Leadership Style and Job Satisfaction on Retention among Nurses in A Healthcare Facility

Leadership Style and Job Satisfaction on Retention among Nurses in A Healthcare Facility

Chato, Arbel O.

Master of Arts in Nursing Management Student, University of the Visayas, College of Allied Health Sciences, Philippines

DOI: https://doi.org/10.51244/IJRSI.2024.1110037

Received: 22 June 2024; Revised: 14 October 2024; Accepted: 17 October 2024; Published: 14 November 2024

ABSTRACT

Nursing organizations must keep their nurse workforce intact to maintain a strong nursing workforce. In Cebu City Health Department, nurse retention presents a significant challenge that impacts both patient care and the stability of healthcare systems. This study, conducted during the second quarter of 2024, employed a quantitative, descriptive-correlational research design to examine how leadership styles and job satisfaction affect nurse retention in healthcare facilities. As such, this study investigated the effect of leadership style and job satisfaction on nurse retention in healthcare facilities during the Second Quarter of 2024. The statistical analysis revealed a significant relationship between leadership style and nurse retention, with an R-value of 0.5068 (p-value = 0.00), indicating that effective leadership strongly influences nurses’ decisions to stay. Additionally, job satisfaction also plays a crucial role, as evidenced by an R-value of 0.2133 (p-value = 0.0274), demonstrating that higher job satisfaction contributes to better nurse retention. Therefore, both leadership style and job satisfaction are key factors in retaining nurses. To increase Nurse Retention rates, healthcare Organizations should improve working conditions, create reward programs, such as recognition programs, allow flexible work arrangements, invest in leadership development, ensure regular feedback, and encourage employee communication. Thus, they should create supportive workplaces where everyone feels involved.

Keywords: Nurse retention, Healthcare facilities, Job Satisfaction, Cebu City

INTRODUCTION

Nurse retention is crucial for maintaining a strong and effective nursing workforce within healthcare organizations. Retaining skilled nurses ensures continuity and quality of patient care, as experienced nurses are familiar with their patients and workplace procedures and possess advanced clinical skills. High nurse turnover can disrupt patient care and escalate the costs associated with recruiting, hiring, and training new staff. Therefore, strategies to enhance nurse retention are essential for both organizational stability and patient outcomes.

Leadership style plays a significant role in creating a positive work environment that supports nurse retention. Transformational leaders, who inspire and motivate their teams, often foster an environment of personal and professional growth. Their ability to build strong relationships and create a supportive atmosphere can lead to higher job satisfaction and increased loyalty among nurses. In contrast, transactional leadership, which focuses primarily on tasks, rewards, and penalties, may not effectively support a nurturing work environment. This approach can result in a more rigid and less supportive atmosphere, potentially contributing to higher nurse turnover.

Job satisfaction among nurses is influenced by various factors, including work environment, interpersonal dynamics, role clarity, and overall job perception. Leaders who address both deep-seated and surface-level factors impacting job satisfaction are more likely to retain their staff. Allowing nurses to have input into their roles and decisions can empower them and enhance their job satisfaction, leading to greater retention. When nurses perceive their leaders as fair, engaged, and responsive to their needs, they are more likely to remain committed to their organization.

The interplay between leadership style and job satisfaction significantly affects nurse retention. Nurses who perceive their leaders as supportive and empowering are more likely to experience higher job satisfaction, which in turn reduces turnover intentions (Boamah et al., 2018). Effective leadership can create a work environment where nurses feel appreciated and empowered, leading to increased job satisfaction. This positive environment helps to foster a sense of belonging and commitment to the organization. On the other hand, poor leadership can result in low job satisfaction, leading to higher turnover rates. Therefore, leadership style is a critical determinant of job satisfaction and, consequently, nurse retention.

Healthcare facilities in Cebu City are confronted by the act of keeping their nursing staff, which is a significant problem. This means that such medical centers must have highly skilled and committed nurses due to the dynamism and complexity of the healthcare environment in this urban center. Nonetheless, the attrition rate among them remains a disturbing issue that has far-reaching effects on patient care and healthcare system stability. In itself, nursing is an inherently challenging and stressful occupation depicting an interweaving of intricate care delivery, emotional labor, and continuous professional development mandates. The healthcare facility in Cebu City can maintain a constant stream of nurses since they are creating an employment base that can meet society’s demand for good medical treatment instead of filling a job gap.

There is a lack of research specific to the Cebu City Health Department most studies focus on either leadership style or job satisfaction in isolation rather than examining their combined effect on nurse retention. This study aims to fill these gaps by exploring these factors within the local context and their synergistic impact on nurse retention. This research holds significant practical value for nursing management by identifying effective leadership styles and key factors contributing to job satisfaction, enabling healthcare administrators to develop targeted strategies to improve nurse retention and maintain a stable nursing workforce.

This study aligns with Sustainable Development Goal #3: Good Health and Well-being. Ensuring the retention of skilled nurses is vital for achieving universal health coverage and improving health outcomes. A stable nursing workforce enhances the quality of care, reduces patient mortality, and promotes overall health system efficiency. This research contributes to the broader goal of strengthening healthcare systems by addressing leadership style and job satisfaction

The relationship between leadership style, job satisfaction, and retention among healthcare professionals is crucial within the Cebu City Health Department (CCHD). This can lead to potential challenges if the leadership styles used in the department do not match the needs and expectations of personnel. Employee dissatisfaction and low morale due to autocratic or unsupportive leadership could cause high turnover rates. On the other hand, when leaders are transparent, sympathetic, and inviting, it helps create an inclusive atmosphere at work that makes workers feel important, leading them to stay longer in their jobs. In addition, Cebu City Health Department healthcare professionals’ job satisfaction is influenced by workload, remuneration packages offered, opportunities for career advancement, and personal life maintenance. These concerns will require a range of measures, such as creating a caring work environment for committed leaders in administration and implementing policies prioritizing employee welfare and development programs like training opportunities for future promotions. Consequently, the Cebu City Health Department can improve its talent retention rates within its jurisdiction, ensuring quality healthcare delivery for people’s well-being.

This study allows the nursing service administration to make data-informed decisions and implement evidence-based practices that positively impact employee retention. In addition, the study can also help the nursing service administration identify areas where improvement is needed in terms of leadership practices and the work environment. Identifying and addressing these areas can improve retention rates, organizational effectiveness, and patient care. This knowledge can be used to develop strategies and interventions to improve retention rates, enhance the work environment, and ultimately contribute to better patient care.

Theoretical Framework

This study isnchored to several theorists to help explain the relationship between leadership style, job satisfaction, and retention. Leadership Theory by Kurt Lewis (1939). Leadership styles are classified into three categories: autocratic, democratic, and laissez-faire. Autocratic leaders make decisions without input from the group members, establish clear expectations, and dictate all the activities and processes. This style can be efficient but may lead to lower group member satisfaction. Democratic leaders involve group members in the decision-making process, encourage discussion, and take the group’s opinions into account. These are leaders who do not get significantly involved but let leadership from the group take over making choices. At the same time, this may grow a more robust sense. Lewin’s theory has been widely influential in the study of leadership. It provides a framework for understanding different leadership styles and their potential impact on a group’s functioning and outcomes, including member satisfaction and effectiveness Two-Factor Theory by Frederick Herzberg (1959). The two-factor theory addresses job satisfaction and provides insights into how job satisfaction can influence employee retention. Herzberg proposed that there were factors that, when identified, would motivate employees to do well, known as the motivators (factors leading to satisfaction and thus motivation) such as achievement and recognition, among others; Herzberg also found factors that led only to dissatisfaction if not present, but merely prevented from causing unhappiness in work, called hygiene factors (reducing dissatisfaction), such as company policy and supervision. Equity Theory by J. Stacy Adams (1963). It posits that employees are motivated to stay with an organization when they perceive fairness in their treatment, particularly compared to their co-workers. Employees assess what they put into their work (input) and what they receive in return (outcome). They may feel less satisfied and consider leaving if they perceive an imbalance.

Incorporating Kurt Lewin’s leadership theory allows one to examine nurse work satisfaction and retention in healthcare institutions. Lewin’s three identified leadership styles are autocratic, democratic, and laissez-faire. Democratic leadership generally involves group participation, which leads to autonomy and respect among nurses that may improve job satisfaction. On the other hand, an autocratic approach might be dissatisfying if it limits nurses’ professionalism, autonomy, and input. Lack of support or direction from laissez-faire leaders can make nurses feel dissatisfied with their jobs when they lack clarity or purpose. This study will find out how different leadership philosophies directly impinge on nursing environments through this theory, for it will consider intricate dynamics harboring employee retention and job satisfaction issues. Herzberg’s Two-Factor Theory and Equity Theory provide additional insight into the motivational factors of job satisfaction. According to Herzberg, genuine job satisfaction springs from intrinsic aspects such as accomplishment, recognition, and professional growth closely related to leadership behavior. Thus, when nurses feel managers recognize their input and promote their professional growth, they become more satisfied with their jobs, and many retain them. Alternatively, as proposed by Equity Theory, nurses may evaluate their job satisfaction based on whether their work rewards seem fair compared to the exchange received for what others do; hence, if a leadership approach that promotes equality by acknowledging individual contributions and promoting an ethical working environment has the potential to influence job satisfaction and nurse retention considerably. The thesis will examine these theories as they relate to what keeps nurses interested and motivated in their roles, or more precisely, how nursing leadership influences the retention decision-making process of whether a nurse remains within a healthcare organization.

Figure 1. Schematic Diagram of the study utilizing the Leadership Theory of Kurt Lewis (1939) Equity Theory of J. Stacy Adams (1963) and Two-Factor Theory by Frederick Herzberg

Figure 1 presents the schematic diagram of the study, which includes two independent and dependent variables. The independent variable is the leadership style among nurses in a healthcare facility and the job satisfaction among nurses in a healthcare facility. In contrast, the dependent variable is the key factors among nurses and their retention in a healthcare facility. The single-headed arrow connecting the two variables will determine their relationship. The research paradigm presented above was also adopted to guide the flow of the study. The output box indicates the output of the study in the form of a retention plan.

Statement of the Problem

The study determined the relationship between leadership style and job satisfaction and their impact on nurse retention in Cebu City healthcare facilities during the second quarter of 2024.

1. What are the leadership styles among nurses in healthcare facilities in terms of:

1.1 authoritative style;

1.2 democratic style; and

1.3 laissez-faire?

2. What is the job satisfaction among the nurses in health care facilities on the following dimensions:

2.1 teamwork;

2.2 leadership;

2.3 rewards and recognition;

2.4 empowerment and participation;

2.5 Training and Individual Development;

2.6 Working hours; and

2.7 Communication?

3. What is the retention of nurses in the health care facility?

4. Is there a significant relationship between:

4.1 leadership style and retention of nurses?

