Abstract

Employee engagement is of growing interest in healthcare organizations. Engaged employees give an extra measure of effort to contribute to organization goals, whereas disengaged employees withdraw, have lower performance and are more likely to leave their jobs. The aim of this ethnographic study was, in part, to explore the reasons why high-calibre nurses became disengaged from their work and opted to leave their hospital-based employment in favour of independent practice, as well as to consider the organizational conditions that influenced their desire to leave. The findings revealed that nurses left their hospital-based jobs because of health system change, job characteristics, working conditions and lack of respect, which relate closely to the antecedents of employee engagement. Employee engagement can be fostered through organizational support, trust-building management behaviour and transformational leadership.