Date of Award

4-2026

Document Type

Dissertation

Selected Creative Commons License

Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

Degree Name

Doctor of Philosophy (Ph.D.) Nursing

Department

Nursing

School

School of Nursing and Health Sciences

Abstract

Background

The persistent nursing shortage, exacerbated by the COVID-19 pandemic and the subsequent “Great Resignation,” continues to challenge healthcare systems nationwide. High turnover rates among acute care nurses negatively affect patient outcomes, organizational stability, and healthcare costs. Prior research highlights the importance of workplace factors, such as social capital and organizational commitment, in shaping nurses’ intentions to stay in their roles. However, limited studies have examined these relationships collectively within the acute care setting.

Purpose

The purpose of the quantitative cross-sectional study was to examine the relationships between workplace social capital, organizational commitment, and intent to stay among clinical nurses working in acute care settings. This study also explored whether select demographic characteristics were associated with intent to stay and included a qualitative component to better understand the factors influencing nurses’ decisions.

Theoretical Framework

This study was guided by Cowden and Cummings’ theoretical model of clinical nurses’ intent to stay, which advises that characteristics of the manager, organization, work environment, and individual nurse shape cognitive and affective responses that ultimately influence intent to stay.

Methods

A nationwide convenience and snowball sample of 132 acute care nurses was recruited via social media and professional networks. Data was collected via a Qualtrics survey that included the Turnover Intention Scale (TIS-6), the Workplace Social Capital questionnaire, the Three-Component Model Employee Commitment Survey, and demographic items. Descriptive statistics, Pearson correlations, and ANOVA were used for quantitative analysis. Qualitative content analysis was applied to responses to an open-ended question.

Results

Participants demonstrated an overall intent to stay, with a mean TIS-6 score below the threshold indicating turnover intention. Workplace social capital was rated at a “good” level and showed a strong negative correlation with turnover intention. Affective and Normative organizational commitment were also significantly associated with greater intent to stay. Demographic variables showed no significant relationships, though age approached significance. Qualitative findings revealed five themes: management and leadership issues; employee value and recognition; work environment and colleague relationships; job satisfaction and career longevity; and organizational culture and values.

Conclusion

This study revealed that while strong workplace social capital significantly contributes to nurses’ intent to stay in their roles, pervasive systemic issues, including feelings of undervaluation, a lack of transparency, and a corporate-driven culture, actively erode nurses' affective organizational commitment. These findings highlight a critical need for a multifaceted strategic approach across leadership, education, and practice. Nurse leaders must prioritize transparent communication, equitable recognition, and genuine empowerment; adopting a model that values and exemplifies the nursing staff. Nursing education requires curriculum adjustments to prepare future nurses for organizational complexities and advocacy. Leveraging peer-level strengths while addressing systemic challenges is critical to transform nurses' undecided organizational commitment into a sustainable bond, ensuring long-term retention and a robust nursing workforce.

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