Translated from Indonesian to English - www.onlinedoctranslator.

com

AHoJ : Allied Health Journal

Pages X - X
ISSN xxxx-xxxx (Print)
ISSN xxxx-xxxx (Online)
DOI: XXXXXXXXXXXXXXXXXXXXXXX

The Relationship between Job Stress and Turnover Intention in Nurses in the Inpatient Room
at TK III Hospital, Dr. Reksodiwiryo Padang in 2023

Nisma Khairani1, Asmawati2, Rebbi Permata Sari3

Alifah Padang College of Health Sciences Jl. Khatib Sulaiman No. 52 B

e-mail:nismakha irani70@gmail.com wati.as45@yahoo.comrebbi.permatasari @gmail.com

Abstract

Turnover Intention is a final, planned, conscious decision to leave a company or organization caused by work
stress. Based on the latest data in 2020 by the State of the Worlds Nursing (SWON) reported by the World
Health Organization (WHO), it is revealed that the global nursing workforce currently reaches 27.9 million
and it is estimated that there is a global shortage of 5.9 million nurses. Indonesia itself has shown quite high
nurse turnover in several regions. On the island of Java, private hospitals in Surabaya since 2014–2016 were
13.67%, 13.69%, 16.91%, which of course was caused by many factors. The aim of this research was to
determine the relationship between work stress and turnover intention among nurses in the hospital. inpatient
treatment at TK III Dr. Reksodiwiryo Padang Hospital in 2023. This research is quantitative with a cross
sectional design. The population in this study were all inpatient nurses at TK III Dr. Reksodiwiryo Padang
Hospital from January 2023 to August 2023 totaling 120 respondents. This data collection was carried out
using a sampling technique using a purposive sampling technique of 92 respondents with data collection
using questionnaires. , then the data was analyzed univariately and bivariately using the Chi-Square test p-
value < 0.05. The results of the research showed that more than half, namely 59.8% of nurses, had high
turnover intention, many found, namely 45.7% of nurses, had high work stress. There is a relationship
between work stress and turnover intention, p-value 0.000 (p<0.05) for nurses in the inpatient ward at TK III
Dr Hospital. Reksodiwiryo Padang 2023. Based on the research results, it can be concluded that there is a
relationship between work stress and turnover intention, p-value 0.000 (p<0.05) in nurses. Suggestions,
through the head of the inpatient room, to be able to know more about the incidence of turnover intention
among all implementing nurses, and find out the causes of turnover intention and it is hoped that this can be
done by providing education about turnover intention so that implementing nurses can overcome excessive
work stress.

Keywords: Job stress, turnover intention, Nurse, Hospital.

