables, personality, career, and workplace environment, which cannot depict the complete picture of the association between the studied variables among Taiwanese nurses. For example, although the model includes personality, career, and workplace environment, sufficient evidence is not available to demonstrate the importance of these variables. Thus, the absence of mental health data for employees is a significant limitation, and findings related to nurses’ perceptions of their workplaces have limited value. To extend this theory through an identification perspective, future studies are encouraged to examine whether this perspective can also be applied to understand the associations between turnover intention, personality, and other types of self-perception.
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