4.2 job satisfaction and retention of nurses?

Statement of Null Hypotheses

Ho1:    There is no significant relationship between leadership style and retention.

Ho2:    There is no significant relationship between job satisfaction and retention.

Significance of the Study

Multiple stakeholders in healthcare institutions have much to learn from the impact of different leadership styles and job satisfaction on nurse retention. Consequently, these findings pave the way for management approaches that enhance working conditions, empower nurses, better patient outcomes, and shape the direction of future studies in nursing leadership.

Nurses. The study’s outcomes directly impact nurses by emphasizing leadership’s importance in job satisfaction and retention. Understanding the specific leadership behaviors and practices that contribute to positive outcomes can empower nurses to advocate for supportive leadership, seek growth opportunities, and actively shape their work environment.

Clients. Effective leadership in healthcare settings positively influences patient outcomes and experiences. When nurses are satisfied with their jobs and feel supported by their leaders, they are more likely to provide high-quality patient care, improving patient satisfaction, safety, and outcomes.

Administration. This study’s findings can provide valuable insights to hospital management regarding the importance of effective leadership in promoting job satisfaction and retention among nurses. They can help them understand the specific leadership behaviors and practices contributing to positive outcomes, enabling them to tailor their leadership development programs and policies accordingly.

Association of Nursing Service Administrators in the Philippines. The Association of Nursing Service Administrators in the Philippines (ANSAP) is a professional organization representing nursing service administrators in the Philippines. The operational definition of ANSAP is the specific activities, processes, or functions the organization undertakes to achieve its goals and fulfill its mission. This may include organizing seminars and training programs for nursing service administrators, advocating for the advancement of nursing administration in the Philippines, providing networking opportunities for its members, and contributing to developing standards and best practices in nursing service administration.

Philippine Nurses Association. The Philippine Nurses Association (PNA) is a professional organization representing nurses’ interests in the Philippines. The PNA’s operational definition refers to the specific activities, functions, and initiatives the organization undertakes to fulfill its mission and serve the needs of its members and the nursing profession.

Researchers. This study contributes to the existing knowledge on leadership, job satisfaction, and retention among nurses in government and private hospitals. It provides a foundation for further research and exploration of the topic, helping researchers uncover additional insights, develop theoretical frameworks, and inform evidence-based practices in nursing leadership.

Future Researchers. This study can contribute to and build upon the existing theoretical frameworks to explore the nuanced relationship between leadership, job satisfaction, and retention among nurses in private and public hospitals.

DEFINITION OF TERMS

The definitions of key terms related to the study on leadership style and job satisfaction on retention among nurses in a healthcare facility:

Leadership Style. This study examines how leaders’ approach and interact with their subordinates or team members. It encompasses the leader’s behaviors, attitudes, and decision-making processes that influence how they guide, motivate, and communicate with their team. Leadership style can vary greatly; leaders may prefer a particular style or exhibit a combination of styles.

Authoritative this refers to a leadership approach where the leader maintains control and authority over decision-making, sets goals and expectations, and directs subordinates with clear instructions and guidelines.

Democratic. Characterized by a leader who involves team members in the decision-making process, encourages their participation and input, and values their contribution.

Laissez-faire. Characterized by a leader who provides autonomy and freedom to team members, allowing them to make decisions and take ownership of their work with minimal interference or guidance from a leader.

Job Satisfaction. This study refers to the level of contentment, fulfillment, and positive feelings an individual experiences in their job. It encompasses various factors, including work environment, job design, work-life balance, recognition, compensation, and opportunities for growth and development.

Teamwork. Refers to the collaborative effort of a group of individuals working together to achieve a common goal. It involves mutual support, effective communication, and leveraging individual strengths to accomplish tasks.

Recognition. It refers to acknowledging and appreciating an individual or a team’s contributions, achievements, or positive behaviors within the organization. This can be done through formal or informal means.

Rewards refer to Tangible or intangible incentives provided to employees in recognition of their performance, achievements, or contributions to the organization. These can include salary increases, bonuses, promotions, or non-monetary rewards such as public acknowledgment.

Empowerment. Refers to enabling employees to own their work, make decisions, and take action independently. Empowered employees are given the authority and resources to carry out their responsibilities confidently.

Participating Decision. Refers to the decision-making process in which input and ideas from employees at various levels of the organization are actively solicited and considered before a decision is made. This approach encourages collaboration and can lead to more well-informed decisions.

Professional growth and development. Refers to expanding and improving one’s skills, knowledge, and abilities within a professional context. This can involve formal training, education, mentorship, and on-the-job learning opportunities.

Workload management. Refers to effectively allocating, prioritizing, and balancing tasks and responsibilities among employees to ensure that work is completed efficiently and without undue stress or burnout.

Communication refers to exchanging information, ideas, and messages between individuals or groups within an organization. It can encompass verbal, written, and nonverbal modes of interaction.

Retention. This study refers to the ability of an organization, in this case, a government or private hospital, to retain its nurses as employees over a certain period. It involves creating an environment that encourages nurses to stay within the organization by addressing factors contributing to turnover, such as job dissatisfaction, burnout, or lack of career advancement opportunities.

Nurse. This study refers to a healthcare professional trained and licensed to provide medical care, support, and treatment to patients. Nurses play a critical role in healthcare delivery, performing various tasks, including assessing patient needs, administering medications, providing patient education, and coordinating patient care.

Retention Plan. The plan includes various initiatives and strategies to address factors contributing to turnover, such as improving compensation and benefits, providing opportunities for growth and development, creating a positive work environment, and enhancing communication and support systems.

RESEARCH METHODOLOGY

The research design of the study, the environment, the respondents, the sampling strategy, the inclusion and exclusion criteria, the instrument, the data collection process, and the statistical analysis were all covered in this chapter.

Design

This study utilized a quantitative, descriptive-correlational research design. According to Judith Quaranta (2016), descriptive research is a study where the researcher is primarily interested in describing relationships among variables without seeking to establish a causal connection. In contrast, correlational research is a type of non-experimental research in which the researcher measures two variables and assesses the statistical relationship between them with little or no effort to control extraneous variables. The present study examines the impact of leadership style and job satisfaction on nurse retention in a healthcare institution. A quantitative approach has been chosen for this study, which collects and analyzes numerical data to understand how leadership style, job satisfaction, and retention are related. Employing this method allowed for the thorough examination of these factors about statistics that would support the study’s findings.

Environment

The study was carried out at the various barangay health centers that are part of the Cebu City Health Department in Barangay Carreta, Cebu City, which employs 107 nurses. The primary goal of the Cebu City Health Department is to provide residents with primary healthcare services in a community-oriented healthcare setting. This urban barangay’s diverse population is served by the health department, which offers services for a range of ailments, from common illnesses to primary care. It offers a setting that makes it possible to comprehend the dynamics of public health in an urban Filipino community and evaluate problems that benefit the people of Cebu City, including the distribution of resources, the effectiveness of healthcare delivery, and the welfare of nurses.

Respondents

In total, 107 nurses were involved in the study who served as respondents and investigated the link between leadership style and job satisfaction on retention at Cebu City Health Department. These people form part of professionals who provide medical services directly to the people of Cebu City. These nurses could also be engaged in activities that revolve around public health, from direct patient care to outreach and education programs, such as assisting patients upon doctor referral or acting as supportive figures during counseling sessions conducted by psychologists. As respondents, they can provide valuable information about their experiences, challenges, and perceptions of working conditions, patient care, health outcomes, the effectiveness of health programs, etc. Hence, studying them properly can shed light on how administrative policies affect their work output levels, assess whether or not there is a connection between management styles/and job satisfaction concerning employee turnover rates, identify areas where customer service could be improved upon, etc., all of which would go a long way towards making hospitals more efficient while contributing immensely towards overall quality improvement within any given hospital system. Knowledge obtained from these nurses may lead to streamlining operations in a health department for enhanced healthcare provision in general.

Inclusion and Exclusion Criteria

This study established parameters for selecting and excluding participants, ensuring that the research captured only relevant critical views and reflections within the nursing profession. The group of individuals eligible to participate in the research was defined by inclusion criteria, which outlined the specific characteristics that potential respondents needed to demonstrate. These criteria included being currently employed as registered nurses in the Cebu City Health Department and having at least six months of work experience in their current healthcare facility. Participants needed to be either full-time or part-time employees who were regularly scheduled to work, ensuring they were exposed to the leadership styles within the facility. Additionally, participants had to express willingness to take part in the study.

Conversely, the exclusion criteria delineated the characteristics or circumstances that would render individuals ineligible to participate in the study. This included excluding nurses who had worked in the facility for less than six months, as they might not have sufficient exposure to accurately assess leadership styles or job satisfaction. Agency or traveling nurses were also excluded due to potentially differing experiences within healthcare facility leadership, which could influence their retention rates differently. Additionally, individuals excluded from the study were those who had submitted termination notices, were retiring, or had left for reasons unrelated to job satisfaction or leadership style during the study period without providing valid reasons.

Establishing explicit inclusion and exclusion criteria was essential to ensure that the research participants accurately represented the target population of interest and that any insights gained applied to the objectives of the study. This approach ensured that all collected information closely related to leadership style, job satisfaction, and retention among nurses in a healthcare facility.

Instrument

By adapting standardized questionnaires, the researcher aimed to evaluate the impact of leadership behaviors and job satisfaction on nurse retention in a healthcare. The survey instrument consisted of three distinct sections: the first segment was derived from the Leadership Style Questionnaire by P. Northouse (2009), the second section was adapted from the Job Satisfaction Questionnaire (JS-Q) developed by Ahmad et al. in 2020, and the third part was the Turnover Intention Scale (TIS) by Bothma and Roodt (2013).

Part one, the Leadership Style Questionnaire, helps incoming leaders understand their preferred leadership style. The questionnaire provides three categories of leadership style (Authoritative, Democratic, and Laissez-faire), which are determined by a participant’s cumulative score. Additional descriptions of each style are also included in the questionnaire, which provides further insight into each style. This questionnaire measures three common leadership styles: authoritarian, democratic, and laissez-faire. By comparing your score, you can determine which style is most dominant and least dominant in your leadership style. Scoring: Sum the responses for items 1, 2, 6, 10, 15, and 16 (authoritarian leadership), Sum the responses for items 4, 5, 8, 11, 14, and 18 (democratic leadership), and Sum the responses on items 3, 7, 9, 12, 13, and 17 (laissez-faire leadership. You are in the very high range if your score is 26-10. You are in the high range if your score is 21-25. You are in the moderate range if your score is 16-20. You are in the low range if your score is 11-15. Moreover, you are in the shallow range if your score is 6-10.     Part two of the instrument is an adopted standard questionnaire—the Job Satisfaction Questionnaire (JS-Q) by Ahmad et al. (2020). It consists of a total of 8 domains with 34 items, namely: teamwork (5 items), leadership (4 items), reward and recognition (5 items), empowerment and participation (5 items), training and individual development (5 items), working hours (3 items), communication (4 items), and working conditions (3 items). It is answered using a 5-point Likert scale where one is strongly disagree, two is disagree, three is neither agree nor disagree, four is agree, and five is strongly agree.

