حفاظت از مراقبت های بهداشتی از طریق پشتیبانی سازمانی برای کاهش قصد فروش Protecting healthcare through organizational support to reduce turnover intention

Introduction: The importance of health care sector is essential in improving health related outcomes. This requires improvement in quality as well as quantity of health care providers (Zhang et al., 2016) . In terms of quality, scarcity of the qualified health care professional (Wong et al., 2015) and in terms of quantity the shortage of the nurses (Nardi & Gyurko, 2013) is the main obstacle in achieving improved health care outcomes. According to the statistics provided by the World Health Organization (WHO, 2006), there is a shortage of 4.3 million nurses across globe. While, as per the statistics provided by European Commission and United States, this figure would become worse in 2020, i.e. 590,000 and 340,000 respectively (Sermeus & Bruyneel, 2010; Auerbach, Buerhaus & Staiger, 2007). In Pakistan, the number of nurses rose from 25000 in 1997 to 90,276 in 2015 (Economic survey of pakistan, 2014-15). However, the problem of nurse shortage is still the same as the government of Pakistan has reported a shortage of 60,000 nurses (Khawaja, 2013). There are a number of reasons behind the shortage of nurses in Pakistan i.e. less institutions, brain drain, bullying, monetary incentives and turnover (Islam, Ahmed & Ali, 2017; Khowaja, 2009; Khawaja, 2013). Amongst these, the issue of turnover among Pakistani nurses is at a higher level (Shehzad and Malik, 2014; Somani & Khowaja, 2012), which has become a challenge for the health care professionals. Despite ample literature, researchers are still unable to identify the actual reasons of nurse turnover, therefore, they have suggested study turnover intention (Tett and Meyer, 1993; Miller et al., 1979). According to Islam et al., (2013), “…turnover intention is the last cognitive step employees make in voluntary turnover”. Employees’ intention to leave the organization may be reduced by increasing their level of organizational commitment (OC) and organizational citizenship behavior (OCB) (Gupta et al., 2016; Islam, Khan & Bukhari, 2016). OCB is the ” individual behavior that is discretionary, not directly or explicitly recognized by the formal reward system and in the aggregate promotes the efficient and effective functioning of the organization (Organ 1988, p. 4)”.