The Relationship between Professional Quality of Life, Passion, and Intention to Quit Jobs among Nurses in the Post-COVID-19 Era in Mississippi

Abstract: The National Council of State Boards of Nursing revealed that approximately 100,000 registered nurses (RNs) exited the profession during the COVID-19 pandemic (Muoio, 2023). By 2027, around 800,000 RNs are estimated to leave the profession in the United States (Muoio, 2023). The continuous decline of the nursing workforce could increase the workload for the remaining RNs, prevent the sustainability of the profession, and negatively impact patient satisfaction (Shdaifat et al., 2023; BLS, 2022; Penn & Nezamis, 2022; Zhang et al., 2021). The primary reason RNs quit their jobs is their declining Professional Quality of Life (ProQOL), mainly contributed by burnout and stress (Shdaifat et al., 2023).
ProQOL is “the emotional state of mind of a healthcare worker while discharging his or her duties” (Stamm, 2020, p. 8). The emotional state of mind could result in either compassion satisfaction (CS) derived from helping patients or compassion fatigue (burnout and traumatic stress) due to patients' prolonged physical and emotional demands (Stamm, 2010). A report from a survey of 1,000 workers shows that 92% of American workers quit their jobs because they do not want to stay in jobs that they are not passionate about (Madison & Kaplan, 2021).
As a philosophical concept, passion refers to a solid motivational impetus or enthusiasm that drives people to engage in their work (Vallerand et al., 2003). Passion has two meanings: harmonious and obsessive passion. In harmonious passion, an individual builds personal harmony for a profession that is in accord with aspects outside his or her profession (Vallerand et al., 2003). In obsessive passion, an individual engages in uncompromising determination for a job even when the circumstances surrounding the job might be counterproductive (Rip et al., 2006). While prior studies have examined the individual relationships between ProQOL, passion, and intention to quit jobs (Shdaifat et al., 2023; Smith et al., 2019), there are limited attempts to study these factors collectively among RNs after the COVID-19 pandemic. Examining employee passion and its relationship to RNs’ intent to quit jobs could help improve job quality and increase job satisfaction, reducing the high turnover experienced since the COVID-19 pandemic.
The research question for this study is, how do ProQOL and passion affect RNs’ intention to quit jobs? The study will adopt the ProQOL model (Stamm, 2010), the two-factor model of passion (Vallerand & Houlfort, 2019), and the psychological contract theory (Rousseau, 1989) as conceptual framework. The research hypotheses (Ra) are Ra1- Passion mediates the relationship between the intention to quit a job and ProQOL among nurses. Ra2- The intention to quit a job mediates the relationship between passion and ProQOL among nurses. Ra3- ProQOL mediates the relationship between the intention to quit a job and passion.
Data will be collected after IRB approval using a survey questionnaire and Qualtrics from RNs working in hospitals in Mississippi due to how their shortage contributes to the current strain experienced by professional nurses in the state (Holcombe et al., 2021). There are 29,370 RNs in Mississippi (BLS, 2023); a sample size of 380 will attain a 95% confidence level, 5% margin error, and a 50% outcome distribution (Raosoft, 2023). ProQOL scale (Stamm, 2010) will be adopted, using a 5-point Likert scale. Circenis et al. (2013) found a Cronbach's alpha coefficient of 0.880 for the CS, 0.711 for the burnout, and 0.740 for the traumatic stress subscales. The passion scale (Vallerand et al., 2003) will also be utilized. The scale is divided into harmonious and obsessive subscales using a 7-point Likert scale. Mudo-Głagolska et al. (2019) found a Cronbach alpha coefficient of 0.77 for harmonious passion and 0.81 for obsessive passion subscales.
The Nurse Turnover Intention Scale (NTIS) (Michael & Spector, 1982) will measure nurses' intention to quit jobs. The NTIS scale comprises three subscales, using a 4-point scale. Hu et al. (2022) achieved Cronbach’s alpha coefficients for the three dimensions being 0.79, 0.63, and 0.72, respectively. A reliability test and a pilot study will also be conducted to avoid instrument errors and ambiguity. The RNs’ email addresses in each hospital will be retrieved via a contact person to email the survey link. $20 Amazon gift cards as incentives will be given to the best five participants after a drawing. Frequency distribution will be used to analyze the demographic characteristics of the participants. Pearson’s r correlation, multiple regression analysis, and Two-Way ANOVA will be used to test the research hypotheses using IBM SPSS. The study may help to identify interventions and strategies to reduce job quitting among RNs.