Leadership Perspectives on Nurse Retention: A Phenomenological Study of Workforce Sustainability in Private Hospitals of Nueva Ecija

Kristhine Abegail M. Gamiao; Helen Ruth DC De Guzman; Froilan C. Diolosa

Authors

Kristhine Abegail M. Gamiao Nueva Ecija University of Science and Technology
Helen Ruth DC De Guzman Nueva Ecija University of Science and Technology
Froilan C. Diolosa Nueva Ecija University of Science and Technology

Keywords:

Nurse retention, nursing shortage, job satisfaction, work environment, leadership perspectives

Abstract

The healthcare sector in the Philippines faces a severe nursing shortage, intensified by high turnover rates—particularly in private hospitals in Nueva Ecija. This qualitative phenomenological research investigates strategies for retaining nurses by delving into the experiences of nurse supervisors and chief nurses within these institutions. Through purposive sampling and in-depth interviews, the study investigates factors influencing staff nurses’ decisions to stay leave, focusing on job satisfaction, burnout, and leadership practices. Findings highlight that nurse retention is shaped by generational differences, financial constraints, and workplace conditions. While many nurses remain committed to their profession, issues such as inadequate compensation, limited advancement opportunities and burnout hinder retention. Effective solutions must be comprehensive, combining competitive pay, structured mentorship, manageable workloads, and inclusive leadership. The study underscores the importance of cultivating supportive work environments, enhancing recognition, and involving nurses in policy development to boost morale and commitment. Recommendations include developing onboarding programs tailored to generational needs, institutionalizing mentorship, improving compensation packages, ensuring adequate staffing and resources, strengthening feedback mechanisms, and promoting continuous professional development. By focusing on nursing leaders’ perspectives, this research addresses a notable gap in the literature concerning private hospitals in Nueva Ecija. The insights generated aim to inform evidence-based strategies to reduce nurse turnover, stabilize the workforce, and improve healthcare delivery in the region. Ultimately, the study calls for systemic reforms and responsive leadership as essential steps toward sustaining the nursing workforce amid ongoing challenges.

References

AbdELhay, E. S., Taha, S. M., El-Sayed, M. M., Eladawi, N., Mohamed, A. H., & Abdelaziz, E. M. (2025). Nurses retention: The impact of transformational leadership, career growth, work well-being, and work-life balance. BMC Nursing, 24, 148. https://doi.org/10.1186/s12912-025-02762-1

Almalki, M. J., FitzGerald, G., & Clark, M. (2023). The relevance of nurses' self-concept in the social exchange process. Management Decision, 61(4), 1025–1038. https://doi.org/10.1108/MD-07-2022-1015

Alshammari, F., Alotaibi, M., & Alshammari, M. (2024). Bridging the generational gap between nurses and nurse managers. Journal of Multidisciplinary Healthcare, 17, 1234–1249. https://doi.org/10.2147/JMDH.S123456

Bell, S., Gorsuch, P., Beckett, C., McComas, A., Boss, K., & Rose, K. (2025). An evidence-based initiative to reduce new graduate nurse turnover: Implementation of a mentorship program. Worldviews on Evidence-Based Nursing, 22(2), e70009. https://doi.org/10.1111/wvn.70009

De Guzman, A. B., & Dela Cruz, F. A. (2022). Should I stay or should I go? A mixed methods study on nurse retention and migration intentions in the Philippines. Human Resources for Health, 20(1), Article 86. https://doi.org/10.1186/s12960-022-00776-1

Dluha Mafula, H., Arifin, H., Chen, R., Sung, C.-M., Lee, C.-K., Chiang, K.-J., Banda, K. J., & Chou, K.-R. (2025). Prevalence and moderating factors of turnover rate and turnover intention among nurses worldwide: A meta-analysis. Journal of Nursing Regulation, 15(4), 20–36. https://doi.org/10.1016/S2155-8256(25)00031-6

Department of Health. (2023, June 21). DOH chief warns PH may run out of nurses in 3–5 years amid exodus. Manila Standard. Retrieved June 14, 2025, from https://manilastandard.net/?p=314342002

Duffield, C., Roche, M., Blay, N., & Stasa, H. (2023). Nursing staffing, nursing workload, the work environment and patient outcomes. Applied Nursing Research, 70, 151490. https://doi.org/10.1016/j.apnr.2022.151490

Duffield, C., Roche, M., Blay, N., & Stasa, H. (2024). Impact of the work environment on nurse outcomes: Emotional exhaustion and intent to leave. Journal of Nursing Management, 32(2), 345–355. https://doi.org/10.1111/jonm.13895

Fang, D., & Li, X. (2021). Advancing nursing education to meet evolving healthcare demands: The rise of BSN and graduate degrees and implications for workforce development. Journal of Nursing Scholarship, 53(4), 456–465. https://doi.org/10.1111/jnu.12635

Galanis, P., Moisoglou, I., Katsiroumpa, A., Gallos, P., Kalogeropoulou, M., Meimeti, E., & Vraka, I. (2025). Workload increases nurses’ quiet quitting, turnover intention, and job burnout: Evidence from Greece. AIMS Public Health, 12(1), 44–55. https://doi.org/10.3934/publichealth.2025004

Gharaibeh, M. B. (2024). A conceptual model of nurse retention integrating quality of work life and human resource management: The case of Jordan. International Journal of Human Resource Studies, 14(1), 56–78. https://doi.org/10.5296/ijhrs.v14i1.21430

