The impact of hospital ethical climate on turnover intention among nurses working in intensive care, oncology, and emergency department units: a cross sectional study

Hospital ethical climate is a key determinant of the quality of nursing care and plays a critical role in shaping nurses’ professional experiences. A positive ethical environment has been associated with improved job satisfaction and reduced nurse turnover intention. This study aimed to examine the influence of hospital ethical climate and sociodemographic factors on turnover intention among nurses working in intensive care, oncology, and emergency department units in Saudi Arabia. A cross-sectional, correlational study was conducted with 143 participant nurses working in intensive care, oncology and emergency department units in both governmental and private healthcare organizations from 13 regions in Saudi Arabia. The Hospital Ethical Climate Survey (HECS) and the Turnover Intention Scale were administered to the participants to determine the influence of sociodemographic and HECS variables on nurses’ turnover intention. The nurses who work in oncology units reported higher turnover intention (F = 3.34, p = 0.038). Additionally, hospital ethical climate and turnover intention showed significant moderate negative association ( r = − 0.483, p < 0.001), indicating that more positive perceptions of the ethical climate were associated with lower intention to leave. Furthermore, hospital ethical climate emerged as the only significant predictor of turnover intention (β = −0.490, p < 0.001). The model explained 25.5% of the variance in turnover intention (R² = 0.255; adjusted R² = 0.216). The findings confirm that a supportive ethical hospital climate significantly reduces nurses’ intention to leave, as those who perceive their workplace as ethically sound tend to remain loyal and engaged within their organizations. Healthcare organizations should implement strategic interventions including ethics training to promote positive ethical climates that help in effective retention of their nursing workforce.