Organisational mechanisms shaping nurses’ professional quality of life and turnover intention: a mixed-methods study in a tertiary hospital in the United Arab Emirates

Abstract Background Nursing workforce shortages and turnover remain major challenges for healthcare systems worldwide, particularly in expatriate-dominant healthcare contexts. Professional Quality of Life (ProQOL), comprising compassion satisfaction, burnout, and secondary traumatic stress, provides a useful framework for understanding nurses’ professional wellbeing. However, limited evidence explains how organisational mechanisms shape ProQOL and turnover intention among internationally recruited nurses in Gulf healthcare systems. Methods This study used an explanatory sequential mixed-methods design in a tertiary hospital in Abu Dhabi, United Arab Emirates. In the quantitative phase, 211 registered nurses completed the Professional Quality of Life Scale Version 5 (ProQOL-V5) and the Turnover Intention Scale (TIS-6). Descriptive statistics, Pearson correlations, multiple linear regression, and multicollinearity diagnostics were conducted. In the qualitative phase, two focus group discussions with 18 participants, including frontline nurses, nurse supervisors, and unit managers, explored organisational factors influencing nurses’ professional experiences. Qualitative data were analysed using reflexive thematic analysis, and findings were integrated through meta-inference. Results Participants reported moderate compassion satisfaction, low-to-moderate burnout, and moderate secondary traumatic stress. Burnout and secondary traumatic stress were positively associated with turnover intention, while compassion satisfaction was negatively associated with turnover intention. The regression model explained 31% of the variance in turnover intention; however, findings were interpreted cautiously because the TIS-6 showed low internal consistency in this sample. Findings involving turnover intention should therefore be regarded as exploratory. Multicollinearity diagnostics indicated that severe multicollinearity was not present, although burnout and secondary traumatic stress were strongly correlated. Four qualitative themes emerged: leadership responsiveness, workload and documentation burden, peer support and professional fulfilment, and organisational structures influencing retention. The qualitative findings explained how workload pressure, staffing shortages, delayed organisational responses, workplace support, and professional development shaped nurses’ wellbeing and retention intentions. Conclusion Nurses’ professional quality of life and turnover intention appeared to be shaped by the balance between organisational demands and resources. Supportive leadership, adequate staffing, peer support, and meaningful professional development may help strengthen nurse wellbeing and retention in expatriate-dominant healthcare settings. The findings highlight the need for organisational and policy-level strategies that address workforce planning, leadership responsiveness, and culturally responsive retention support.