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Articles 1 - 30 of 178
Full-Text Articles in Medicine and Health Sciences
Using An Evidence-Based Practice Nurse Recognition Practice To Improve Job Satisfaction, Hali Bianchi
Using An Evidence-Based Practice Nurse Recognition Practice To Improve Job Satisfaction, Hali Bianchi
Student Scholarly Projects
Practice Problem: The project targeted low job satisfaction and high nurse turnover in a Central Florida bone marrow transplant unit, impacting patient care and costs.
PICOT: (P) For registered nurses (RNs) on the bone marrow transplant unit, (I) does implementing an evidence-based practice employee recognition program (C) compared to no employee recognition program, (O) lead to an increase in job satisfaction (T) over 10 weeks?
Evidence: The evidence supported the effectiveness of meaningful recognition programs, such as personalized verbal acknowledgment from leadership, in boosting job satisfaction among nurses.
Intervention: The intervention involved nurse managers using a weekly employee recognition …
Nursing Students’ Views On An E-Learning Activity On Clinical Leadership And Ageism: A Cross-Sectional Study, Kelly Baskerville, Sherry Dahlke, Kathleen F. Hunter, Mary T. Fox, Sandra J. Davidson, Alison L. Chasteen, Jeffrey I. Butler, Elaine Moody, Lori Schindel Martin
Nursing Students’ Views On An E-Learning Activity On Clinical Leadership And Ageism: A Cross-Sectional Study, Kelly Baskerville, Sherry Dahlke, Kathleen F. Hunter, Mary T. Fox, Sandra J. Davidson, Alison L. Chasteen, Jeffrey I. Butler, Elaine Moody, Lori Schindel Martin
Quality Advancement in Nursing Education - Avancées en formation infirmière
Background: Students require knowledge and skills in clinical leadership in order to address the issue of ageism. An e-learning module was developed that used ageism as an exemplar to practise using the skills and knowledge needed for clinical leadership. Ageism was chosen because it is prevalent in nursing culture and nursing education and influences nursing practice with older people.
Purpose: The aim of this study was to understand nursing students’ perspectives about how a clinical leadership and ageism e-learning module enhanced their knowledge, confidence, and ability to use clinical leadership to address ageism, and whether the module was an enjoyable …
Fostering Relationships Between New Graduate Nurses And Leadership To Increase Retention, Michelle Cotton
Fostering Relationships Between New Graduate Nurses And Leadership To Increase Retention, Michelle Cotton
Doctor of Nursing Practice Projects
Objective: To implement weekly one-on-one touch bases between nursing leaders, such as managers and directors, with newly hired, new graduate nurses, up to 1 year after graduation to improve retention of those employees. The intent is to improve retention from a baseline of 23% in 2022.
Results: 35.8% of the newly hired nurses plan to remain in their current role for the next 2-3 years.
Conclusions: Almost 55% said that they strongly agreed with the touch base contributing to development/growth. This was the lowest scoring question and the most concerning related to retention. An overwhelming majority felt …
Leadership Style And Nursing Retention, Brenae J. Reason
Leadership Style And Nursing Retention, Brenae J. Reason
MSN Capstone Projects
Nursing is the heart of healthcare, for decades we have been the drivers of innovation and have contributed to so many advancements in the profession. Even with nursing being a sincere passion amongst many nurses, there is an alarming trend of nurses who are faced with burnout (Brusie, C., n.d.). It has been reported that 1 in 5 nurses left their position in one particular health system (Andreyeva et al., 2023). It is also noted that turnover can be costly for organizations (Zuniga et al., 2019). While there are a multitude of reasons nurses could be leaving their companies, one …
The Impact Of Shared Governance On Work Engagement And Job Satisfaction, Mikayla Adkins
The Impact Of Shared Governance On Work Engagement And Job Satisfaction, Mikayla Adkins
MSN Capstone Projects
In 2023, the National Council of State Boards of Nursing revealed that 100,000 nurses left the workforce during the COVID-19 pandemic and another 900,000 plan to leave by 2027 due to stress, burnout, and retirement. Identifying and implementing practical strategies to reduce voluntary turnover as a result of stress and burnout is a top priority for nursing leaders across the country. Work engagement and job satisfaction have well been documented in the literature as antidotes to occupational stress and burnout in the nursing profession (Schaufeli & Bakker, 2004; Pressley & Garside, 2022). Evidence suggests that implementing shared governance is a …