Address : Jl. Khatib Sulaiman No. 52 B

E-mail : nismakhairani18@icloud.com

AHoJ : Allied Health of Journal Vol X No X 202X

2 The Relationship between Job Stress and Turnover Intention in Nurses in the Inpatient Room at
TK III Hospital, Dr. Reksodiwiryo Padang in 2023
INTRODUCTION
Turnover Intentionis a final decision made in a
planned, conscious, deliberate manner to leave a
company or organization (Lompolio et el.,
2020).Nursing staff provides 24 hour service for
patients and their families so that nursing staff
can make a very significant contribution to the
services provided by the hospital. The incidence
of turnover intention can reach 60% per year,
where the factors that influence this turnover
intention are job dissatisfaction, high workload
and organizational culture (Taufik, 2017).
Work stress is an emotional condition that
arises due to a mismatch between the workload and
the individual's ability to overcome the work stress
faced, in other words, when the workload is too
heavy for a person's physical and psychological
abilities, he will experience work stress (Antonius,
2020).
Based on the latest data in 2020 by the State of
the Worlds Nursing (SWON) reported by the World
Health Organization (WHO), it is revealed that the
global nursing workforce currently reaches 27.9
million and it is estimated that there is a global
shortage of 5.9 million nurses. Other evidence
shows that 89% of this nursing shortage occurs in
lower middle countries, with large gaps in countries
in the African, Southeast Asian and Eastern
Mediterranean regions so that a total of 10.6 million
nurses are needed by 2030.
Based on data from the World Health
Organization (WHO) in 2020, the disease caused by
work is depression in many countries with an
incidence rate of 8%. The results of the Labor Force
Survey research in 2016 found that there were
440,000 cases of work-related stress, in England the
incidence rate was 1,380 cases per 100,000 workers
experiencing work stress (Sari, 2016).
According to the American National
Association for Occupational Health (NIOSH),
work stress among nurses ranks in the top forty
cases of stress in workers (Runtu et al, 2017). In
2020-2021 stress, depression or anxiety accounted
for 50% of all cases of work-related health disorders
(ANA, 2020). In South Korea, 42.9% and nurses are
willing to change jobs (Yoon, 2020). In the
Philippines, up to 46.1% of nurses intend to change
jobs in one year as much as 78.9% in five years
(Labrague et al., 2020).
Based on data from the Health and Safety
AHoJ : Allied Health of Journal Vol X No X 202X
Executive (HSE), it is stated that there are 822,000
cases of work stress in England with a prevalence rate
of 2,480 cases per 100,000 workers in the 2020-2021
period (Health Safety Executive, 2021). This incident
of work stress also occurs in several countries in
Southeast Asia with a prevalence rate of work stress for
nurses in Vietnam of 18.5% (Tran et al, 2017), while in
Hong Kong it reached 41.1% (Cheung and Yip, 2015).
According to the Indonesian Ministry of Health in
2020, 60.6% of workers experienced depression. This
disorder is related to emotional mental disorders and
career development stressors. The causes of stress in
the workplace are caused by work load, such as targets,
interpersonal relationships, with superiors or other
coworkers.
The results of a survey conducted by PPNI (2020),
stated that around 50.9% of nurses in Indonesia
experienced work stress (Hendarti, 2020). Many
nursing workers in Indonesia also suffer from stress
due to their work. This work stress is also experienced
by several nurses who work in West Sumatra
provincial hospitals. This can be seen in the results of
Izzati's research (2020). among nurses in the inpatient
ward of Padang Panjang City Regional Hospital, where
it was found that more than half of the nurses (52.2%)
experienced work stress (Izzati, 2020).
Research in Indonesia has shown quite high nurse
turnover rates in several regions. In private hospitals in
Surabaya since 2014 there were 13.67% nurses, in
2015 there were 13.69% nurses, and in 2016 there were
16.91% nurses. Private hospitals in Malang show a
nurse turnover rate of 34.15% (Dewanto & Wardhani,
2018). On the island of Sumatra, especially the Batam
area, Riau Islands, data was obtained from 2018 to
2019. The turnover rate in one of the private hospitals
which is a referral hospital was 14% (Christiani &
Ilyas, 2018).