Gularte-Rinaldo, J., Baumgardner, R., Tilton, T., & Brailoff, V. (2023). A nurse mentorship program’s impact on transition to practice and decision to remain in nursing for newly graduated nurses. Journal of Multidisciplinary Healthcare, 16, 2345–2357. https://doi.org/10.2147/JMDH.S9375843

He, F., Zhang, L., & Liu, Y. (2025). Analysis of nursing staff job satisfaction and its influencing factors: A cross-sectional study in Nantong, China. International Journal of Nursing Sciences, 12(1), 45–54. https://doi.org/10.1016/j.ijnss.2024.12.004

Higgins, J. (2022). Retention strategies for the current nursing workforce (Doctoral dissertation, Walden University). Walden Dissertations and Doctoral Studies. https://scholarworks.waldenu.edu/dissertations/12345

International Council of Nurses. (2025). Caring for nurses: Our nurses, our future – ICN’s agenda for sustainable workforce well-being. Geneva, Switzerland: Author.

Jang, S.-Y., & Kim, J.-H. (2024). The experience of good mentoring focused on overcoming turnover among millennial nurses in the nursing workforce. Frontiers in Medicine, 11, Article 1288829. https://doi.org/10.3389/fmed.2024.1288829

Kelly, L. A., Gee, P. M., & Butler, R. J. (2024). The impact of nurse burnout on organizational and position turnover. Nursing Outlook, 72(1), 44–52. https://doi.org/10.1016/j.outlook.2023.09.002

Kurniati, A., & Wulandari, L. (2025). Factors influencing nurse retention in conflict zones: A systematic review. Indonesian Journal of Global Health Research, 7(2), 55–66. https://doi.org/10.37287/ijghr.v7i2.5302

Kutney-Lee, A., Wu, E. S., Sloane, D. M., & Aiken, L. H. (2021). Changes in hospital nurse work environments and nurse job outcomes: An analysis of panel data. International Journal of Nursing Studies, 115, 103823. https://doi.org/10.1016/j.ijnurstu.2020.103823

Manila Standard. (2025, June 12). Poor job prospects for nursing, medicine graduates in Philippines. Manila Standard. Retrieved June 14, 2025, from https://manilastandard.net/news/314602210/poor-job-prospects-for-nursing-medicine-graduates-in-philippines-study.html

Manley, K., Sanders, K., Cardiff, S., & Webster, J. (2024). Effective workplace culture: The key to nurse retention. Journal of Nursing Management, 32(3), 456–465. https://doi.org/10.1111/jonm.13900

National Academies of Sciences, Engineering, and Medicine. (2020). The future of nursing 2020–2030: Charting a path to achieve health equity. Washington, DC: National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK573922/

National Healthcare Retention & RN Staffing Report. (2025). Retrieved from https://www.nsinursingsolutions.com

Nguyen, T. H., & Parker, V. (2021). Leadership strategies for early detection of nurse dissatisfaction and turnover: A mixed-methods study. Journal of Nursing Administration, 51(6), 320–327. https://doi.org/10.1097/NNA.0000000000001012

Park, H., & Yu, S. (2019). Effective policies for eliminating nursing workforce shortages: A systematic review. Health Policy and Technology, 8(3), 296–303. https://doi.org/10.1016/j.hlpt.2019.08.003

Rillo, M. (2025, January 2). PH faces shortage of nurses, solon warns. Manila Standard. Retrieved June 14, 2025, from https://manilastandard.net/news/314542714/ph-faces-shortage-of-nurses-solon-warns.html

Roche, M. A., Duffield, C., & White, E. (2025). Scheduling is everything: Nurses’ perspectives on scheduling practices and job satisfaction. Journal of Nursing Administration, 55(3), 145–152. https://doi.org/10.1097/NNA.0000000000001234

Shields, M. A., & Ward, M. (2025). Improving nurse retention: The role of compensation, work environment, and organizational culture. Journal of Nursing Management, 33(1), 112–123. https://doi.org/10.1111/jonm.14012

Smith, J., & Jones, M. (2024). A systematic review on how the nursing work environment, job satisfaction, and burnout influence nurse retention. Educational Administration: Theory and Practice, 30(1), 1916–1925. https://doi.org/10.53555/kuey.v30i1.6752

Wang, Y., & Zhang, L. (2022). The effects of work satisfaction and work flexibility on burnout in nurses. Journal of Nursing Research, 30(6), e234. https://doi.org/10.1097/jnr.0000000000000234

Wu, F., Lao, Y., Feng, Y., Zhu, J., Zhang, Y., & Li, L. (2024). Worldwide prevalence and associated factors of nursing staff turnover: A systematic review and meta-analysis. Nursing Open, 11(1), e2097. https://doi.org/10.1002/nop2.2097

Vanaki, Z., & Navipour, H. (2020). Analysis and strategy research on quality of nursing work life. International Journal of Nursing Sciences, 7(1), 123–130. https://pmc.ncbi.nlm.nih.gov/articles/PMC7015641/

Zhang, Y., & Liu, Y. (2022). Understanding nurse burnout and job satisfaction: The role of workload, leadership support, and communication in healthcare settings. Journal of Nursing Management, 30(3), 789–797. https://doi.org/10.1111/jonm.13567