The effects of emotional exhaustion and resilience on the relationship between the practice environment and turnover intentions among acute care nurses: A moderated mediation analysis
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Nursing shortage is a complex national crisis compounded by high turnover of qualified nurses, particularly during and in the post-pandemic period. Objectives: To examine the effects of emotional exhaustion and resilience on the relationship between the practice environment and turnover intentions among acute care nurses. Design: Cross-sectional descriptive online survey study. Setting s: Acute care hospital settings in the United States. Participants: A total of 240 acute care nurses were recruited between October 2023 and April 2024. Methods: Participants completed four validated instruments: Practice Environment Scale-Nursing Work Index, Workplace Resilience Scale, Maslach Burnout Inventory-Human Service Survey for emotional exhaustion, and Anticipated Turnover Scale. Data were analyzed using moderated mediation regressions with Hayes' PROCESS macro in SPSS version 28.0. Results: = .015), such that the association was stronger among nurses with lower resilience. The model explained 30% of the variance in turnover intentions. Conclusions: Emotional exhaustion is a central mechanism linking practice environment conditions to turnover intentions. Resilience functions as a preventative moderator, buffering the impact of practice environment on emotional exhaustion. Implications for clinical practice: The findings support multilevel strategies that address both work conditions and resilience to promote retention among acute care nurses.
Authors: Elizabeth H. Fraser, Lingling Zhang, Anna E.Schierberl Scherr, Sun S. Kim
Language: English
Subfield: Research and Theory
Field: Nursing
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,930
OpenAlex ID: W7136197092