NURS 623 Week 6 Discussion Board Forum 2 on Organizational Culture and Nurse Retention Example

Discussion Board Forum 2: Organizational Culture as a Retention Strategy

NURS 623 Nursing Administration I: The Role of the Nurse Administrator, Discussion Board Forum 2

Thread by [Student Name]

The unit, the nurses and the classmates replied to are composites written for a model discussion.

Last spring, the medical intensive care unit at my practicum hospital received a market adjustment that raised nurses' base pay by about eight percent. Over the next twelve months, it still lost six experienced nurses, roughly a fifth of its core staff. Exit interviews mentioned pay only twice. More often, they mentioned schedules posted late and changed without notice, a manager who was rarely on the unit, and a feeling that whatever staff said at monthly meetings disappeared without a reply. My argument in this thread is that organizational culture is the nurse administrator's most powerful retention tool, because nurses decide whether to stay based on how work feels day after day, and pay cannot compensate for a culture that wears them down.

Roussel (2018) defines organizational culture as the values, beliefs and unwritten norms a workforce holds in common, which steer daily conduct even when nobody states them. Culture is visible in small practices: who gets the holiday off, whether a nurse who raises a safety concern is thanked or labeled difficult, and whether leaders keep their promises.

Recent evidence links culture to retention directly. In a cross-sectional study, Alalyani et al. (2026) surveyed 355 registered nurses in five public hospitals and found that workplace culture was positively correlated with intent to stay and negatively correlated with burnout. In their structural model, culture had a strong direct effect on intent to stay, and burnout carried a smaller part of the effect, so culture appeared to keep nurses both directly and by reducing exhaustion. The model explained about 39% of the variance in intent to stay. A single-time-point survey like this one cannot prove that improving culture will raise retention, but the size of the association is hard to ignore. If nearly two-fifths of the variation in nurses' plans to stay tracks with culture, then culture is not background; it is the main event.

Qualitative research shows what supportive culture looks like to nurses. Johnson et al. (2026) interviewed 12 nurses who had returned to work after maternity leave and found that flexibility, emotionally intelligent and supportive managers, and a positive workplace culture made them more likely to stay, while rigid rosters, poor managerial support and gaps between written policy and actual practice pushed them toward leaving. That gap between policy and practice is exactly what the ICU exit interviews described.

Three administrative moves follow. First, measure culture regularly with a validated survey and share the results with staff, so culture becomes something leaders track rather than assume. Second, fix scheduling: post schedules on time, limit last-minute changes and allow self-scheduling where possible. Third, invest in managers, since staff experience the organization's culture mostly through the person who leads their unit. On the ICU, that would mean a manager who rounds on both shifts each week, answers every staff meeting concern in writing within a month, and is evaluated partly on whether nurses stay.

Paul instructed believers to clothe themselves with "compassion, kindness, humility, meekness, and patience" (English Standard Version Bible, 2001/2016, Colossians 3:12). A unit culture built on those qualities is one that nurses would choose to stay in, and building it is part of the administrator's calling.

Reply to Marcus

Marcus, you made a strong case that pay still matters and that hospitals cannot culture their way out of uncompetitive wages, and I agree that culture and compensation work together rather than as alternatives. Recent evidence suggests a way to connect them. In a survey of 141 nurses in two hospitals, Shaqiqi (2026) found that nearly half reported a high intention to leave, that perceived organizational support and job satisfaction were both negatively correlated with turnover intention, and that job satisfaction partly mediated the effect of organizational support. Pay is one signal of organizational support, but so is a manager who listens or a schedule that respects family life. If nurses read support from many signals, then a raise without the other signals may produce less loyalty than leaders expect, which is what happened on the ICU I described. I would put it this way: fair pay keeps nurses from leaving for a competitor, but culture keeps them from leaving at all. Proverbs 3:27 tells us, "Do not withhold good from those to whom it is due, when it is in your power to do it" (English Standard Version Bible, 2001/2016), and that applies both to wages and to respect. In your hospital, when wages were last adjusted, did leaders also ask staff what else would make them stay? I suspect the answers would point to scheduling and management more than to money, and gathering them before the next budget cycle could help leaders spend the next retention dollar far more wisely.

Reply to Dana

Dana, your point that new graduates leave in their first year at much higher rates than experienced nurses deserves more attention, because it suggests that culture is felt most sharply by those who are newest to it. The study of nurses returning from maternity leave adds a related insight. Johnson et al. (2026) found that nurses in a transition, in that case back to work after having a child, were especially sensitive to whether policies were applied in practice and whether their managers were flexible and understanding. New graduates are also in a transition, and they may read the culture of a unit from the way they are treated in their first weeks. If a preceptor is overloaded, if the schedule ignores the orientation plan, or if questions are met with impatience, a new graduate learns quickly what the unit values. That suggests one practical step for administrators: treat transitions, whether a new graduate's first year, a return from leave or a move between units, as moments when retention is decided, and give managers time and tools to support people through them. Paul urged believers to "encourage one another" and to build each other up (English Standard Version Bible, 2001/2016, 1 Thessalonians 5:11). How does your unit currently protect preceptors' time, so they can actually build up the new graduates they are assigned? Even a modest reduction in a preceptor's patient load during the first month could change how a new nurse experiences the unit's culture and whether that nurse is still there a year later.

References

Alalyani, M., Buta, J., Areola, B., Aldughmi, O. N., Jacinto-Caspillo, I., Shanmugam, S. R., Maestrado, R., Dominguez, A. J., Gonzales, A., Alatawi, N. A. H., Mostoles, R., Alalawi, R. H., & Pasay An, E. (2026). The mediating effect of burnout on the relationship between workplace culture and intent to stay among registered nurses in Saudi Arabia. PLOS ONE, 21(6), Article e0352383. https://doi.org/10.1371/journal.pone.0352383

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Johnson, E., Kosiol, J., & Elder, E. (2026). Returning to work after maternity leave: A qualitative study of nurses' experiences and factors influencing their retention. Nursing Open, 13(6), Article e70654. https://doi.org/10.1002/nop2.70654

Roussel, L. (2018). Management and leadership for nurse administrators (8th ed.). Jones & Bartlett Learning.

Shaqiqi, W. (2026). The mediating role of job satisfaction in the relationship between perceived organizational support and nurses' turnover intentions. Journal of Nursing Management, 2026(1), Article e2960879. https://doi.org/10.1155/jonm/2960879