Reliability. Results of the reliability testing of the JS-Q in the study revealed the following Cronbach alpha values: teamwork (.924), leadership (.930), reward and recognition (.879), empowerment and participation (.876), training and individual development (.878), working hours (.826), communication (.871), and working conditions (.751). The JS-Q is a valid and reliable study instrument for measuring job satisfaction among healthcare workers. It can also be recommended for use in several other related purposes, such as in management and research that involve an assessment of job satisfaction.

Parametric Score and Interpretation. Parametric scores and interpretation for the performance are as follows: 1.00-1.80 is very dissatisfied, 1.81-2.60 is dissatisfied, 2.61-3.40 is neither satisfied nor dissatisfied, 3.41-4.20 is satisfied, and 4.21-5.00 is very satisfied.

Part three of the instrument is an adopted standard questionnaire—Turnover Intention Scale by Bothma and Roodt (2013). It is a six-item instrument. Items 1, 3, 4, and 6 are answered using a scale of 1 to 5, where one is never, and five is always. Item 6 is reversely scored. Item 2 is answered using a scale of 1 to 5, where one is very satisfying, and five is dissatisfying. Item 5 is answered using a 1 to 5 scale, with one highly unlikely and five highly likely.

Reliability. A Cronbach alpha reliability coefficient of 0.80 has been reported for the TIS-6 (Bothma & Roodt, 2013).

Parametric Score and Interpretation. A score of 1.00 – 1.80 is very low, 1.81 – 2.60 is low, 2.61 – 3.40 is moderate, 3.41 – 4.20 is high, and 4.21 – 5.00 is very high.

Data Gathering Procedure

The data gathering procedure for examining leadership styles’ impact on organizational culture and performance. It includes pre-data gathering approvals, actual data collection with rigorous participant inclusion criteria, and post-data gathering analysis, ensuring data integrity, confidentiality, and comprehensive reporting of findings and implications.

Pre-Data Gathering

Before data gathering commenced, the study title was submitted online to the clearance board for approval. The Dean of the College of Nursing initially approved the study, followed by a Design Hearing with a panel of experts. The institutional review board at the University of Visayas (UV-IRB) provided the necessary consent approvals, allowing the research to proceed. The researcher adopted a questionnaire with specific inclusion and exclusion criteria to ensure reliable and valid data collection.

Actual Data Gathering

On the designated distribution day, participants who met the inclusion criteria were recruited and given questionnaires with clear instructions to ensure accurate completion. The questionnaires were collected on the same day, maintaining control over the data collection process and ensuring high response rates and data completeness. Each returned questionnaire was carefully reviewed to ensure all items were answered; if any items were omitted or unanswered, the questionnaire was returned to the respondent for completion. During data processing, any incomplete questionnaires identified were discarded, and additional participants were recruited to replace them. This ongoing recruitment and replacement process ensured the desired sample size was achieved, maintaining data consistency and reliability for robust statistical analysis.

Post Data Gathering

The collected questionnaire responses were analyzed using descriptive and inferential statistical methods, providing a summary of data trends and drawing conclusions to address the research objectives. To maintain confidentiality, physical copies of the questionnaires were shredded after data extraction and electronic copies were scheduled for deletion upon project completion. The final step involved compiling a comprehensive report detailing the methodology, findings, and implications. Adhering to guidelines on academic integrity and originality, the report was shared with stakeholders, including the academic community and UV-IRB, ensuring the research’s impact and relevance.

Statistical Treatment of Data

The statistical data treatment for the study “Leadership Style and Job Satisfaction on Retention among Nurses in a Healthcare Facility” involved a thorough and systematic analysis to organize and interpret the collected responses meaningfully. Various statistical methods and approaches were utilized to ensure the extraction of insights that align with the research objectives of the study.

Mean Score It was determined by summing all individual scores and dividing by the total number of respondents, resulting in an average that represented the typical response level within a sample group. The Mean Score was essential for summarizing data, comparing subgroups, and serving as a foundation for future comparisons. However, because it could be affected by extreme values and skewed distributions, other statistical measures were often needed to fully understand the dataset’s characteristics.

Standard Deviation – quantified the variation or dispersion of a dataset, showing how much figures in a sample deviated from the mean or average value. A low standard deviation signified that values were close to the mean, suggesting homogeneity in the dataset, whereas a high standard deviation indicated a wider range of values, implying more significant heterogeneity. In research, evaluating whether scores on measures provided reliable estimates of treatment effects was necessary; minor standard deviations indicated that these scores accurately represented data, while large ones suggested they might not. Understanding what standard deviation meant when reporting results for descriptive studies enabled researchers and readers to grasp response variability relevant to conclusions drawn from findings.

Pearson R – quantified how two continuous variables related linearly by examining their covariance. The values ranged between -1 (for a perfect negative linear relation) to +1 (for a perfect positive linear relation), with approximately zero indicating a lack of linear correlation. Correlational studies that relied on this coefficient aimed to discover the extent and direction of associations but did not infer causality. The practical significance and the likelihood of randomness were determined based on the interpretation of its value and considerations of statistical significance and effect size for correlation research and purposeful case analysis.

Ethical Considerations

This study adhered to ethical guidelines by ensuring informed consent, maintaining confidentiality, and respecting participants’ autonomy. Voluntary participation was emphasized, with no coercion or penalties for withdrawal. The research prioritized participant well-being and integrity throughout the study. The following ethical principles were observed.

Protection of Human Rights. This study was guided by three ethical principles, namely beneficence, justice, and respect for persons. To respect people, participants were treated as independent individuals and given the

option to accept or reject the offer by signing an informed consent form. Participants were kept as safe as possible, and no other treatments or interventions were used other than a questionnaire to gather data. By using the same technique for gathering data from each participant, distributing the questionnaire consistently, and choosing participants according to predetermined inclusion and exclusion criteria, justice was maintained. Together, these guidelines guaranteed moral behavior and protected the welfare and rights of every study participant.

Transparency. A copy of the finished study was placed in the university library. Furthermore, the research results were submitted for publication in national or international journals and possible oral or poster presentations in research forums both domestically and abroad.

Risk-Benefit Ratio Determination. The researcher made sure that the benefits outweighed the risks.

Risks The study participants were subjected to minimal risks that were similar to those that arise from routine activities. Since no treatments or invasive procedures were performed, the questionnaire-based data collection method ensured that no physical harm occurred. Additionally, there was less chance of emotional or psychological harm because the questionnaire did not ask participants to recall or divulge private or upsetting information. Because the questionnaire items were created to exclude any content that might promote discrimination or stigma, social harm was also decreased. From an economic standpoint, study participants incurred no costs associated with their involvement; instead, they received reimbursement for any such costs. All of these steps worked together to guarantee that moral principles were respected and that participants’ welfare was protected at all times.

Benefits Nurses benefited from this study’s insightful analysis of their resilience and mental health, which enabled them to take proactive measures to protect and enhance their well-being. As a result, nurses were more capable of carrying out their duties in healthcare. The enhanced emotional well-being of nurses also had a major positive impact on clients, particularly patients. Nurses who were resilient provided better care to patients, frequently exceeding their expectations, which enhanced patient satisfaction. These results highlighted how important it is to take care of nurses’ mental health to improve patient care and satisfaction in hospital environments.

Healthcare Administrators. The findings provided insights into employees’ mental well-being and resilience. This enabled the development of activities that were reflected in operational and strategic plans aimed at protecting mental health and improving the resilience of nurses, ultimately safeguarding their welfare. These findings served as a basis for drafting regulations, policies, or laws to protect mental health, not only during pandemics but also during regular hospital employment. Consequently, new regulations and policies were issued to mandate hospitals to introduce specific activities that protected the mental health of their employees. Findings served as a reference for mental well-being and resiliency studies. The results could be validated using broader coverage in terms of the environment and a larger number of respondents. Moreover, these findings provided a foundation for new research studies employing more complex designs to yield further insights and research outcomes.

Informed Consent. This study used informed consent to guarantee that the respondents’ participation was voluntary. The informed consent form will contain the following:

Participants Status. The respondents were apprised that the effort was solely intended for educational purposes and fulfilled the researcher’s master’s degree requirement.

Study Goals. The nurses’ profiles, resilience, and mental health were evaluated in connection to one another.

Type of Data. Quantitative information is gathered through questionnaire responses.

Procedures. The nature of the commitment was emphasized as processes were detailed under the data-gathering methods. The respondents’ time to complete the questionnaire, which took only five to ten minutes, was the only reason they participated in the study.

Sponsorship. The study is not being sponsored.

Participant Selection. The sampling design, together with the inclusion and exclusion criteria, were used to choose the respondents.

Alternatives. Since the study was strictly non-experimental, neither interventions nor treatments were offered to the respondents; there were no substitutes for them.

Compensation. Rewards or remuneration were not given to the responders. Rather than using words of praise, the researcher personally thanked them for their involvement.

Confidentiality Pledge. The respondents were guaranteed both anonymity and the confidentiality of their information. In the study’s later portions, specifics about confidentiality precautions were included.

Voluntary Consent. There was no force, intimidation, duress, or improper influence applied to subjects; participation in the study was completely voluntary. Without being under any duress, they were free to choose whether or not to take part.

Right to Withdraw and Withhold Information. The participants were apprised of their right to withdraw from the research or conceal information at any given time. They were informed that their decision to conceal or remove information would not have any negative consequences for them or their standing as nurses in the medical field.

Contact Information. If the respondents had any queries, concerns, or grievances regarding the study, they could get in touch with the researchers or the UV-IRB via the informed consent form. The UV-IRB contact details were given to them, including the phone number (+63 (32) 4168607) and email address rec@uv.edu.ph.

Authorization to Access Private Information. In order to prevent unwanted access to additional sensitive data, the researcher rigorously restricted access to the respondents’ resilience, mental health, and profiles as the only categories of personal information.

Privacy and Confidentiality. In order to ensure respondents’ privacy, the Data Privacy Act’s regulations were strictly followed and they were given the choice of where to answer the questionnaire. To ensure confidentiality, all responders were anonymously assigned a number only; no personal or private information was collected. The original data was housed in a locked, safe cabinet and kept that was only accessible to the researcher. To avoid identifying the responders, the data were shown in tabular form. The study concluded with the permanent deletion of the original data and the shredding of the completed questionnaires for disposal.

