Nurses’ Turnover Intention: The Role of Loneliness and Emotional Labor

AIM: Guided by social exchange theory and the concept of social integration, this study examined whether emotional labor strategies mediate the association between loneliness and turnover intentions among nurses. BACKGROUND/INTRODUCTION: Nurse turnover remains a critical challenge globally, with turnover intentions exceeding other healthcare professions' averages. Loneliness has been increasingly recognized as a psychosocial risk factor in healthcare settings, yet its relationship with emotional labor strategies and turnover intention remains underexplored. METHODS: The study utilized a cross-sectional correlational design. RESULTS: Nurses reported moderate levels of loneliness and turnover intentions. Loneliness was significantly associated with both organizational and professional turnover intention. When mediators were included, the direct effects of loneliness on turnover remained significant. Surface acting partially mediated the relationship between loneliness and organizational turnover intention, while deep acting and expression of naturally felt emotions were nonsignificant mediators. For professional turnover intention, indirect effects were nonsignificant, indicating a primarily direct association with loneliness. DISCUSSION: The central finding reinforces prior research demonstrating the association between social disconnection and nurses' well-being and retention. CONCLUSIONS: Findings highlight loneliness as a potential salient predictor of nurse turnover intentions, with surface acting amplifying its effect on organizational turnover. IMPLICATIONS FOR NURSING: Interventions should prioritize fostering social integration, reducing workplace ostracism, and promoting healthier emotion regulation strategies to mitigate turnover risks. Future research should employ longitudinal and interventional designs to clarify causal mechanisms and test the effectiveness of targeted support programs. IMPLICATIONS FOR HEALTH POLICY: The findings contribute to healthcare policy by highlighting the necessity of addressing psychosocial determinants of workforce stability alongside financial and structural reforms.