Job Satisfaction and Nurses’ Retention: The Mediating Role of Nurses’ Engagement Among Nurses at Madinah Hospitals Complex, Saudi Arabia

Background: Healthcare organizations need to have steady staffing levels to ensure stability of their workforce and to continuously provide care to their patients. The goals of an organization may remain out of reach if staff attrition affects service delivery. Healthcare organizations must therefore address issues related to nurse retention as the loss of a single nurse may impact on a specific patient. Job satisfaction has been identified as a possible reason why nurses stay while engagement has been shown to be an important psychological mechanism in the relationship between job satisfaction and retention. Purpose: To determine the relationship between job satisfaction and retention of nurses employed at Madinah Hospitals Complex, Saudi Arabia, and the role engagement may play in mediating nurses’ retention. Methods: The researcher employed a quantitative cross-sectional survey to collect 308 completed surveys from nurses. The researcher used validated measures of job satisfaction, engagement, and retention, and PLS-SEM to analyze the data. The coefficients for this paper were extracted from the author's dissertation to represent the four-construct model and therefore the adjustment of transformation leadership, whereas other studies re-estimated the model to include three constructs. Results: There was a positive association between satisfaction at work and engagement of nurses (β = .686, t = 11.928, p < .001) and the intention to remain (β = .502, t = 8.799, p < .001). The intention to remain was positively associated with the engagement of nurses (β = .305, t = 5.384, p < .001). The indirect association that was mediated by engagement was significant (β = .209, t = 4.616, p < .001), which provides support to the complementary partial mediation in the Four-Construct Model. Conclusion: Relationships were found between job satisfaction, engagement, and nurses’ retention intentions. With job satisfaction, engagement was the statistical pathway connecting favorable employment evaluations with greater retention intentions. In the presented cross-sectional data, there is no indication of causality or temporality; thus, the reported coefficients can only be considered as approximations of the well-defined four-construct model.