• nurses;
  • turnover;
  • organizational commitment;
  • perceived organizational support;
  • well-being;
  • employee engagement;
  • international



We examined the impact of workplace relationships (perceived organizational support, supervisor–nurse relationships and teamwork) on the engagement, well-being, organizational commitment and turnover intentions of nurses working in Australian and USA hospitals.


In a global context of nurse shortages, knowledge about factors impacting nurse retention is urgently sought. We postulated, using the Social Exchange Theory, that nurses' turnover intentions would be affected by several factors and especially their relationships at work.


Based on the literature review, data were collected via a self-report survey to test the hypotheses.


A self-report survey was used to gather data in 2010–2012 from 510 randomly chosen nurses from Australian hospitals and 718 nurses from US hospitals. A multi-group structural equation modelling analysis identified significant paths and compared the impact between countries.


The findings indicate that this model was more effective in predicting the correlations between variables for nurses in Australia compared with the USA. Most paths predicted were confirmed for Australia, except for the impact of teamwork on organizational commitment and turnover, plus the impact of engagement on turnover. In contrast, none of the paths related to supervisor–subordinate relationships was significant for the USA; neither were the paths from teamwork to organizational commitment or turnover.


Our findings suggest that well-being is a predictor of turnover intentions, meaning that healthcare managers need to consider nurses' well-being in everyday decision-making, especially in the cost-cutting paradigm that pervades healthcare provision in nearly every country. This is important because nurses are in short supply and this situation will continue to worsen, because many countries have an ageing population.