Debriefings, Communication, and Referrals. Since responders already had instructions on the questionnaire, there was no need for debriefings. Referrals were given as needed, and only verbal communication was used when necessary.

Conflict of Interests.  No conflicts of interest are disclosed by the researcher.

Collaborative Study Terms of Reference. Without a connection to any person or organization, this study was carried out independently. All intellectual property rights, including the right to publish, belong to the researcher. That being said, a formal written agreement might designate the Research Adviser as a secondary author.

Recruitment. Strict health precautions were taken to prevent COVID-19 cross-infection during the face-to-face intercept method of recruiting respondents. The selection procedure adhered to the inclusion and exclusion criteria and was conducted per the sampling methodology.

Vulnerability Assessment. To make sure that none of the respondents belonged to vulnerable groups, the researcher thoroughly assessed each one before hiring them. No vulnerable individuals would be solicited to participate as respondents, and this was rigorously adhered to.

PRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA

Table 1. Level of Leadership Style among Nurses in Healthcare Facility

Authoritative Style	f	%	Mean
Very High	9	8.41%	2.27
High	36	33.64%	7.49
Moderate	47	43.93%	7.86
Low	13	12.15%	1.79
Very Low	2	1.87%	8.18
	107	100%	19.59
Democratic Style
Very High	30	28.04%	9.17
High	51	47.66%	10.98
Moderate	11	10.28%	1.92
Low	13	12.15%	0.972
Very Low	2	1.87%	0.168
	107	100%	23.21
Laissez-faire Style
Very High	6	5.61%	1.52
High	23	21.50%	4.91
Moderate	62	57.94%	1.34
Low	16	14.95%	2.08
Very Low	0	0.00%	0
	107	100%	18.85

Note: Total number of respondents: 107

Legend: Very High: 26-30, High: 21-25, Moderate: 16-20, Low: 11-15 and Very Low: 6-10

Table 1 shows that democratic style is the most favored leadership approach among nurses, with 47.66% rating it as “high” and an overall mean score of 23.21, the highest among the styles surveyed. This suggests that nurses perceive democratic leadership as highly effective. Conversely, the laissez-faire style is predominantly rated as “moderate” by 57.94%, with a lower mean score of 18.85, indicating it is less preferred and perceived as less effective. The Authoritative Style has a mean score of 19.59, showing moderate favorability but not as high as the democratic style. This highlights the Democratic Style’s strong preference and effectiveness in the healthcare setting.

A successful leadership style for retention emphasizes empathy, communication, and recognition. Leaders who actively engage with their team, listen to feedback, and show genuine concern for employees’ well-being create a supportive work environment. Providing opportunities for professional growth and career advancement is crucial, as it demonstrates investment in employees’ futures. Recognizing and celebrating achievements fosters a sense of belonging and appreciation, which strengthens loyalty. By addressing concerns promptly and fostering a positive workplace culture, leaders build strong, trusting relationships with their team. This approach not only enhances job satisfaction but also contributes to long-term retention and organizational stability.

Essential data on the prevalence of different leadership styles in healthcare institutions, emphasizing the authoritative style. It is important to note that most of them scored in the moderated Range, indicating a general inclination toward this form of leading. This finding is consistent with prior research by Fernandez et al. (2019), which found that authoritative styles are vital for providing clarity, direction, and accountability in healthcare settings. However, many nurses are within the high range, suggesting that many employees have authoritarian or control-oriented tendencies. Consequently, this raises questions about how such propensities affect teamwork, morale among workers, and ultimate results related to patient care.

Moreover, it is essential to note that there was a smaller but significant number of respondents recording scores in the low and very low ranges, which indicates some needs to be improved regarding expertise in authoritative leadership skills by some individuals. This point supports calls by Choi et al. (2020) for targeted leadership development programs within healthcare organizations to enhance leadership competencies among health professionals. By bridging the competency gap and promoting continuous learning and development orientations at all levels of the organization, the nursing staff will be better equipped to navigate complex modern health systems, continually adapting to change while maintaining quality patient care.

The average score is 19.59, which implies moderate range positioning for the authoritative style among nurses when considering leadership levels quantitatively. This shows an average level of proficiency per score, but various spreading throughout different ranges necessitates customized approaches to develop leaders accordingly. Therefore, acknowledging individual variations in guiding preferences and abilities could assist medical bodies in fostering dynamic adaptive cultures characterized by diversity across their clinical officer ship ranks, thereby unlocking the most significant potential inherent in nurse team performance, as highlighted earlier in various targeted training programs. Thus, funding and supporting leadership development results in better nurse professional growth and more resilient and effective healthcare systems.

In democratic leadership most nurses scored high marks, implying they greatly favor this leadership style. This finding is consistent with studies such as those by Liu et al. (2017) that have pointed out the advantages of having a democratic healthcare system regarding employee involvement, cooperation, and inventiveness. Nevertheless, it is essential to consider that a significant proportion of participating nurses fell within the very high range, denoting an overwhelming preference for participative and inclusive leadership. In addition, this observation suggests a potential alignment with research by Yang et al. (2019), which explains democratic leadership as a critical requirement for nurturing a supportive and empowering work environment leading to improved job satisfaction among staff members, translating into better organizational outcomes.

Moreover, based on the distribution of scores, some nurses within the moderate, low, and shallow range indicated that individuals had different skills in practicing democratic leadership. This discovery has been emphasized in works such as those by Cummings et al. (2021), who state that focused interventions should be used in development programs like taking part in formalized training plans to enhance leader capabilities among healthcare professionals. This helps to fill any gaps while at the same time creating an environment where one can get new skills since they are willing and able personnel who are ready to take up responsibilities sharing decisions, thus making collective choices towards inclusivity and leading to employee empowerment; strengthening workforce resilience thereby improving performance ability resulting into more resilient organizations than ever before.

The distribution of scores for nurses highlights the prevalence of Laissez-faire leadership style within healthcare facilities. The data indicated that most had moderate range scores, indicating a great disposition towards this hands-off or passive leadership approach. Though, at times, Laissez-faire leadership can empower employees and promote autonomy, its commonness in medical care settings may lead to concerns about lack of direction, accountability, and coordination, among other things. This finding is consistent with studies by AbuAlRub et al. (2018) and Wong et al. (2020), which underscored the negative consequences that Laissez-faire leadership might have on employee satisfaction and the quality of patient care.

Further absence of any scores in the very low range means no apparent extreme lack of respect for Laissez-faire in the population under study. However, only relatively low numbers of nurses scored within the High and Very High Ranges, failing to provide strong support for laissez-faire leadership. This supports Hu et al.’s (2019) argument regarding well-balanced leadership styles in healthcare that would require some level of autonomy and guidance to ensure the effective functioning of teams through improved patient care outcomes. Given that many nursing leaders and managers exhibit a Laissez-faire style along the moderate range, interventions are required to promote more active and engaged leadership behaviors.

The average score in Laissez-faire leadership is 18.85, giving a quantitative evaluation level on how many exist among nurses, putting it in the moderate range position. On average, this suggests moderate competence; however, healthcare organizations must consider how this type of management influences their culture and patient treatment outcomes. It might be beneficial for leaders or managers to take part in training or developmental programs to encourage a more active, supportive form of leading that balances autonomy with being directive and supportive. When healthcare institutions foster a culture of accountability and empowerment, team effectiveness improves, leading to better patient care.

Table 2. Level of Job Satisfaction among Nurses in Healthcare Facility

Dimensions	Factor Mean	SD	Interpretation
Teamwork	3.90	1.12	Satisfied
Leadership	3.86	1.11	Satisfied
Rewards and Recognition	3.33	1.12	Neither Satisfied/Nor Dissatisfied
Empowerment and Participation	3.83	1.07	Satisfied
Training and Individual Development	3.80	1.08	Satisfied
Working Hours	3.72	1.18	Satisfied
Communication	3.67	1.04	Satisfied
Working Conditions	3.50	1.05	Satisfied
average score	3.70	1.10	Satisfied

Legend: 4.21-5.00 Very Satisfied, 3.41-4.20 Satisfied, 2.61-3.40 Neither Satisfied, 1.81-2.60 Dissatisfied and 1.00-1.80 Very Dissatisfied

The table shows that the teamwork factor is 3.9 (Satisfied); the Leadership factor 3.86 (Satisfied); Rewards and Recognition 3.33 (Neither Satisfied); Empowerment and participation 3.83 (Satisfied); Training and Individual Development 3.8 (Satisfied); Working Hours 3.72 (Satisfied); Communication 3.67 (Satisfied) and Working Conditions 3.5 (Satisfied).

The Average Mean value of 3.70 revealed that the level of job satisfaction among nurses in a healthcare facility is satisfied

An in-depth analysis of job satisfaction levels among nurses in a healthcare facility, examining key factors such as teamwork, leadership, rewards, empowerment, training, working hours, communication, and working conditions. With an average satisfaction score of 3.70, the data reveals overall contentment among the nursing staff. High satisfaction is particularly noted in teamwork and leadership, underscoring the importance of positive team dynamics and effective supervision. Conversely, rewards and recognition receive a neutral rating, indicating potential areas for improvement. This analysis offers critical insights into both strengths and areas for development, guiding healthcare facilities in enhancing job satisfaction, fostering a supportive work environment, and ultimately improving nurse retention and patient care outcomes.

The data indicates nurses’ job satisfaction in health facilities emphasizing teamwork an average mean score of 3.90. This finding reinforces previous studies by Milliken et al. (2018) that examine and highlight how positive relationships among teammates enhance patient care outcomes and staff well-being, particularly regarding the significance of team cohesion in healthcare settings. Feeling valued and included as part of a team working towards common objectives could enhance job satisfaction, reduce burnout, and foster a sense of belonging within the organization.

This score implies improvement in creating a cooperative environment within the health facility. Wagner et al.’s research (2020) has demonstrated that a supportive and cooperative work environment is essential for job satisfaction and organizational effectiveness. Some strategies to promote collaboration amongst nursing teams include team-building activities, clear communication channels, and recognition of collaborative efforts, ultimately enhancing nurse job satisfaction and overall organizational performance.

The weighted mean value for teamwork showed that nurses generally agree on their level of job satisfaction about this dimension: 3.90. This finding underline what is essential about focusing more on promoting teamwork and collaboration initiatives by healthcare organizations rather than other factors such as individualism or competition among workers at hospitals regardless if they provide clinical care or support services like food preparation or cleaning hospital facilities etcetera… By investing in ways to strengthen teams internally, healthcare institutions can enable their members to feel valued as individuals motivated by what they do being fulfilled at work, increasing productivity levels through satisfied employees. Ultimately, fostering a culture of teamwork not only improves nurse job satisfaction but also influences better patient outcomes and organizational success.