The Cancer Nursing Workforce In Australia: A National Survey Exploring Determinants Of Job Satisfaction, Natalie Bradford, Elizabeth Moore, Karen Taylor, Olivia Cook, Lucy Gent, Theresa Beane, Natalie Williams, Kimberly Alexander, Erin Pitt, Jemma Still, Cameron Wellard, Gemma Mcerlean, Deborah Kirk, Leanne Monterosso, Alexandra Mccarthy, Zerina Lokmic-Tomkins, Jessica Balson, Priscilla Gates
The Cancer Nursing Workforce In Australia: A National Survey Exploring Determinants Of Job Satisfaction, Natalie Bradford, Elizabeth Moore, Karen Taylor, Olivia Cook, Lucy Gent, Theresa Beane, Natalie Williams, Kimberly Alexander, Erin Pitt, Jemma Still, Cameron Wellard, Gemma Mcerlean, Deborah Kirk, Leanne Monterosso, Alexandra Mccarthy, Zerina Lokmic-Tomkins, Jessica Balson, Priscilla Gates
Research outputs 2022 to 2026
Background: To maintain and improve the quality of the cancer nursing workforce, it is crucial to understand the factors that influence retention and job satisfaction. We aimed to investigate the characteristics of cancer nurses in Australia and identify predictors of job satisfaction. Methods: We analysed data from an anonymous cross-sectional survey distributed through the Cancer Nurses Society Australia membership and social media platforms from October 2021 to February 2022. The survey was compared to national nursing registration data. Data were analysed with non-parametric tests, and a stepwise, linear regression model was developed to best predict job satisfaction. Results: Responses were …
Transformational Leadership Training For Leaders, Kristie M. Gilliland
Transformational Leadership Training For Leaders, Kristie M. Gilliland
Electronic Theses and Dissertations
The purpose of the study was to evaluate the impact of transformational leadership training on improving a leader’s skills and knowledge in performing daily operations and interacting with frontline staff, decreasing attrition. Ineffective leadership contributes to staff dissatisfaction, poor performance, and attrition. The literature supports transformational leadership is effective in leading teams of nurses and contributes to staff autonomy, staff satisfaction, decreased attrition, and improved patient outcomes. A quasi-experimental research study was completed on a leadership team in a managed care organization. Fourteen leaders with anywhere from 1 to more than 6 years of leadership experience were evaluated. Lewin’s change …
Breaking The Transactional Mindset: A New Path For Healthcare Leadership Built On A Commitment To Human Experience, Kirsten Krull, Jerry Mansfield, Jennifer Gentry, Karen Grimley, Barbara Jacobs, Jason Wolf
Breaking The Transactional Mindset: A New Path For Healthcare Leadership Built On A Commitment To Human Experience, Kirsten Krull, Jerry Mansfield, Jennifer Gentry, Karen Grimley, Barbara Jacobs, Jason Wolf
Patient Experience Journal
Numerous health care publications have focused on the compelling need to improve patient experience and the associated improvements necessary to address workforce well-being. The COVID-19 pandemic exacerbated and illuminated long-standing problems in health care including workforce shortages, inequity in health care delivery outcomes, care provider burnout, and overall societal structural racism.1,2 The Beryl Institute’s Nursing Executive Council (NEC) manuscript Rebuilding a Foundation of Trust: A Call to Action in Creating a Safe Environment for Everyone3 focused on actions and behaviours to heal relationships and build trust between care providers and leaders with commitments to safety, empathy, shared decision …
Unit-Based Onboarding Program For New Graduates On A Medical-Surgical Unit, Racquel A. Brewster
Unit-Based Onboarding Program For New Graduates On A Medical-Surgical Unit, Racquel A. Brewster
Electronic Theses and Dissertations
Nurse turnover is prevalent among new graduate nurses. Many new graduate nurses feel unsupported by their peers, lack self-confidence, or feel overburdened due to the workload assigned to them. New graduate nurses with support systems are more likely to stay with an organization. Research suggests the creation of a supportive environment for new graduate nurses to help increase nurse retention in this demographic. A unit-based transition onboarding program was launched to create a supportive environment to help retain new graduate nurses on a medical-surgical unit. New graduate nurses with at least 1 to 3 years of experience completed a Likert-type …