An increase in nurse turnover also occurred in
West Sumatra, one of which occurred at Ibnu Sina
Hospital in Padang. Based on HR data from Ibnu Sina
Hospital Padang, the turnover rate for nurses at Ibnu
Sina Hospital Padang in 2019, the turnover rate was
13% and there was an increase in 2020 by 15%.
Turnover also affects human resource development and
the provision of nursing care (Brook et al., 2019).
Turnover intentiondirect impacts, for example in
the form of costs for recruiting and training new staff,
as well as indirect costs in the form of low productivity
of new staff, quality of health services, and decreased
quality of work life (Rondeau & Wagar, 2016).
3 The Relationship between Job Stress and Turnover Intention in Nurses in the Inpatient Room at
TK III Hospital, Dr. Reksodiwiryo Padang in 2023
This causes an increased workload due to the and cause job loss.
lack of professional colleagues in their previous Based on the initial survey conducted by
fields. This can be one of the triggers that can cause researchers using the Expanded Nurse Stress Scale
work stress due to a lack of understanding in (ENSS) questionnaire, the stress levels of respondents
managing employees themselves, including found that 6 nurses had moderate levels of work stress.
workload, working time, or overtime, feeling It was found that the subscales that caused the most
burdened with work which can cause employees to work stress were workload, problems with patients'
feel stressed about their work (Moreira et el. 2020 ). families, and conflicts with colleagues, while
Mental health problems are a problem that is discrimination subscale was not found. There are 4
neglected in the workplace, the result is that others who have a low level desire to change jobs
because they have been nurses for a long time and have
workers experience work stress and are unable to
worked for more than 10 years.
work optimally. Work stress is an emotional
condition that arises due to a mismatch between the
workload and the individual's ability to overcome RESEARCH METHODS
the work stress faced, in other words, when the This type of research is quantitative with a cross
workload is too heavy for a person's physical and sectional design. This research was conducted in all
psychological abilities, he will experience work inpatient rooms at the Kindergarten hospital. III dr.
stress (Antonius, 2020). Reksodiwiryo Padang City in 2023, the population
Work stress can occur in workers and pose a in this research were all inpatient nurses, namely
risk to the health and safety of workers if workers 120 people at the Tk hospital. III. Dr. Reksodiwiryo
are exposed to work activities that are carried out Padang. Sampling in this study used purposive
continuously in their workplace and exceed the sampling, the population was calculated using the
threshold of capacity, resources and abilities. Slovin formula, the number of respondents was 92
Working in the health sector is also not free from respondents. Data was collected using the
the problem of work stress, in fact quite a lot of Expanded Nurse Stress Scale (ENSS) questionnaire
cases occur. This occurs due to the enormous for work stress and the Turnover Intention
humanitarian responsibility demands of health questionnaire and analyzed using univariate and
sector workers towards patients (Melo, Kawatu & bivariate analysis using the chi-square statistical
Tucunan, 2019). test showing a value (p-value <0.05).
Many factors cause work stress in nurses,
including night shifts, multiple role conflicts, lack
of social support, conflict between work and family,
varied task demands that are not in accordance with
competence, excessive workload, uncomfortable
working conditions, job uncertainty, lack of the
existence of rewards, and the unequal ratio of the
number of nurses to the number of patients
(Martina, 2020).
Work stress can have an impact on individuals,
organizations, and even society. For individuals,
work stress has a negative impact on workers'
physical and mental health, resulting in decreased
performance, lack of career development, and job
loss. In severe cases, work stress can cause
depressive disorders. For organizations, the impacts
of work stress include absenteeism, losses related to
worker health, and turnover (Maftuhah & Tashiro,
2016). For the social environment, work stress
results in high pressure on society and social
security services, especially if problems get worse

