Supervisor Support and Turnover Intention: A Systematic Review of the Literature

Maintaining adequate nursing staff is a real challenge that many healthcare organizations are facing. Many factors have been identified to positively influence the reduction of Turnover Intention (TI) among registered nurses. One significant factor recently discussed in literature that requires more attention is supervisor support in the workplace.

Aim. This systematic review of the literature aims to: (a) review and critique the published research on supervisor support in the workplace as an approach to reduce TI, (b) synthesize the findings across studies, and (c) identify the gaps in the literature and make recommendations for further research.

Methods. Five steps to conducting a systematic review were adopted (Khan, et. al, 2003). These steps included (a) framing the question as “What is the relationship between supervisor support and TI” (b) identifying relevant work, (c) assessing the quality of studies, (d) summarizing the evidence, and (e) interpreting the findings. Electronic literature databases CINAHL, Academic Search Complete, Business Source Premier, Education Research Complete, Health Source, and PsycINFO were searched for review using a combination of keywords.

Results. The question was framed as: What is the relationship between supervisor support and TI.  In total, 531 publications were located. 318 unique publications remained after de-duplication. After reading titles and abstracts, a total of 14 articles were selected to be read in full text. Examination of the reference lists of these 14 articles revealed eight more articles to be included in the review. After screening, a total of 12 articles were included in this systematic review.  Only one study included registered nurses as subjects (Galletta, et al. 2011). All 12 studies included in the review consistently found a negative association between supervisor support and TI. However, there were variations in the strength of this association. 

Nursing Implications.  Support in the workplace could be seen as a serious resource for reducing nursing turnover. Nursing supervisor and managers are encouraged to improve their supportive behaviors. Nursing administrators are encouraged to educate nursing supervisors about the importance of support for the benefit of the nurses, supervisors, patients and the organizations. The concept of supervisor support can be introduced to nursing students early in their education, as a part of the nursing leadership and management curricula.

Conclusion. This systematic review points to the potential of decreasing TI by improving supervisors’ support behaviours. Although there are discrepancies within the literature regarding the strength of the association between supervisor support and TI, evidence suggests that supervisor support could impact employees’ TI and thus actual turnover. However, further research to evaluate the effectiveness of supervisor support on TI is highly recommended, including interventional studies.  Further studies that examine the influence of different types supervisors’ behaviors perceived as supervisor support are encouraged. Such studied would help supervisors to identify most influential behaviors to enhance the perceived supervisor support among employees. Lastly, with the current shortage and high rates of turnover in nursing, it is recommended to conduct more studied in hospital setting that  evaluate the impact of supervisor support on nurses TI.