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Nurse Corner

Nurses Turnover Intentions

Ms Mable Yip

Ward Manager, YCH A&E

Nurses play a significant role in the fight against infectious diseases especially COVID-19 pandemic. The pandemic and public health crisis cause extraordinary stress on emergency nurses as a gatekeeper to the health care system. They are fear of being infected, fear of spreading the virus to family members, concerns about long working hours and excessive workloads in unpredictable and unfavorable work environment.

The effect of the COVID-19 pandemic and repeated waves of widespread infections on the level of stress, burnout has caused an unprecedented wave of turnover intention. As a frontline healthcare provider emergency nurse, they must perform day-to-day roles in managing situations of overcrowding. Emergency nurses are at a higher risk for mental disturbances, exhaustion, cognitive impairment when comparing to other healthcare providers. They are constantly facing with high stressful, inappropriate and overcrowded workplace environment. Limited space, limited resources, and limited staff might have impaired emergency nurses’ ability to fully focus on patient care. At the peak of pandemic, the increasing job demand and extra burden has added to the already fatigue emergency nurses extending their high levels of emotional exhaustion and low work motivation that could contribute to increase the turnover intention rate.

High turnover rate has several impacts: increased patient mortality, low nurse-to-patient ratios result in fewer nursing care hours, patient safety and quality of care are adversely affected, high job demands and overwork leading to stress and burnout, compromise nurse ability to deliver care in a higher risk of work-related errors. As a result, stress level and long-term burnout are strong determinant for emergency nurses to leave their profession. Emergency nurses have a higher turnover intention than other departments, and even higher than before COVID-19 pandemic. It is related to deal with critical and complex patients’ condition and encountering serious challenges with low understanding.

Although emergency nurses who experience exhaustion are still needed to maintain physical, emotional, and cognitive effort while at work, they have a strong sense of professional loyalty, mission, and obligation. Once the emergency nurse experienced emotional exhaustion and burnout may occur, the outcomes of patient may suffer. Decrease moral with turnover rate increase would become devastating to the nurse, the patients, and the organization. Shortage of nurses is an attrition crisis in an organization. Nurses’ high turnover intentions have not only been locally concern, it is also internationally.

Hospital management should provide safety and healthy working environment in the emergency department, re-evaluate and update the current practices, redesign emergency department services for crisis situations, rapid availability of sufficient reserves of resources and isolation facilities. Nurse manger should provide physical and psychological support to reinforce emergency nurses’ resilience, create and cultivate a better motivational work environment for our professional emergency nurses, ongoing infection control education and training on management of communicable diseases that may help emergency nurses to cope with complex and uncertain situations in the emergency department that could nurture, retain,

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