The data in the tables provides insight into the level of job satisfaction among nurses in healthcare institutions, particularly concerning leadership. Respondents had the average mean of 3.86 interpreted as satisfied. This result suggests that visible and engaged leadership is essential for promoting a quality culture within healthcare facilities. Research by Hayes et al. (2018) supports this idea and points out the positive effects of a leader’s visibility on staff morale, motivation, and overall organizational performance. When their supervisors show dedication to quality, it can increase nurses’ job satisfaction and confidence and align them better with organizational objectives.

Studies such as those conducted by Wong et al. (2019) emphasize effective leadership and management skills in enhancing staff satisfaction and organizational efficiency. Developing more vital managerial skills among nursing supervisors will help improve communication channels, decision-making processes, and resource allocation, thus increasing job satisfaction levels and retaining personnel at higher rates.

The dimension of leadership had a weighted mean value of 3.86, showing generally acceptable levels of job satisfaction amongst nurses. In addition, this suggests investing in leadership development initiatives within healthcare organizations. This will help establish trustful supervisory relationships with senior managers or supervisors who nurture competent teams capable of working together towards hospital goals. By training and supporting nursing supervisors / senior managers, hospitals can develop a culture of continuous improvement through an environment characterized by trustworthiness and cooperation between workers. Leading effectively means improved nurse work fulfillment, patient outcomes, and organizational triumphs.

From the provided data in the table, it can be deduced that it is about job satisfaction among nurses in healthcare facilities, particularly regarding reward and recognition. Accordingly, this statement attracted an average mean of 3.33, meaning that nurses were not satisfied with the fairness of the annual salary increase. This finding implies a usual positive nurse perception towards yearly raises, which could result in overall job satisfaction. In addition, Li et al. (2020) research supports the view, indicating that fair pay practices are significant factors for retaining healthcare professionals and ensuring high levels of job contentment. Better motivation, morale, and organizational commitment are achievable when the nursing staff feels compensated.

Some nurses may not be pleased with the retirement benefits offered by their healthcare institution. Despite not necessarily indicating unhappiness, this score suggests room for general improvement in retirement planning and benefits given to nursing personnel. Research conducted by Lerner et al. (2019) shows how comprehensive retirement plans enhance financial stability and well-being among medical providers. If their retirements are sufficiently catered for, then it is more likely that retention rates of nurses will increase alongside their job satisfaction.

The overall figure of 3.33 indicates a mean value of indifference on rewards and recognition dimension among registered nurses regarding employee satisfaction with rewards and recognition programs. While some things like yearly raises get positive responses from employees, others, such as pensions, might require attention and improvement to boost them up from these midpoints of indifference where people’s feelings are uncertain about the matter being discussed above since it means they do not care whether or not such benefits exist but would be happier to receive them. However, they were told nothing about their existence because why should they know anything about what they do not want? Therefore, healthcare organizations should regularly evaluate their rewards and recognition programs to ensure they meet the aspirations and likings of their nursing workforce. Healthcare facilities can create a favorable working atmosphere, enhance job satisfaction, and retain competent staff through competitive salaries, complete pension plans, and meaningful appreciation schemes.

The data contained in the table provides insights into the job satisfaction levels of healthcare institution’s nurses, mainly on empowerment and participation dimensions. This shows that nurses are empowered to make significant contributions to the overall success of an organization, which is crucial for creating meaning and a sense of fulfillment in their work. Moreover, research by Sfantou et al. (2017) supports this idea and further points out that employee involvement in organizational decision-making enhances job satisfaction and commitment.

This implies that even though they think they are helping their employer attain its objectives, there is a probability that they will not fully utilize their skills in the current posts that they hold as certified nursing assistants or CNAs. This finding underlines the importance of matching tasks with individual knowledge to increase workplace happiness and efficiency. De Jonge et al. (2018) carried out a study that outlined vital aspects such as role flexibility and job designing when considering how best individuals can optimize their potentiality and enhance overall work-life satisfaction. To this end, healthcare organizations should ensure that they give advanced positions or roles to registered nurses who will use their unique professional traits effectively.

In general terms, there was consensus among these nurses about how satisfied they were with their jobs concerning empowerment/participation; this was evidenced by a weighted mean value of 3.83 for the empowerment/participation factor itself (Table 2). However, while nurses believe that what they are doing helps the company achieve its goals, there are ways that they might make use of their abilities and skills more efficiently in these positions. When healthcare organizations foster a culture of empowerment, involvement, and role flexibility, it can help improve job satisfaction and engagement with nursing staff. However, healthcare firms may offer an environment that promotes job satisfaction, employee well-being, and organizational performance by enabling meaningful participation in decision-making while aligning job roles with specific talents.

The table’s information illustrates job satisfaction levels experienced by nurses in various healthcare facilities, particularly in training and personal development. According to the results, the nurses overwhelmingly satisfied with it, indicating that learning and development opportunities are available within their organizations. This research supports the idea that professional growth is encouraged by employers among nurses, thus securing talent and job happiness. This was supported by Hayes et al. (2019), who found that nurse satisfaction, engagement, and retention can be improved through more chances for continuous learning and development. Healthcare institutions should invest in continuing education programs for nurses, enhancing skills, expertise, and confidence while improving the quality of care.

This means that even though most of them were satisfied with their first training program, there could be areas where it was not done well. The necessity of proper initial training programs that equip future nurses to succeed at work while promoting lifelong learning is highlighted in this study. Ghanbari et al.’s (2020) research findings show the importance of comprehensive and practical training programs to equip nurses with the necessary knowledge and skills to provide quality healthcare services. Thus, healthcare organizations should continually update their internship plans and consider changes in clinical practices to improve nursing competence, confidence, and job satisfaction.

The weighted mean value represented a general agreement between all these reviews about the dimension of education/training/developmental opportunities as indicated by (mean=3:80). Yet, initial programs may be more practical even when staff argues that they learn and grow in positions. To ensure nursing staff retention and job satisfaction, healthcare providers must make long-term investments by implementing all-rounded training programs tailored for professional development purposes and aligned with the organizational objectives. With a focus on learning and growing employees, healthcare institutions can develop highly motivated workforces that deliver high-quality patient care services and drive organizational success.

The mean score of working hours is 3.72, which shows that nurses satisfied on their total working hours. Thereby, this result hints at a general satisfaction level of nurses about their job time as an essential condition for work-life balance and job satisfaction in general (Hayes et al., 2011). Geiger-Brown et al.’s (2012) study supports this claim by emphasizing the significance of reasonable working time in avoiding burnout and enhancing well-being among healthcare professionals. Job satisfaction increases when nurses are contented with their job schedules, leading to less staff turnover, higher job engagement, and more outstanding employee commitment.

Most nurses prefer flexible work schedules, although there could be ways to improve freedom. This paper argues how critical it is for hospitals to have various scheduling options to meet different needs and preferences among nursing staff. Cheng et al.’s (2018) research demonstrates how beneficial nurse retention programs can be in increasing nurse satisfaction and reducing burnout rates caused by long hours and inflexible shifts. Therefore, healthcare organizations should consider ways of offering more control over work schedules for better job happiness and healthier lifestyles among workers, such as telecommuting choices, self-scheduling applications, or even flexible shift patterns.

Regarding the weighted mean value for the working hour dimension, which stands at 3.72, there is general agreement amongst the nurses regarding job satisfaction within this domain. Many nurses seem comfortable with their work timetables, apart from issues concerning flexibility in programming them. Healthcare institutions that provide an integrated mix of professional and personal life for their employees can facilitate workforce satisfaction and retention among their staff. This can be achieved by healthcare facilities offering flexible work arrangements, enabling nurses to manage their professional and personal lives successfully. To foster a healthy workplace environment for nurses that supports employees’ job contentment, well-being, and overall organizational success, these organizations should prioritize life balances and continuity of operations with the help of relevant policies.

Effective communication between supervisors and nurses is essential for clarifying roles, setting expectations, and fostering a supportive work environment. Research by Boamah et al. (2017) supports this notion, highlighting the positive impact of clear communication on nurse job satisfaction and organizational commitment. When nurses receive clear guidance and expectations from their supervisors, it can enhance their confidence, job satisfaction, and overall performance. Although most nurses feel the organization informs them about significant issues, communication procedures may be enhanced. Organizations must communicate effectively to guarantee openness, establish credibility, and sustain worker involvement. The significance of open communication in creating happy workplaces and lowering nurses’ intentions to leave is highlighted by research conducted in 2016 by Laschinger et al. To facilitate communication, foster transparency, and fortify organizational cohesion, healthcare organizations ought to make an effort to improve their channels of communication and procedures.

The weighted mean value of 3.67 for the dimension of communication indicates an overall agreement among nurses regarding their level of job satisfaction in this aspect. While nurses generally feel satisfied with communication regarding job expectations from their supervisors, there may be opportunities to improve organizational communication practices. Healthcare facilities can support job satisfaction and retention among nursing staff by prioritizing clear and transparent communication at all levels of the organization. By fostering open dialogue, providing timely information, and soliciting feedback from nurses, healthcare organizations can create a culture of communication excellence that enhances nurse engagement, satisfaction, and, ultimately, patient care outcomes.

The table provides insight into nurses’ job satisfaction in healthcare facilities, particularly emphasizing the aspect of working circumstances. Nurses think most nurses have a reasonable workload, which is necessary to prevent burnout and maintain job satisfaction, as stated by Hayes et al. (2015). This research also backs up Hayes et al.’s study and shows how workload influences nurses’ job satisfaction and well-being. Adequately perceived workloads among nurses have also been associated with enhanced job satisfaction, increased productivity, and reduced stress levels. Although most nurses think they have satisfactory physical working conditions, there may be room for improvement in areas such as ergonomic lighting and ventilation. The significance of optimal working environments in promoting nurse job satisfaction and patient safety was stressed by Cimiotti et al. (2012). Health institutions, therefore, need to improve their physical working environment to provide a haven for their workers, who will then exhibit higher levels of job satisfaction, leading to increased productivity.

The dimension of working conditions had a weighted mean value of 3.50, showing general agreement among nurses regarding their self-perceived levels of job satisfaction in this area. There might be room for improvement within the workspace, even if most nurses are content with their assignments. Healthcare organizations can enhance nursing staff’s job satisfaction and retention by improving the physical work environment by providing ergonomic tools, better ventilation systems, and increasing lighting within these settings. Creating a workplace that ensures safety and comfort for nurses may promote worker contentment while lowering turnover and ultimately enhancing the quality of patient care in healthcare companies.

