Title : Identifying factors influencing nurses’ decision to remain in the clinical setting

Background: Nursing turnover continues to challenge healthcare organizations worldwide by compromising workforce stability, increasing operational costs, and affecting the quality of patient care. Despite retention initiatives, understanding the factors that influence nurses' decisions to remain in clinical practice is essential for developing effective workforce strategies. This study aimed to identify the factors associated with job satisfaction and nurses' intention to remain in the clinical setting at a Magnet-designated tertiary hospital in Saudi Arabia.

Methods: A descriptive, quantitative survey study was conducted at King Faisal Specialist Hospital & Research Centre, Jeddah in Saudi Arabia. A simple random sample of 286 full-time Staff Nurse I employees with at least one year of clinical experience participated. Data were collected using a validated self-administered questionnaire that assessed demographic characteristics, job satisfaction (19-item Likert scale), turnover intention (4-item Likert scale), and intention to return. Descriptive statistics and inferential analyses, including Chi-square testing, were performed using SPSS.

Results: Participants were predominantly female (91.6%), with a mean age of 39 years and an average of 15 years of clinical experience. Overall job satisfaction was moderate (mean = 3.01). The lowest satisfaction scores were related to salary (2.69), work schedule flexibility (2.98), and supervisor recognition (2.91), consistent with previous studies identifying compensation and workload as major contributors to nurse dissatisfaction (Alonso et al., 2017; Duffield et al., 2014). In contrast, peer relationships (3.08) and job security (3.05) received the highest satisfaction ratings, highlighting the importance of supportive work environments. Nurses reported moderate turnover intentions, with returning to previous employment (3.46) representing the strongest intention, while transferring to another local healthcare organization (2.61) was the least likely option. No statistically significant association was found between gender and turnover intention (p > 0.05).

Conclusion: This study is consistent with existing literature demonstrating that female nurses continue to represent the majority of the nursing workforce. Addressing their work-life needs is essential to enhance job satisfaction and retention. Competitive compensation that reflects the cost of living, flexible scheduling to support work-life balance, and meaningful recognition from nursing leaders and colleagues are key organizational factors that contribute to retaining a satisfied and sustainable nursing workforce.

Shoug Alsobhi, BSN, ICPM, is a Nurse Recruiter in Nuring recruitment and retention at King Faisal Specialist Hospital & Research Centre (KFSH&RC), Jeddah, Saudi Arabia. She earned her Bachelor of Science in Nursing with Second Honors from King Abdulaziz University in 2009 and has worked at KFSH&RC since 2010. Her clinical experience includes surgical and renal transplant units before transitioning to nursing recruitment and retention. She obtained the Certified Supervisor (ICPM) certification in January 2026. Shoug presented at the ANCC National Magnet® Conference in 2016 and recently completed research focusing on nursing workforce sustainability, job satisfaction, and nurse retention strategies.