From Crisis Management To Multi-Level Interinstitutional Partnerships: Development Of The Southeastern Conference Deans Nursing Coalition, Jeannette O. Andrews, Victoria Niederhauser, Julie Sanford, Suzanne Prevost, Demetrius Porche, Janie Heath, Pamela Jeffries, Nancy Fahrenwald
From Crisis Management To Multi-Level Interinstitutional Partnerships: Development Of The Southeastern Conference Deans Nursing Coalition, Jeannette O. Andrews, Victoria Niederhauser, Julie Sanford, Suzanne Prevost, Demetrius Porche, Janie Heath, Pamela Jeffries, Nancy Fahrenwald
School of Nursing Faculty Publications
The Southeastern Conference (SEC) Nursing Dean's Coalition is a purposeful alliance organized to collaboratively address several challenges that arose during the COVID-19 pandemic. Over the last three years, this strategic team of academic leaders has evolved from a crisis response team to a multidimensional support team, leveraging both individual and collective strengths, to provide several benefits to the dean members, as well as other SEC nursing faculty members, students, and institutions. Participation has grown from the original 12 deans to engage a broader team of associate deans and nurse leaders in faculty development, research, service, and diversity, equity, and inclusion. …
Effects Of Leadership Education And Mentoring For Assistant Nurse Managers, Karen T. Descent
Effects Of Leadership Education And Mentoring For Assistant Nurse Managers, Karen T. Descent
Doctor of Nursing Practice (DNP) Projects
Background: Nurse manager knowledge and leadership styles influence quality of care, patient satisfaction, staff engagement, and retention. Dissatisfaction with the assistant nurse manager (ANM) role can lead to high job turnover with negative influences on patient satisfaction, quality of care, workforce engagement, and achievement of organizational goals.
Local Problem: Two hospitals and one free-standing ambulatory surgery unit of a large integrated healthcare organization experienced high ANM turnover due to role dissatisfaction, ANM frustration with low-quality care in the units they oversaw, and patient satisfaction metrics below the 65th percentile. The regional healthcare system leadership team recognized the need to increase …
Implementing Ethics Education For Nurse Managers, Mona L. Lateyice, Rachel E. Marzec
Implementing Ethics Education For Nurse Managers, Mona L. Lateyice, Rachel E. Marzec
Doctor of Nursing Practice Scholarly Projects
Background: Every day, nurses are faced with making decisions for patient care and may come across complicated ethical decisions. Ethical practice is essential in every health care organization in providing care and how they conduct themselves (ANA, 2015). Nurse managers are responsible for ensuring ethical standards are met by nursing staff.
Problem: Nurse managers are faced with ethical problems more than fifty percent of their work time (Aitamaa, 2019). There are studies that show nurse managers and nurses have difficulty solving ethical problems because they lack understanding of ethical principles (Huang, et al., 2020). Evidence shows nurses are deficient in …
Go Forth With Wisdom & Leadership, Kristen Montgomery
Go Forth With Wisdom & Leadership, Kristen Montgomery
Epsilon Sigma at-Large Research Conference
see attached pp
Building Organizational Learning Capacity: A Road Map For Nurse Executives, Bret Lyman, Marie M. Prothero, Joy Parchment
Building Organizational Learning Capacity: A Road Map For Nurse Executives, Bret Lyman, Marie M. Prothero, Joy Parchment
Faculty Publications
The purpose of this article is to guide nurse executives in building learning capacity within their organizations. The Organizational Learning Road Map provided is grounded in the American Organization for Nursing Leadership’s Nurse Leader Core Competencies. Key steps include: developing one’s self as a learning leader, sharing a learning-focused vision for the organization, establishing a culture of learning, charting a course toward becoming a learning organization, developing a leadership team to support learning throughout the organization, measuring progress toward the vision, and sustaining momentum.