AHoJ : Allied Health of Journal Vol X No X 202X

 4 The Relationship between Job Stress and Turnover Intention in Nurses in the Inpatient Room at
TK III Hospital, Dr. Reksodiwiryo Padang in 2023
RESEARCH RESULTS AND respondents, had a high turnover intention among
DISCUSSION nurses in the inpatient ward at TK III Dr Hospital.
A. Respondent Characteristics Reksodiwiryo Padang in 2023.
The characteristics of respondents in this Based on table 3, it can be seen that from 92
study include gender, age, length of work, education, respondents, 45.7% of respondents had high work
type of employment. stress among nurses in the inpatient ward at TK III
Table 1. Frequency Distribution of Dr Hospital. Reksodiwiryo Padang in 2023.
Characteristics of Inpatient Nurses at TK II Dr. Based on the research results, it can be seen that of
Reksodiwiryo Padang Hospital in 2023
the 92 respondents, more than half, namely 59.8% of
respondents, had high turnover intention among nurses
Respondent Characteristics f %
in the inpatient ward at TK III Dr Hospital.
J Gender
a. Man 29 31.5 Reksodiwiryo Padang in 2023.
b. Woman 63 68.5 The results of this research are in line with
U Age research conducted by Budianri, et al (2018) which
a. 25-30 Years 8 8.7 states that there are similarities in the research results
b. 31-40 Years 56 60.9 that more than half, namely 67.2% of respondents, had
c. 41-50 Years 28 30.4 high turnover intention among implementing nurses at
Length of working Kembangan Hospital, West Jakarta. The results of
a. 1-5 Years 83 90.2 research conducted by Windrawati (2020) stated that
b. 6-10 Years 9 9.8 more than half, namely 72.6% of respondents,
P Education experienced turnover intention among implementing
a. DIII 56 60.9 nurses at the Sultan Fatah Java Hospital, Karangawen,
b. S1+Ners 36 39.1 Central Java.
J Type of Employment The results of the questionnaire analysis showed
a. Military 18 19.6
that respondents who had high turnover intention were
b. Non civil servant 46 50.0
because respondents agreed to actively seek
c. Civil servants 28 30.4
information on job vacancies, that is, 38% of
J Total 92 100
respondents answered doubtfully and actively sought
information on job vacancies, namely 35.9% of
Based on table 1, it can be seen that of the 92 respondents answered agree. Meanwhile, respondents
respondents, more than half, namely 68.5% of who had Turnover intention is low because respondents
respondents, were female, more than half, namely strongly disagree that they will quit their job next year,
60.9%, were aged 31-40 years, more than half, namely namely 13%, and many respondents answered that they
90.2%, had worked for 1-5 years, more than half disagree that they will quit their job this year, namely
namely 60.9% of respondents had a DIII education and 58.7%.
half of the 50% of respondents were non-civil servants, 2. Job Stress
namely nurses in the inpatient ward at TK III Dr Table 3. Frequency Distribution of Job Stress
Hospital. Reksodiwiryo Padang in 2023 among Nurses in the Inpatient Room at TK III Dr
B. Univariate Analysis Hospital. Reksodiwiryo Padang in 2023.
1. Turnover Intention No Job Stress f %
Table 2.Frequency Distribution of Nurse Turnover 1 Tall 42 45.7
Intention in the Inpatient Room at TK III Dr 2 Currently 33 35.9
Hospital. Reksodiwiryo Padang in 2023 3 Low 17 19.5
No Turnover Intention f % Amount 92 100
1 Tall 55 59.8
2 Low 37 40.2
Amount 92 100 Based on table 3, it can be seen that from 92
Based on table 2, it can be seen that of the 92 respondents, 45.7% of respondents had high work
respondents, more than half, namely 59.8% of stress among nurses in the inpatient ward at TK III Dr

