The importance of supervisor–nurse relationships, teamwork, wellbeing, affective commitment and retention of North American nurses

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Using Social Exchange Theory, this study examines links between supervisor–nurse relationships, teamwork, psychological wellbeing and turnover intentions for nurses in the USA.


Nurses in the USA comprise the biggest workforce of any country in the world. However, nurses continue to be in short supply even with an aggressive campaign to attract foreign nurses. The shortage of qualified registered nurses has negative implications for patient care and mortality because it affects problem-solving and teamwork as a result of poor communication among nurses.


The study uses a cross-sectional design and 730 completed surveys were obtained using a self-report strategy.


The findings indicate that supervisor–nurse relationships, teamwork and wellbeing explain almost half of nurses' commitment to their hospital and their intentions to leave. Further, there was evidence of a generational effect in that Baby Boomer nurses perceived higher levels of wellbeing and commitment, and lower intention to leave.

Implications for nursing management

These findings suggest that management must focus on improving the quality of workplace relationship as a first step in retaining skilled nurses. It may be time for management to embed performance indicators for all levels of management, linked to ensuring effective workplace relationships.

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