Facilitating Staff Education To Improve Effective Styles Of Nursing Leadership In An Orientation Setting, Tammy Melinda Finney
Facilitating Staff Education To Improve Effective Styles Of Nursing Leadership In An Orientation Setting, Tammy Melinda Finney
Walden Dissertations and Doctoral Studies
Nursing leadership is the cornerstone of the ever-changing landscape of healthcare. Minimal courses are included in nursing curriculums to prepare nurses to become proficient and develop knowledge of nursing leadership styles. There is a direct correlation of evidence-based leadership styles that impact effective communication, improved patient outcomes, succession planning, nursing retention, and relationship management. In an effort to bridge the gap of knowledge, an educational face-to-face training was developed and presented to new nursing staff in an orientation setting. The project practice question focused on commitment from nursing staff to implement increased knowledge of nursing leadership styles into their practice. …
Facilitating Staff Education To Improve Effective Styles Of Nursing Leadership In An Orientation Setting, Tammy Melinda Finney
Facilitating Staff Education To Improve Effective Styles Of Nursing Leadership In An Orientation Setting, Tammy Melinda Finney
Walden Dissertations and Doctoral Studies
Nursing leadership is the cornerstone of the ever-changing landscape of healthcare. Minimal courses are included in nursing curriculums to prepare nurses to become proficient and develop knowledge of nursing leadership styles. There is a direct correlation of evidence-based leadership styles that impact effective communication, improved patient outcomes, succession planning, nursing retention, and relationship management. In an effort to bridge the gap of knowledge, an educational face-to-face training was developed and presented to new nursing staff in an orientation setting. The project practice question focused on commitment from nursing staff to implement increased knowledge of nursing leadership styles into their practice. …
The Heart And Soul Of Engagement In The Float Pool Team, Kymberly Dexter
The Heart And Soul Of Engagement In The Float Pool Team, Kymberly Dexter
Master's Projects and Capstones
Problem: The assistant nurse manager (ANM) role is considered an entry-level management position and is not intended as a permanent career role. The unintended consequence is that there is a high rate of organizational turnover, making it challenging to build and retain a solid, cohesive, and productive team.
Context: A new manager of a float pool team in a 166-bed community hospital found that with little financial investment, a significant impact is made by holding a safe space for listening to the ANM team and designing education and training around what is most important to frontline managers.
Interventions: A baseline …
Leading With Emotional Intelligence In Perioperative Nursing: An Integrative Review, Elise Rhodes, Paula Foran
Leading With Emotional Intelligence In Perioperative Nursing: An Integrative Review, Elise Rhodes, Paula Foran
Journal of Perioperative Nursing
Background: Emotional intelligence has increasingly become synonymous with effective leaders within successful organisations. The perioperative environment is a complex setting within an organisation that requires nurse leaders to possess self-awareness that allows them to understand and control their emotions while using this insight to benefit others. Perioperative nurse leaders can use their emotional intelligence to manage conflict, negotiate between multidisciplinary team members, motivate staff to provide high level safe patient care and promote a positive work culture that can increase staff retention.
Review methods: A literature search of databases of CINAHL, Pubmed, Medline and Scopus was conducted to extract qualitative, …
Teamwork That Affects Outcomes: A Method To Enhance Team Ownership, Brian Carlson, Richelle Graham, Brad Stinson, Jordan Larocca
Teamwork That Affects Outcomes: A Method To Enhance Team Ownership, Brian Carlson, Richelle Graham, Brad Stinson, Jordan Larocca
Patient Experience Journal
Healthcare is the ultimate team sport, and this case study explores how to build teamwork across teams. The ability for nursing, environmental services and food and nutrition services to work collaboratively to benefit patients is paramount to a patients experience and outcomes. The case study describes how the work was done to build teams and then improved outcomes in both patient and employee experiences. The learnings are applicable to any team setting not just those described in this case study.
Experience Framework
This article is associated with the Staff & Provider Engagement lens of The Beryl Institute Experience Framework ( …
Hidden Relationships: Perspectives On Leadership And Management In Afghan Maternity Services - An Ethnographic Exploration, Rachel Arnold, Edwin Van Teijlingen, Kath Ryan, Immy Holloway
Hidden Relationships: Perspectives On Leadership And Management In Afghan Maternity Services - An Ethnographic Exploration, Rachel Arnold, Edwin Van Teijlingen, Kath Ryan, Immy Holloway
Journal of Asian Midwives (JAM)
Introduction: Health system leaders have a vital role to play in ensuring the delivery of high-quality care. Improving the quality of healthcare, particularly in low-income countries often focuses on the performance of healthcare providers and the availability, acceptability, and uptake of services. The role that health service leaders play in facilitating effective care has received less attention in the literature. This study explored the perspectives of Afghan maternity care providers, managers and other stakeholders on leadership and the provision of quality maternity care.
