Emergency Nurses’ Perceptions of Leadership Strategies and Intention to Leave: A scoping review of the literature


  • Samantha Horvath McMaster University
  • Nancy Carter




Retention of registered nurses in emergency departments (EDs) is as a critical issue, further exacerbated by the COVID pandemic. Leaders influence work life and working environment, but it is unclear what strategies leaders use to address nurse staffing issues in the ED. The purpose of this scoping review is to understand if leadership strategies used in EDs have links to nursing retention and turnover.

This scoping review was completed with a comprehensive search within Cumulative Index to Nursing and Allied Health Literature, EMCARE, EMBASE. Two authors developed inclusion and exclusion criteria, did title and abstract screening, and full text screening using review software. Data extracted from included studies was analyzed to determine leadership strategies and relationships to intent to stay, retention, intent to leave, or turnover.

Of the 553 records identified, nine met inclusion criteria. Leadership strategies identified in the studies included support from supervisor, engagement by the leader, organizational culture assessment, and a cultural change toolkit. No leadership strategy influenced nurse intention to stay, retention, intention to leave or turnover.

Emergency nurse retention and the prevention of turnover is a multidimensional issue stemming from various factors that may not be controllable due to the nature of the setting. However, leaders can implement strategies and provide support to staff to enhance quality of work life and the work environment. More information is needed to understand how leaders can influence the current and future supply of emergency nurses to produce quality patient care outcomes.

Author Biography

Nancy Carter

McMaster University, Hamilton, ON


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How to Cite

Horvath, S., & Carter, N. (2022). Emergency Nurses’ Perceptions of Leadership Strategies and Intention to Leave: A scoping review of the literature. Canadian Journal of Emergency Nursing, 45(2), 11–23. https://doi.org/10.29173/cjen138



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