Table 3. Level of Retention of Nurses in the Healthcare Facility

Statement	Mean	SD	Interpretation
1. How often have you considered leaving your job?	2.86	1.19	Moderate
2. How satisfying is your job in fulfilling your personal needs?	3.64	1.01	High
3. How often are you frustrated when not given the opportunity at work to achieve your personal work-related goals?	3.06	0.96	Moderate
4. How often do you dream about getting another job that will better suit your personal needs?	3.09	1.13	Moderate
5. How likely are you to accept another job at the same compensation or level should it be offered to you?	3.09	1.12	Moderate
6. How often do you look forward to another day at work?	3.51	1.06	High
Weighted Mean	3.21	1.08	Moderate

Legend: 4.21-5.00 Very High, 3.41-4.20 High, 2.61-3.40 Moderate, 1.81-2.60 Low, 1.00-1.80 Very Low.

The table shows that question number 2 has the highest mean of 3.64 and is interpreted as “Satisfying.” On the other hand, question number 1 has the lowest mean of 2.86 and is interpreted as “Neutral.”

The weighted mean value of 3.21 revealed that the Level of nurse retention in the health care facility is “Neutral.”

The table provides data on the turnover of nurses in medical facilities by their job satisfaction and intent to leave, which can give us insights into what makes it a wrong choice for their future. The question number 2 received the highest mean score of 3.64, showing that most nurses find their jobs satisfactory enough to meet their personal needs. This finding suggests that nurses perceive their roles as meeting their requirements and expectations to a considerable extent, which is essential for promoting retention. Kutney-Lee et al. (2016) conducted research that supports this notion, stating that job satisfaction plays a vital role in nurse retention. When nurses feel they can meet their needs and ambitions through work, they are more likely to stay committed and loyal.

Conversely, question number 1 had the lowest mean score of 2.86. However, not all times do these scores imply that there are no ideas about quitting from among the nursing staff. This research emphasizes how important it is for healthcare businesses to monitor potential retention problems and deal with underlying problems that could be causing employees to consider leaving. This study by Ma et al. (2019) reveals nurse retention’s intricate nature involving workload, organizational support, and career prospects. Retention can be promoted if hospitals anticipate why nurses would consider quitting.

The weighted mean value of 3.21 for the retention level among nurses in the healthcare facility indicates a neutral position. Nurses generally find their jobs satisfying when it comes to fulfilling personal needs; nevertheless, some improvements might still be required concerning staff retention. Healthcare organizations should develop strategies to address issues leading to turnover intentions and enhancing nurse retention. A positive working atmosphere supports job satisfaction improvement initiatives through support provision for professional development opportunities. Nursing staff can thus be retained within healthcare organizations by offering them a quality job that ensures continuity.

Table 4. Pearson Correlations Between Retention of Nurses and Their Leadership Style

Variables	r-value	p-value	Decision	Interpretation
Authoritative vs. Retention	0.383	0.000	Rejected Ho	Significant
Democratic vs. Retention	0.386	0.000	Rejected Ho	Significant
Laissez-Faire vs. Retention	0.462	0.000	Rejected Ho	Significant
OVERALL	0.507	0.000	Rejected Ho	Significant

Legend: p ≤ 0.05 Rejected Ho Significant and p > 0.05 Accepted Ho Not Significant

As revealed in the table, it was found that a statistically significant positive relationship exists between nurse retention and authoritarian leadership (𝑟=0.383, p<0.001). This shows that the concept and application of authoritarian leadership influence nurse retention in Cebu City’s healthcare facilities. Similarly, a strong positive correlation was also shown between democratic leadership and nurse retention (r=0.386, p<0.001), which indicates that democratic leadership also has a positive impact on nurse retention among healthcare facilities. The Laissez-Faire leadership style also demonstrated a statistically significant relationship with nurse retention (r=0.462, p<0.001), which shows that administrators in healthcare institutions that use a hands-off approach to management increase nurse retention. Generally, it was indicated that the overall effect of these leadership philosophies was substantially associated with nurse retention (r=0.507, p<0.001). These results indicate that these leadership styles—Authoritarian, Democratic, and Laissez-Faire—positively influence nurse retention in Cebu City healthcare facilities. Specchia et al. (2021) mentioned that nursing leaders are crucial in fostering healthy work environments that retain an engaged and motivated team. Positive and supportive leadership styles can boost nurses’ job happiness, organizational commitment, and intent to stay in their posts while simultaneously lowering emotional tiredness. Among the mentioned leadership styles, the Laissez-Faire leadership style was found to have the strongest association which means that nurses are more likely to stay in their workplace if leaders adopt a more hands-off approach in leading healthcare facilities. These findings are crucial in maintaining success in nursing management and healthcare administration. Alsadaan et al. (2023) added that to provide high-quality care and guarantee patient safety, nurses must perform better, and nursing leadership plays a crucial role in enabling and enhancing this process.

Alsadaan et al. (2023) added that to provide high-quality care and ensure patient safety, nurses must perform effectively, and nursing leadership plays a crucial role in enabling and enhancing this process. The insights from this study underscore the importance of adopting leadership styles that foster a supportive and engaging work environment, which is essential for retaining skilled nursing staff and ensuring the overall quality of healthcare services.

Effective nurse retention is vital for maintaining high-quality patient care and ensuring the stability of healthcare services. Recent research underscores the significant role leadership styles play in influencing nurse retention rates. This study investigates the correlation between various leadership styles—Authoritarian, Democratic, and Laissez-Faire—and nurse retention within Cebu City healthcare facilities. The findings reveal a statistically significant positive relationship between all three leadership styles and nurse retention, with Laissez-Faire leadership showing the strongest association. These results highlight that different leadership approaches can positively impact nurse job satisfaction and retention. The study aligns with existing literature, emphasizing that supportive and engaging leadership fosters a healthy work environment, enhances job commitment, and reduces burnout. Understanding these dynamics is crucial for healthcare administrators aiming to improve nurse retention and ultimately deliver high-quality patient care.

Table 5. Pearson Correlations Between Retention of Nurses and Their Job Satisfaction

Variables	r-value	p-value	Decision	Interpretation
Teamwork vs. Retention	0.236	0.014	Rejected Ho	Significant
Leadership vs Retention	0.200	0.039	Rejected Ho	Significant
Rewards/Participation vs. Retention	-0.017	0.870	Accepted Ho	Not Significant
Empowerment/Participation vs. Retention	0.240	0.013	Rejected Ho	Significant
Training/Development vs. Retention	0.172	0.076	Accepted Ho	Not Significant
Working Hours vs. Retention	0.334	0.000	Rejected Ho	Significant
Communication vs. Retention	0.151	0.119	Accepted Ho	Not Significant
Working Condition vs. Retention	0.125	0.199	Accepted Ho	Not Significant
OVERALL	0.213	0.027	Rejected Ho	Significant

Legend: p ≤ 0.05 Rejected Ho Significant and p > 0.05 Accepted Ho Not Significant

The table revealed a significant positive correlation between nurse retention and teamwork (r=0.236, p=0.014), which means that good teamwork among co-workers and leaders influences nurse retention in facilities. Bragadottir et al. (2023) indicated that increased job satisfaction and good teamwork may help to reduce turnover and the nursing shortage, which is predicted to worsen during and after the COVID-19 pandemic.  Leadership also showed a statistically significant correlation with nurse retention (r=0.200, p=0.039), implying that diverse leadership practices can contribute positively to the retention of nurses. Retention may be increased by knowing how the leadership philosophies of nurse managers affect anticipated nurse turnover. Therefore, to increase job satisfaction and lower turnover, nurse managers should enroll in training programs on effective leadership (Suliman et al., 2020). Empowerment and participation (r=0.240, p=0.013) and working hours (r=0.334, p=0.0004) also showed an evident relationship on the retention of nurses, highlighting the relevance of involving nurses and other employees in decision-making and utilizing their working hours effectively. Indeed, the levels of nurses’ work motivation and occupational mental health can be predicted through the levels of structural and psychological empowerment (Moh et al., 2021). In addition, increased risk of burnout, job dissatisfaction, and intention to quit were also linked to nurses working shifts longer than thirteen hours (Stimpfel et al., 2012).

In contrast, it was noted that there is no significant relationship between nurse retention and rewards and recognition (r=−0.017, p=0.870), training and development (r=0.172, p=0.076), communication (r=0.151, p=0.120), and working condition (r=0.125, p=0.199). Alahiane (2023) mentioned that research has shown that monetary rewards alone are insufficient for nurses. In contrast, Elsafty and Oraby (2022) emphasized that training is regarded as the primary tactic to affect employee retention and is a crucial component in improving organizational success. Furthermore, Tran et al. (2018) signified that improved commitment among nurses, reduced job stress and fatigue, and an improved understanding of the societal impact of nursing were all significantly aided by positive working relationships. The overall correlation between job satisfaction factors and nurse retention is significant (r=0.213, p=0.027). Dissatisfaction with autonomy and training opportunities was found to be substantially connected with nurses’ high overall turnover intention. Ward administrators should consistently improve nurses’ job happiness, autonomy, and training opportunities (Gebregziabhel et. al, 2020).

These results indicate that certain aspects of job satisfaction—specifically teamwork, leadership, empowerment/participation, and working hours—are important for retaining nurses in Cebu City healthcare facilities. Healthcare administrators and leaders should promote teamwork, practice effective leadership, empower nurses through participation in decision-making, and ensure manageable working hours to enhance nurse retention.

RETENTION PLAN

Rationale

Nurse turnover in healthcare institutions is of great concern due to its significant impact on patient care quality, operational efficiency, and financial viability. Retaining skilled nurses ensures good quality patient care because they possess advanced clinical skills, critical thinking, and a deep understanding of the healthcare protocols developed through years of practice. When experienced nurses leave, less experienced staff often fills their unmatched shoes, thus leading to reduced care quality and patient satisfaction. High turnover rates interfere with continuity of care, which forms a bedrock for building nurse-patient relationships and achieving good health results. Besides, high turnover frequently disrupts workflow and operational efficiency within healthcare organizations. Each departure needs expensive and time-consuming recruitment, hiring, and training processes that strain the institution’s resources. The cost implications include replacing one bedside nurse, costing tens of thousands, and expenses associated with recruitment, training, and productivity. Therefore, robust retention programs must be implemented by all healthcare facilities that face these challenges head-on.

Employers who Want to keep their nursing workforce should consider competitive benefits packages, including salary levels, sign-in bonuses, loyalty bonuses, and flexible work hours. Effective leadership and management are also instrumental in retention because when leaders supportively lead transparently, it dramatically enhances nurse satisfaction with their working environment. This supports employees in reconciling their professional and personal lives without compromising either side or becoming victims of burnout cases. By focusing on these areas, healthcare facilities can create a supportive work environment that attracts and retains skilled nursing professionals, ensuring high-quality patient care, operational efficiency, and financial stability.