Methods: This ethnographic study used semi-structured interviews, participant observation, and background interviews for data collection. …
The Development Of Evidence-Based Practice Mentors Through A Competency-Based Educational Program: A Leadership Perspective, Laura C. Moore, Tracy L. Brewer, Pamela Hardesty, Diana Burdick
The Development Of Evidence-Based Practice Mentors Through A Competency-Based Educational Program: A Leadership Perspective, Laura C. Moore, Tracy L. Brewer, Pamela Hardesty, Diana Burdick
Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)
One of the most productive strategies to achieving the safest, high-quality patient care is promoting the widespread use of evidence-based practice (EBP) in clinical settings. Despite the considerable emphasis and support for EBP, many clinicians still fail to translate current research into clinical practice. To address the pervasive lack of EBP among clinicians, an EBP project was developed at an acute care pediatric facility to increase EBP utilization via the implementation of a virtual EBP educational program. The findings from this project describe the establishment of an EBP educational program with the intent to create a critical mass of EBP …
The Impact Of Covid-19 On Nurse Leadership Characteristics, Karen Fowler, Leslie K. Robbins
The Impact Of Covid-19 On Nurse Leadership Characteristics, Karen Fowler, Leslie K. Robbins
Nursing Faculty Publications
Background: Nurse leaders are vital for improving nursing efficiencies and the quality of care that they provide during a crisis and its aftermath. The value of positive leadership characteristics has never been more critical than during the COVID-19 pandemic. Functioning in a crisis mode required nurse leaders to demonstrate the necessary skills for clear communication and solid leadership. Therefore, nursing leadership, especially in emergencies such as the COVID-19 pandemic, needs to be transformative in the sense that leaders are informational, motivating, and able to advance the organization, notwithstanding a global pandemic. Timely leadership research during and after COVID-19 is crucial …
Factors Contributing To Nurse Burnout In Oncology, Caroline Withers
Factors Contributing To Nurse Burnout In Oncology, Caroline Withers
The Eleanor Mann School of Nursing Undergraduate Honors Theses
Nurse burnout is a pressing concern for healthcare with significant implications for all areas of nursing and patient outcomes. However, the specialty of oncology experiences burnout differently than other specialties for a multitude of reasons. This literature review aims to determine factors that contribute to nurse burnout within oncology, and identify evidence-based prevention strategies. The twenty studies included in the review underscore the crucial role of management and leadership in the prevention of nurse burnout. Further education and research are needed to better understand causes of burnout, as well as proper interventions. Interventions need to be established on a hospital …
The Effects Of A Formal Organizational Program On Nursing Supervisor Self-Perception Of Leadership, Jonathan Allen Judy-Del Rosario
The Effects Of A Formal Organizational Program On Nursing Supervisor Self-Perception Of Leadership, Jonathan Allen Judy-Del Rosario
Doctor of Nursing Practice Scholarly Projects
Nursing house supervisors oversee hospital operations during evenings, nights, weekends, and holidays, yet many feel disconnected from others in the nursing leadership team. These individuals work as the sole leader on duty, having limited interaction with the daytime leaders and often lack formal leadership development. This quantitative, quasi-experimental study explored the effects of implementing a formal educational and team building program on the perception of the supervisor’s leadership skills as well as collaboration with the leadership team. The Leadership Practices Inventory and the Collaborative Behavior Scale – Shortened were the two surveys administered to assess the effects of this program. …
When "First, Do No Harm" Fails: A Restorative Justice Approach To Workgroup Harms In Healthcare, Pedro L. Flores
When "First, Do No Harm" Fails: A Restorative Justice Approach To Workgroup Harms In Healthcare, Pedro L. Flores
Dissertations
In healthcare, workgroup mistreatment is a pervasive problem that begins during medical education (medical and nursing school) and becomes embedded in the “hidden curriculum of professionalism,” which dissuades and even punishes learners for talking about abuse they witness. Furthermore, the mistreatment of healthcare providers (HCPs) pervades all disciplines in the healthcare delivery chain due to a combination of cultural factors, systemic pressures, dysfunctional hierarchies, and leadership’s tolerance of intimidating and disruptive behaviors. Not surprisingly, 18% of U.S. HCPs have left the medical field since the start of the COVID-19 pandemic, and burnout, stress, anxiety, and increased workloads have been identified …
