Abstract
Background: Nurse shortage has been a worldwide problem. Work exhaustion fuels nurses' turnover intentions. However, there is limited understanding of how peak workload and time pressure contribute to work exhaustion and turnover intentions. Aims: To test the influence of peak workload and time pressure on work exhaustion and nurses' turnover intentions. Design: A research design of using follow-up surveys was employed. Methods: Complete survey responses were obtained from 423 nurses in Taiwan during 2023 and 2024. Structural equation modeling was used for analysis. Results: Peak workload was related with time pressure. Both factors were positively associated with work exhaustion, which in turn was positively associated with turnover intentions. Interestingly, both factors were not directly related to turnover intentions. Conclusion: Work exhaustion is pivotal in the impact of peak workload and time pressure on turnover intention. The unique value of this study is to identify the key role of work exhaustion in fueling turnover intention. Implications for Nursing Management: The results inform the nurse managers that they could consider incorporating more flexibility into nursing routines to reduce peak workload. Additionally, increased support from auxiliary staff, recovery environment, and work flexibility may help alleviate nurses' perceived time pressure or workplace exhaustion.