The Mediating Effect of Burnout and Job Satisfaction on the Relationship Between Professional Identity, Occupational Stress, and Turnover Intentions in the Post-Pandemic Era

Background: The COVID-19 pandemic has exacerbated the global nursing shortage, leading to increased turnover intentions among nurses due to heightened workplace stress, burnout, and job dissatisfaction. This study investigates the mediating effects of burnout and job satisfaction on the relationship between professional identity, occupational stress, and nurses' turnover intentions. Additionally, it explores the impact of socio-demographic factors on these relationships in the post-pandemic era. Methods: A cross-sectional study of 338 nurses across 4 hospitals in Israel was conducted between June 2023 and January 2024. Self-reported questionnaires were utilized to measure turnover intention using the Turnover Intention Scale, with professional identity and occupational stress as predictors and burnout and job satisfaction as mediators. A fixed effect path analysis approach was employed to assess the hypothesized mediation model, controlling for hospital-level variance and socio-demographic variables. Results: The findings revealed that professional identity was negatively associated with burnout (beta = -0.26, p < 0.001) and positively associated with job satisfaction (beta = 0.25, p < 0.001). Occupational stress was positively associated with burnout (beta = 0.57, p < 0.001) and negatively associated with job satisfaction (beta = -0.42, p < 0.001). Burnout (beta = 0.35, p < 0.001) and job satisfaction (beta = -0.10, p = 0.025) were both significantly associated with turnover intentions. Mediation analysis indicated that job satisfaction and burnout fully mediated the relationship between professional identity and turnover intentions, and partially mediated the relationship between occupational stress and turnover intentions. Linking Evidence to Action: The study highlights that professional identity mitigates nurse turnover by increasing job satisfaction and reducing burnout, while occupational stress drives turnover intentions by increasing burnout and decreasing job satisfaction. Tailored interventions aimed at enhancing professional identity and addressing occupational stress, particularly in light of pandemic-related challenges, are essential for improving nurse retention and well-being in the post-pandemic era.