The Impact Of A Formal Leadership Development Program On Charge Nurse Leadership Competencies: An Integrative Review, Ellen Mae Hudson
The Impact Of A Formal Leadership Development Program On Charge Nurse Leadership Competencies: An Integrative Review, Ellen Mae Hudson
Doctoral Dissertations and Projects
This integrative review focuses on the current body of evidence for charge nurse leadership development (CNLD). It identifies common skills and competencies, provides a synthesis of existing training practices, and identifies gaps in the evidence. A thorough literature search of electronic databases and reference lists was completed, resulting in the identification of 22 studies published between 2011 and 2020. Data from the selected studies were evaluated and categorized into common themes; virtually all reported positive outcomes for the charge nurse development program implemented. Two of the studies reviewed were integrative reviews that compared identified themes and methodologies. Four studies were …
Impact Of Emotional Intelligence On Interprofessional Teamwork, Interprofessional Communication, And Interprofessional Leadership, Kathleen M. Cox
Impact Of Emotional Intelligence On Interprofessional Teamwork, Interprofessional Communication, And Interprofessional Leadership, Kathleen M. Cox
Nursing Theses and Dissertations
Objective: The purpose of this body of work was to explore relationships among emotional intelligence (EI) and interprofessional (IP) competency domains to enhance IP team dynamics and communication.
Background: Decentralization of healthcare delivery may hinder effective handoffs creating opportunity for miscommunication of vital information and subsequent medical errors. Fostering effective communication is paramount for IP teams; however, differing communication styles can promote misunderstanding and conflict. Behavioral aspects of team dynamics and communication that comprise EI may be a solution but are rarely addressed in educational and safety programs.
Methods: Included in this portfolio are three manuscripts that help elucidate …
Lived Experiences Of Nurse Leaders, Catherine Jeannette Mohammed
Lived Experiences Of Nurse Leaders, Catherine Jeannette Mohammed
Walden Dissertations and Doctoral Studies
AbstractThe National Academy of Medicine (NAM) has called for more leadership, more accountability, and increased education and training of health care leaders. The NAM has demanded that nurses participate in health care policy making, increase their knowledge of research and data collection, advise leaders across the business world, train and educate seamlessly, and practice to the full extent of their licensure. The purpose of this qualitative phenomenological study was to explore the lived experiences of 12 influential nurse leaders from the state of Arizona. Transformational leadership theory provided the framework for the study. Semi-structured interview data were transcribed, coded, and …
Evaluation Of Action Plan Management Strategy To Improve Survey Readiness And Decrease Negative Accreditation Findings, Carla Pierson
Evaluation Of Action Plan Management Strategy To Improve Survey Readiness And Decrease Negative Accreditation Findings, Carla Pierson
Walden Dissertations and Doctoral Studies
This project was an evaluation of a quality improvement (QI) initiative conducted in a large medical enterprise to address the problem of poor performance of their hospitals in accreditation surveys. The desired outcome was to evaluate whether an innovative plan of correction process was impactful in reducing the negative outcomes of regulatory and accreditation surveys. The practice-focused question guiding this project addressed the effect of the pre-accreditation evaluation and a plan of correction process in this QI initiative on reducing requirements for improvement (RFI) and condition-level deficiencies (CLD) cited in a recent The Joint Commission survey review. This project was …
Leadership Styles And Rn Turnover Intentions In Long-Term Care Facilities, Kelli M. Casey
Leadership Styles And Rn Turnover Intentions In Long-Term Care Facilities, Kelli M. Casey
Walden Dissertations and Doctoral Studies
Employee turnover is a concern for leaders in the nursing home industry because employees with turnover intentions may negatively impact the continuity of operations and strategic plans, resulting in poor quality of care for residents. Grounded in House's path-goal theory, the purpose of this quantitative, correlational study was to examine the relationship among idealized attributes, idealized behaviors, inspirational motivation, intellectual stimulation, individualized consideration, contingent reward, management by exception-active management by exception-passive, and turnover intentions in RNs. The independent variables were the subcategories of transformational and transactional leadership. The dependent variable was turnover intentions. Participants included 110 nonmanagement RNs working in …