AHoJ : Allied Health of Journal Vol X No X 202X

 5 The Relationship between Job Stress and Turnover Intention in Nurses in the Inpatient Room at
TK III Hospital, Dr. Reksodiwiryo Padang in 2023
Hospital. Reksodiwiryo Padang in 2023.
The results of this research are in line with
research conducted by Budianri, et al (2018) which
states that there are similarities in the research
results that more than half, namely 71.6% of Tall
respondents, experienced excessive work stress Currentl
among executive nurses at Kembangan Hospital, y 0,000
West Jakarta. The results of research conducted by
Low
Windrawati (2020) stated that more than half,
namely 63.7% of respondents, had high work stress Amoun
among practicing nurses at the Sultan Fatah Java
Hospital, Karangawen, Central Java.
Work stress is a condition that often occurs in
the world of work, especially in relation to nurse
performance. A good score can help a company
generate profits. Conversely, if performance
decreases, it can be detrimental. Therefore, it is
necessary to pay attention to performance when
conducting research on work stress variables. Work
stress is a state of tension experienced by
employees, which can affect a person's way of
thinking and emotions as well as their physical
condition (According to Sondang, 2016).
The results of the questionnaire analysis
showed that respondents experienced high work
stress because respondents were very stressed
working with nurses of the opposite sex, namely
22.8%, respondents were often stressed when
making decisions under pressure, namely 48.9% and
respondents were sometimes not prepared enough to
help the emotional needs of the patient's family,
namely 46.7 %. Meanwhile, respondents who had
low work stress were because respondents had never
been criticized by the nursing department, namely
30.4% and respondents did not experience stress in
making decisions under pressure, namely 23.9%.
C. Bivariate Analysis
The Relationship between Job Stress and
Turnover Intention among Nurses in the Inpatient
Room at TK III Hospital, Dr. Reksodiwiryo Padang
in 2023.
Table 4. Relationship between Job Stress and
Turnover Intention among Nurses in the
Inpatient Room at TK III Hospital, Dr.
Reksodiwiryo Padang in 2023.
Job Turnover Amount
AHoJ : Allied Health of Journal Vol X No X 202X
Intention P-
Stres
Tall Low Value
s
f % f % f %
3 6 14.3
85.7 42 100
6
26 78.8
7 21.2 33 100
1 5 29.4
70.6 17 100
2
5 37 40.2
59.8 92 100
t 5
Table 4. seen from 63 respondents 22 (95.7%)
Based on table 4, it can be seen that of the 42
respondents, high turnover intention was found in
respondents with high work stress, namely 85.7%
compared to respondents with moderate work stress,
namely 21.2% and among respondents with low work
stress, namely 70.6% among nurses in the TK Hospital
inpatient room. III Dr. Reksodiwiryo Padang in 2023.
Based on the results of the Chi-square test, the p-value
was 0.000 (p<0.05), it can be concluded that there is a
relationship between work stress and turnover intention
among nurses in the inpatient ward at TK III Dr
Hospital. Reksodiwiryo Padang in 2023.
CONCLUSION
Based on the research results, more than half, namely
59.8% of respondents, had high turnover intention
among nurses in the inpatient ward at TK III Dr
Hospital. Reksodiwiryo Padang in 2023. It was found
that 45.7% of respondents had high work stress among
nurses in the inpatient ward at TK III Dr Hospital.
Reksodiwiryo Padang 2023. Based on the research
results, there is a relationship between work stress and
turnover intention among nurses in the inpatient ward
at TK III Hospital Dr. Reksodiwiryo Padang 2023 with
p-value 0.000 p<0.05.
THANK-YOU NOTE
On this occasion the researcher would like
to thank STIKes Alifah Padang who has assisted in
carrying out this research and the researcher would
also like to thank the TK hospital. III Dr.
Rekodiwiryo Padang who has provided support and
permission to researchers to conduct research so
that this research runs smoothly. The researcher
also thanks all respondents who were willing to be
respondents and have given their time so that the
researcher can complete this research.
 6 The Relationship between Job Stress and Turnover Intention in Nurses in the Inpatient Room at
