A global overview of healthcare workers’ turnover intention amid COVID-19 pandemic: a systematic review with future directions

Abstract

Background Globally, the health workforce has long suffered from labour shortages. This has been exacerbated by the workload increase caused by the COVID-19 pandemic. Major collapses in healthcare systems across the world during the peak of the pandemic led to calls for strategies to alleviate the increasing job attrition problem within the healthcare sector. This turnover may worsen given the overwhelming pressures experienced by the health workforce during the pandemic, and proactive measures should be taken to retain healthcare workers. This review aims to examine the factors affecting turnover intention among healthcare workers during the COVID-19 pandemic. Methods A mixed studies systematic review was conducted. The PubMed, Embase, Scopus, CINAHL, Web of Science and PsycINFO databases were searched from January 2020 to March 2022. The Joanna Briggs Institute’s Critical Appraisal Tools and the Mixed Methods Appraisal Tool version 2018 were applied by two independent researchers to critically appraise the methodological quality. Findings were synthesised using a convergent integrated approach and categorised thematically. Results Forty-three studies, including 39 quantitative, two qualitative and two mixed methods studies were included in this review. Eighteen were conducted in the Middle East, ten in the Americas, nine in the Asia–Pacific region and six in Europe. Nurses (n = 35) were included in the majority of the studies, while physicians (n = 13), allied health workers (n = 11) and healthcare administrative or management staff (n = 7) were included in a smaller proportion. Five themes emerged from the data synthesis: (1) fear of COVID-19 exposure, (2) psychological responses to stress, (3) socio-demographic characteristics, (4) adverse working conditions, and (5) organisational support. Conclusions A wide range of factors influence healthcare workers’ turnover intention in times of pandemic. Future research should be more focused on specific factors, such as working conditions or burnout, and specific vulnerable groups, including migrant healthcare workers and healthcare profession minorities, to aid policymakers in adopting strategies to support and incentivise them to retain them in their healthcare jobs.

Longitudinal Study Comparing Mental Health Outcomes in Frontline Emergency Department Healthcare Workers through the Different Waves of the COVID-19 Pandemic

“…Workload-related concerns have grown from 2020 to 2022 across our subgroups of HCWs. The pandemic has placed great pressure on the healthcare system, and many studies have attributed that to a combination of an increase in workload and the attrition of HCWs [ 13 ]. HCWs suffer from stress and burnout when overworked, and that compromises their ability to deliver good care [ 14 ].…”

COVID-19 Pneumonia Complicated by Pneumomediastinum: A Case Report

“…In the clinical case presented, the patient was treated in a secondary hospital in Portugal at the peak of the second wave of COVID-19, the worst in January 2021. The available resources were scarce, both human and material resources, and supply shortages of medical resources were even more exacerbated by disruptions to the global supply chain [ 7 ]. High-flow nasal cannula therapy was not available at the hospital and therapy with NIV was realized in wards.…”

“…High-flow nasal cannula therapy was not available at the hospital and therapy with NIV was realized in wards. Also, healthcare workers faced numerous physical and mental challenges due to increased workloads, constant exposure to infection, and burnout [ 7 ], which may have impacted patient management during the COVID-19 pandemic and predisposed COVID-19 patients to remain in patient-ventilator asynchrony leading to unfavorable airway pressures and barotrauma.…”

Healthcare Challenges due to Global Conflict Escalation Amid the Pandemic, Climate, and Economic Dilemmas

“…Nearly 20% of 1000 American allied health workers (nurses, assistants, etc.) who responded to the survey stated that the pandemic was one of the main reasons they quit their jobs (Poon et al, 2022). According to a cross-sectional study conducted by the US Bureau of Labor Statistics and the University of Minnesota Data Service, pandemic-induced physician turnover was four times that of allied professionals (Frogner & Dill, 2022).…”