Organizational Climate, Ethical Work Environment, and Turnover Intentions Among Healthcare Workers in a Romanian Chronic Care Hospital: A Multidimensional Analysis

TL;DR

This study explores how workplace environment and job satisfaction affect healthcare workers' intentions to leave a Romanian chronic care hospital.

Contribution

The study provides new insights into the relationship between ethical work environment, job satisfaction, and turnover intentions in a specific healthcare context.

Findings

Job satisfaction and ethical work environment are inversely associated with turnover intention.

Nursing and auxiliary staff show higher turnover intentions compared to physicians.

Job satisfaction partially mediates the link between ethical work environment and turnover intention.

Abstract

Background: Turnover intention among healthcare workers represents a growing challenge for chronic care institutions, particularly in resource-constrained healthcare systems. Organizational and ethical factors have been increasingly recognized as relevant correlates of workforce retention. Methods: This exploratory cross-sectional study was conducted in a Romanian chronic care hospital between January 2023 and September 2024. A total of 62 healthcare workers were included using a census-based recruitment approach. Organizational climate, ethical work environment, job satisfaction, and turnover intention were assessed using adapted and composite self-report measures. Correlation, multivariate regression, and exploratory mediation analyses were performed. Results: Job satisfaction and ethical work environment were inversely associated with turnover intention in both correlation and multivariate analyses. Organizational climate did not retain an independent association with turnover intention after adjustment. Exploratory mediation analysis suggested that job satisfaction may partially account for the association between an ethical work environment and turnover intention. Higher turnover intention and less favorable organizational perceptions were observed among nursing and auxiliary healthcare staff compared to physicians. Conclusions: The findings suggest that organizational and ethical conditions, particularly those influencing job satisfaction, are relevant correlates of turnover intention in chronic care settings. Given the exploratory design and limited sample size, these results should be interpreted cautiously. Organizational strategies targeting ethical practices and everyday work satisfaction may represent feasible approaches to workforce retention in similar healthcare contexts.