Purpose

Nurse retention is a complex aspect of healthcare institutions aiming to improve patient care quality, operational efficiency, and financial viability. This is why keeping experienced nurses is critical; it directly impacts the quality of patient care. Experienced nurses know critical thinking skills and clinical expertise are essential in managing patients effectively for positive health outcomes. Also, they possess informed decision-making capacity, handle difficult clinical situations, and teach less experienced colleagues, all of which contribute much to a high-performance healthcare organization.

Patient satisfaction may be compromised while safety decreases due to high nurse turnover rates within organizations. Whenever skilled nurses depart from an organization’s staff establishment, they are often replaced by less qualified or temporary personnel lacking the same competency or familiarity with its protocols and culture. Consequently, quality care diminishes while risks increase, leading to poor patient outcomes and disrepute to such medical establishments.

Objectives

1. Improve nurse job satisfaction and engagement.
2. Reduce nurse turnover rates.
3. Enhance the quality of patient care.
4. Optimize operational efficiency and financial performance.
5. Foster a positive and supportive work environment.

STRATIGIES AND ACTION

1. Professional Development Continuous Education and Training

In a healthcare facility, it is essential for nurses to continuously learn and receive training in order to maintain high standards of care, adapt to the changing healthcare landscape, and adhere to healthcare regulations. These programs ensure that the nurses are always aware of the latest medical advancements, new technologies, and updated clinical practices needed to handle complex patient cases. Therefore, regular workshops, certification courses, and simulation training sessions are critical for fostering lifelong learning and professional development. During these initiatives, the nursing profession can use their practical skills efficiently when addressing patients’ complicated conditions or situations involving them. In addition, continuous education supports interprofessional collaboration, which means they can work with other healthcare professionals more effectively, ensuring good patient outcomes and efficient operations within a facility. Ensuring compliance with mandatory training set by professional licensing bodies also guarantees that all nurses retain their credentials and meet the facility’s standard of care. Offering scholarships for further education helps retain qualified staff by providing clear career advancement pathways since people can earn better qualifications under this approach. To sum up, giving scholarship programs, among other freebies, that would promote continued education and training for nurses working in a medical facility is essential for creating a competent nursing workforce that will be dynamic enough to meet patients’ needs.

Career Advancement Opportunities

Career growth opportunities for registered nurses working at healthcare facilities lead to quality patient care services provided by such health facilities. These include specialized training courses, leadership development programs, or even academic partnerships where they can pursue advanced degrees, e.g., Master of Science in Nursing (MSN). Thus, facilities may have mentorship programs through which junior staff can gradually build on their experience until they become senior practitioners, such as experts who guide others into proficiency levels, forming clinical ladder systems. Moreover, nurses’ organizational skills can also be honed through involvement in research projects, quality improvement initiatives, and professional committees. On the other hand, specialty certificates indicate that one is an expert in critical care, oncology, or pediatrics, which makes him/her suitable for holding nursing positions such as Nurse Practitioner (NP) and Nurse Educator. Some leadership paths include being a nurse manager, which gives them more administrative duties, hence policy formulation and operational decisions influence. Therefore, by investing in ongoing learning opportunities and providing various career pathways, healthcare facilities jointly contribute to patient-centeredness while retaining competent personnel with matching interests in professional growth. Furthermore, a comprehensive promotion approach addresses financial and educational needs, enabling practitioners to achieve their dreams while delivering better healthcare services, thus making it a more dynamic, capable, and motivated workforce.

2. Leadership And Management Effective Leadership Training

Optimal patient care, a positive work environment, and organizational performance are promoted through practical leadership training among nurses in a healthcare facility. Such training should be a multi-dimensional approach to nurse leaders’ unique problems and responsibilities. In addition, it is about nurturing crucial leadership abilities like communication, decision-making, and conflict resolution. Moreover, Nurses must efficiently communicate with interdisciplinary teams, patients, and their family members, ensuring clear understanding and coordination of care. Moreover, training in decision-making allows nurse leaders to make quick decisions based on evidence-based choices necessary for fast-paced health settings that need timely responses in life-threatening conditions. Also, the skills of resolving conflicts are significant in building solid interpersonal relationships within the organization and creating an environment where people can work together peacefully. A practical leadership course should highlight the significance of emotional intelligence and resilience. Many emotionally charged situations beset nurses, who must be ready to handle stress while keeping calm before their teams.

Supportive Management Practices

Supportive management practices among nurses in a healthcare facility foster a culture of collaboration, empowerment, and professional growth. Effective communication between nurse managers and staff is essential for ensuring clarity of expectations, providing feedback, and promptly addressing concerns. Open communication channels facilitate transparency and trust, enabling nurses to voice their opinions, share ideas, and contribute to decision-making. Secondly, supportive management practices involve recognizing and appreciating the efforts of nurses. Acknowledging their hard work, dedication, and achievements boosts morale, motivation, and job satisfaction. Moreover, providing opportunities for skill development, continuing education, and career advancement demonstrates a commitment to nurses’ professional growth and well-being. Additionally, fostering a supportive work environment involves promoting work-life balance, offering resources for stress management, and addressing burnout and compassion fatigue issues. Nurse Managers who prioritize the holistic well-being of their staff cultivate a resilient and engaged workforce capable of delivering high-quality patient care. Supportive management practices enhance nurse satisfaction and retention, improving patient outcomes and organizational success in healthcare facilities.

3. Positive Work Environment Safe Staffing Ratios

Patient safety, quality of care, and nurse well-being are all determined by safe staffing ratios among nurses in a healthcare facility. Good enough staffing entails areas whereby nurses can respond to emergencies promptly, provide timely interventions, and monitor patients appropriately, leading to decreased incidences of adverse events or medical errors. Besides this, it is also true that appropriate staffing ratios contribute towards improved job satisfaction and retention among nurses, thereby mitigating burnout, fatigue, and moral distress due to heavy workloads. Additionally, sympathetic staffing ensures that each patient gets quality time with his caregiver since reduced nurse-patient ratios make them focus more on individual needs, thus facilitating therapeutic relationship building besides personalized care. This means the ideal ratio would lead to seamless care coordination and the best possible patient outcome through interdisciplinary collaboration and communication, which is why safe staffing ratios foster them. Therefore, any program to achieve these objectives must have evidence-based staffing guidelines tailored to patient acuity unit complexity and nurse skill mix. Similarly, health facilities need to maintain safe and effective nursing practices by regularly reviewing their workload fluctuations and changes in demand for healthcare services from various patient populations or communities under their jurisdiction to be able to adjust reliable, professional opinions about such environments. For instance, this can be seen in some establishments where they have invested in having enough people working within departments while others are still struggling because even if there are few people in other sectors, the institution cannot just leave those unattended, meaning such organizations prioritized for both 100 percent safety rate the welfare conditions pertaining our employees up until certain limits will be attained within which we must operate.

Supportive Culture

Cultivating teamwork, flexibility, and professional advancement of nurses in a healthcare facility is a process that requires fostering a supportive culture. Such a culture, which involves mutual respect, trust, and teamwork, ensures that nurses feel esteemed, empowered, and cherished. A strong culture reinforces open dialogue and attentive listening so nurses can effectively share their concerns, brainstorm ideas, or work together. This enhances communication between co-workers, builds stronger bonds of friendship, leads to an enhanced sense of community and collegiality, and ultimately promotes better interpersonal relations among the nursing staff committed to offering high-quality patient care.

SUMMARY, CONCLUSION AND RECOMMENDATION

Summary

Authoritative leadership among nurses demonstrates a distribution across various levels, with 11.59% scoring in the very high range, 38.22% in the high range, and the majority, 40.12%, in the moderate range. A smaller percentage falls into the low (9.16%) and shallow (0.91%) ranges. The average score of 19.59 indicates that authoritative leadership is generally positioned in the Moderate range.

Democratic leadership style is favored among nurses, with 39.49% scoring in the very high range and 47.30% in the high range. Only 8.29% fall into the moderate range, 4.19% into the low range, and a minimal 0.72% into the Shallow range. The average score of 23.21 positions democratic leadership in the High range.

Laissez-faire leadership shows a distribution of 8.08% in the very high range, 26.03% in the high range, and the majority, 54.83%, in the moderate range. A smaller percentage falls into the low (11.06%) range, and no respondents scored in the shallow range. The average score of 18.85 indicates that laissez-faire leadership is positioned in the moderate range.

The distribution of leadership styles among nurses in healthcare facilities presents a complex landscape with varying levels of proficiency and preference. However, this also offers a promising opportunity for improvement. While generally positioned in the Moderate range, authoritative leadership can be further developed to enhance effectiveness. Democratic leadership, already in the High range, can be leveraged to foster even more positive relationships. Laissez-faire leadership, also in the Moderate range, can be transformed into a more hands-on approach. These findings underscore the need for targeted leadership development programs to enhance skills across different styles, fostering a more adaptable, supportive, and effective nursing workforce. By investing in leadership training and development, healthcare organizations can significantly improve team effectiveness, job satisfaction, and patient care outcomes. The impact of these improvements is not to be underestimated. This benefits the individual nurses and contributes to the overall improvement of our healthcare system, painting a brighter future for healthcare.

Job satisfaction among nurses in healthcare facilities is crucial, and it includes teamwork, leadership, rewards and recognition, empowerment and participation, training and individual development, working hours, communication, and working conditions. A positive indicator is that the nurses’ job satisfaction levels were interpreted as satisfied, with an average score of 3.70. It suggests that the current environment is conducive to their professional growth and well-being, which can lead to better patient care outcomes.

Nurses in healthcare facilities express satisfaction with various job satisfaction factors, including teamwork, leadership, empowerment, training, working hours, communication, and working conditions, with an overall average score of 3.70. Teamwork and leadership, which received high satisfaction scores, are crucial for enhancing job satisfaction and organizational performance. However, the rewards and recognition factor, scoring 3.33, indicates an urgent need for improvement in fair compensation and comprehensive benefits to boost motivation and commitment among nurses. Studies support that investing in leadership development, promoting teamwork, and offering continuous professional development are essential for improving job satisfaction.

To further enhance job satisfaction, healthcare organizations should focus on flexible working hours, better communication practices, and improved physical working conditions. Flexible schedules can reduce burnout and promote a healthy work-life balance, while clear communication fosters transparency and engagement. Enhancing ergonomic conditions and the physical work environment can also increase job satisfaction and productivity. By addressing these areas, healthcare facilities can create a supportive and engaging work environment that enhances nurse satisfaction, retention, and overall organizational performance, ultimately leading to better patient care outcomes.