TK III Hospital, Dr. Reksodiwiryo Padang in 2023
Small to Medium Sized Hospitals. Korean J
Heal Service Management. 2014 Sep 30: 8(3):
REFERENCE 75-87.
Abid, G., & Butt, TH (2017). Expressed Turnover Maftuhah, & Tashiro, J. (2016). Novice Nurses Work
Intention: Alternate Method for Knowing Experience During Their First Six Months In
Turnover Intention and Eradicating Common Indonesia. Retrieved December 9, 2017, from
Method Bias. the UIN Jakarta Repository:
www.repository.uinjkt/ilmukekeras/2016.
Ahanian, E., Abasat, M., & Asieh, SF (2016). the
study of correlation between job stress and Martina, A. (2020). Description of the Work Stress
turnover intentions among the operating room Level of Nurses in the Inpatient Room at Dr
nurses in selected hospitals of Tehran Moehammad Goenawan Partowidigo Cisarua
University of Medical Science. Acta Medica Bogor Lung Hospital (RSPG). Depok: FIK UI.
Mediterranean : 32 , 1045-1050. Mobley, W., Horner, S., & Hollingsworth, A. (1978).
An evaluation of precursors
Cao X., Chen L., Tian L., Diao Y. The Effect of of hospital employee turnover. Journal of Applied
Perceived Organizational Support on Burnout Psychology. 63(4), 408-414.
Among Community Health Nurses in China:
The Mediating role of Professional Self- Mobley, W. H. (1986). Employee Turnover: Causes
Concept. J Nurse Management. 2015 Jan 1: and Effects and Control. Translation: Nurul
24(1): E77-86. Imam. Jakarta : PT. Binaman Pressindo Library.
Elmi, Farida. 2018. Investigating Human Resource Notoatmodjo, Soekidjo. 2018. Health Research
Management: Edition 1. Mitra Wacana Methodology. Jakarta: Rineka Cipta
Media. Jakarta.
Okstoria, M.R. (2022). Tendency of Turnover
French, S., Lenton, Rhonda, Walters, Vivienne, Intention in Nurses as an Impact of Workload.
Eyles, et al. (2000). An Empirical Evaluation 01(09), 340–347.
of an Expanded Nursing Stress Scale. Journal
of Nursing Measurement Vol.8 No.2, 161- Park EJ., Han JY., Jo NY. Effects of Professional
178. Self-Concept, Self Efficacy on the Job
Satisfaction in General Hospital Nurses. J
MINISTRY OF HEALTH, R. (2019, October 5). Korean Data Inf Sci Soc (Internet). 2015 Jan 31
The workplace is prone to stress. Taken (cited 2022 Feb 28): 27(1):191- 201. Available
January 7, 2019, from the Indonesian From: http://dx.doi.org/10.7465/jkdi.
Ministry of Health website:
www.depkes.go.id/article/print Robbins NI. Analysis of Workload and Needs for
Executive Nurses Using the Workload Indicator
Republic of Indonesia Ministry of Health, . (2017). Staff Need (Wisn) Method in the Tulip Inpatient
Situation of Indonesian Nursing Personnel. Installation at Bekasi City Regional Hospital in
Jakarta: Indonesian Ministry of Health Data 2018.
and Information Center.
Sari, NR, Hakam, MS, & Susilo, H. (2016). The
Lee E., Jang I. Nurses' Fatigue, Job Stress, influence of job satisfaction on turnover
Organizational Culture, and Turnover intention (Study at Ajb Bumiputera 1912 East
Intention: A Culture–Work–Health Model. Java II/Malang Regional Office). Journal of
West J Nurse Res. 2020 Feb 1: 42(2): 108-16. Business Administration. 27(1), 1-8.
Lee JW., Eo YS., Ha YS. Effects of Organizational Siagian Sondang, 2018. Human Resources
Cultures on Job Satisfaction and Management, Jakarta, PT . Literary Earth.
Organizational Commitment: Focused on
AHoJ : Allied Health of Journal Vol X No X 202X
 7 The Relationship between Job Stress and Turnover Intention in Nurses in the Inpatient Room at
TK III Hospital, Dr. Reksodiwiryo Padang in 2023
Sugiyono. 2018. Quantitative, Qualitative and
R&D Research Methods. Alphabet. Bandung.

WHO. Countries in WHO South East Asia Region

Need 1.9 million More Nurses Midwives to
Achieve Health.

Wisantyo, NI, & Mediistryanto, Martina. (2020).

The influence of work stress, work discipline
and job satisfaction on turnover intentions.
MIX Journal. 5(1), 54-69. international
Letters of Social and Humanistic Sciences.
78, 18-26.

AHoJ : Allied Health of Journal Vol X No X 202X

8 The Relationship between Job Stress and Turnover Intention in Nurses in the Inpatient Room at
TK III Hospital, Dr. Reksodiwiryo Padang in 2023

AHoJ : Allied Health of Journal Vol X No X 202X