Nurse retention in healthcare facilities is moderate, with nurses generally satisfied with how their jobs meet personal needs. However, there’s a noticeable inclination towards considering leaving the job, driven by frustration and the lure of other opportunities. While job satisfaction remains high, the moderate scores related to frustration and job-switching suggest areas for improvement. Addressing these concerns may be crucial for enhancing nurse retention and ensuring a stable and satisfied workforce in healthcare settings. This suggests a need for healthcare organizations to address factors contributing to nurse turnover, such as workload, career development opportunities, and organizational support, to enhance retention efforts effectively. By fostering a supportive work environment and aligning job roles with nurses’ aspirations, facilities can bolster job satisfaction and mitigate turnover intentions among their nursing staff.

Correlations between leadership styles and nurse retention in healthcare facilities in Cebu City. The findings reveal that authoritarian leadership, democratic leadership, and laissez-faire leadership all exhibit positive relationships with nurse retention. Notably, the laissez-faire leadership style shows the strongest correlation. This suggests that healthcare administrators employing authoritative, democratic, or hands-off leadership approaches tend to positively influence nurse retention by fostering supportive work environments and enhancing nurse job satisfaction. Overall, the combined effect of these leadership styles underscores their significant impact on nurse retention, emphasizing the critical role of leadership in shaping organizational culture and staff commitment in healthcare settings.

Pearson correlations between various aspects of job satisfaction and nurse retention in healthcare facilities in Cebu City. The findings indicate significant positive correlations between nurse retention and teamwork, leadership, empowerment/participation, and working hours. These results suggest that effective teamwork, diverse leadership styles, empowering work environments, and reasonable working hours are crucial in enhancing nurse retention. Conversely, no significant correlations were found between nurse retention and rewards/recognition, training/development, communication, and working conditions. Overall, the study underscores the importance of fostering positive work environments characterized by supportive teamwork, effective leadership practices, and opportunities for empowerment to mitigate nurse turnover in healthcare settings.

Conclusion

The hypothesis that there is no significant relationship between leadership style and retention among nurses is rejected. This implies that factors affect the study and make the results significant. Based on the given data, it can be concluded that there is a significant correlation between leadership style and retention among nurses.

The hypothesis that there is no significant relationship between job satisfaction and retention among nurses is rejected. This implies that factors affect the study and make the results significant. Based on the given data, it can be concluded that there is a significant correlation between job satisfaction and nurse retention.

The insights gleaned from the various aspects of leadership styles and job satisfaction among nurses in healthcare facilities in Cebu City paint a comprehensive picture of factors influencing nurse retention. Leadership styles, including authoritative, democratic, and laissez-faire, demonstrate significant positive correlations with nurse retention, highlighting the critical role of effective leadership in fostering supportive work environments. Specifically, laissez-faire leadership shows the strongest correlation, indicating its potential to positively impact nurse retention by allowing autonomy and flexibility.

Job satisfaction factors such as teamwork, leadership, empowerment/participation, and reasonable working hours also play pivotal roles in enhancing nurse retention. These findings underscore the importance of promoting collaborative teamwork, implementing diverse leadership practices, empowering nurses through participation in decision-making, and ensuring manageable working hours to cultivate a supportive and engaging work environment. Addressing areas for improvement, such as enhancing rewards and recognition, training opportunities, communication practices, and working conditions, can further bolster job satisfaction and ultimately contribute to mitigating nurse turnover.

Overall, by investing in effective leadership development, fostering a positive organizational culture, and addressing key job satisfaction factors, healthcare facilities can enhance nurse retention, improve patient care outcomes, and sustain long-term organizational success in Cebu City’s healthcare sector.

The correlations between leadership styles, job satisfaction, and nurse retention in Cebu City healthcare facilities align closely with established theories in leadership and motivation. Kurt Lewin’s framework categorizes leadership into authoritative, democratic, and laissez-faire styles, positively correlating with nurse retention. Authoritative leadership provides clear direction and structure, while democratic leadership fosters participation and collaboration among nurses, contributing to a supportive work environment that enhances job satisfaction and retention. Laissez-faire leadership, characterized by minimal interference and allowing autonomy, also correlates positively with nurse retention, emphasizing the importance of flexibility and trust in leadership approaches.

J. Stacy Adams’ Equity Theory emphasizes the role of fairness in workplace outcomes, such as recognition and career opportunities, relative to inputs like teamwork and empowerment. This theory aligns with the finding that factors such as teamwork, empowerment/participation, and reasonable working hours positively influence nurse retention in Cebu City’s healthcare facilities. Moreover, Frederick Herzberg’s Two-Factor Theory identifies motivators (e.g., recognition, career development) and hygiene factors (e.g., working conditions, communication) that impact job satisfaction. The significant correlations found between leadership styles, job satisfaction factors, and nurse retention underscore the theory’s relevance, highlighting the need for healthcare organizations to invest in effective leadership development and address key satisfaction factors to improve nurse retention and enhance overall organizational performance.

Recommendation

Based on the findings regarding nurse retention in healthcare facilities in Cebu City, several recommendations can be made to enhance organizational effectiveness and improve overall retention rates among nurses:

Nursing Management Practice

1. Invest in Leadership Development: Plan and execute leadership training initiatives customized for various leadership styles (authoritative, democratic, laissez-faire) to improve the efficiency of nurse leaders. Guidelines need to require ongoing professional growth to guarantee that nurse leaders have the essential abilities to lead diverse teams effectively.
2. Promote Collaborative Work Environments: Foster a culture of teamwork and collaboration among healthcare teams. Encourage open communication, mutual respect, and shared decision-making processes. This can enhance job satisfaction among nurses and contribute to a supportive workplace culture.
3. Enhance Empowerment and Participation: Empower nurses by involving them in decision-making processes related to patient care, workflow improvements, and organizational policies. This can increase job satisfaction and commitment to the organization.
4. Address Workload and Working Conditions: Evaluate and optimize nurse workload to ensure manageable working hours and workload distribution. Improve physical working conditions to provide a safe and comfortable environment for nurses. These factors significantly impact job satisfaction and can reduce burnout and turnover intentions.
5. Revamp Rewards and Recognition Programs: Implement fair and competitive compensation packages and comprehensive benefits. Recognize and reward nurses for their contributions, achievements, and dedication to patient care. Effective rewards and recognition programs can increase motivation and job satisfaction.
6. Continuous Feedback and Support: Provide regular feedback, mentorship, and professional development opportunities to nurses. Support ongoing learning and career advancement to enhance job satisfaction and retention.
7. Monitor and Adapt Strategies: Regularly assess retention metrics and employee feedback to identify areas for improvement. Adjust strategies based on feedback and evolving workforce needs to maintain a positive work environment.

Nursing Management Theory

1. Enhance Leadership Approaches: The connection between leadership styles and nurse retention indicates a necessity to enhance theoretical frameworks to investigate the effects of various leadership approaches on nurse retention. Theoretical models should encompass the specific characteristics of authoritative, democratic, and laissez-faire leadership styles within healthcare environments.
2. Contemplation of Factors that Influences Job Satisfaction and Retention: The factors affecting job satisfaction and their effect on nurse retention can aid in creating holistic job satisfaction models. Models must take into account how teamwork, leadership, empowerment, and working hours are interconnected and influence job satisfaction and retention.
3. Organizational Support Theories: The significance of organizational support is underscored by the slight inclination to contemplate leaving the job. Research should investigate how organizational support systems can reduce intentions to leave and improve nurse retention.

Nursing Education

1. Leadership Training in Nursing Curricula: Integrate leadership training into nursing education curricula, focusing on the development of authoritative, democratic, and laissez-faire leadership skills. This educational program would emphasize the importance of leadership in enhancing job satisfaction and retention.
2. Develop Student Nurses: Educate nursing students about the various factors that contribute to job satisfaction, such as teamwork, leadership, empowerment, and working conditions. Highlighting these factors can prepare future nurses to seek environments that support their professional growth and well-being.
3. Retention Strategies in Nursing Education: Incorporate strategies for improving nurse retention into nursing education. Teach students about the importance of organizational support, career development opportunities, and workload management in fostering long-term job satisfaction and retention.

Future Researches

1. Further Study the Leadership Styles: Conduct research to explore the impact of different leadership styles on various aspects of job satisfaction and nurse retention. Studies should investigate how authoritative, democratic, and laissez-faire leadership approaches influence nurse performance and patient care outcomes.
2. Conduct Long-term Studies on Job Satisfaction: Perform longitudinal studies to track changes in job satisfaction over time and identify the long-term effects of improvements in teamwork, leadership, empowerment, and working conditions on nurse retention.
3. Evaluate the Impact of Reward and Recognition: Research the effectiveness of different reward and recognition systems in improving nurse motivation and retention. Studies should evaluate the impact of various compensation and benefit structures on job satisfaction and organizational commitment.
4. Assess Organizational Support Mechanisms: Investigate the role of organizational support mechanisms in mitigating nurse turnover intentions. Research should focus on identifying effective support strategies that align with nurses’ personal and professional needs.
5. Limitation of the Study: Utilizing larger, diverse samples from multiple healthcare settings, employing validated measurement tools, and adopting longitudinal designs to track changes over time. Exploring different leadership styles, reward and recognition systems, and organizational support mechanisms offers a deeper understanding of their impacts on job satisfaction and nurse retention.

The following research titles are suggested:

6.1 Understanding the Role of Work-Life Balance in Nurse Job Satisfaction and Retention: A Qualitative Inquiry

6.2 Investigating the Impact of Professional Development Opportunities on Nurse Job Satisfaction and Retention and;

6.3 The Impact of Recognition and Reward Programs on Nurse Job Satisfaction and Retention: An Empirical Analysis

ACKNOWLEDGEMENTS

Without the direction and aid of several people who, in various ways, contributed and extended their invaluable assistance in the preparation and execution of this study, this research study would not have been feasible.

First and foremost, the researcher should express gratitude to the Almighty God for His unwavering grace, direction, and protection during this study endeavor.

The researcher would like to sincerely thank Dr. Betty Lynn C. Garingo, advisor, for her unwavering support, tremendous expertise, patience, and enthusiasm in this study. Her advice was invaluable to him while he conducted the research and wrote the thesis.

He further expresses his gratitude to Dr. Resty L. Picardo, the Chair of the Panel of Examiners, and to Dr. Joan Bacarisas, and Dr. Jake Napoles, committee members, for the valuable expert guidance he received from polish his thesis.

In addition, he would like to express his gratitude to his parents and family, whose comprehension and unwavering support enabled him to overcome all the difficulties he faced. Because of their encouragement, he became strong and motivated to achieve the pinnacle of his professional career.

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