The Influence of Shift-Scheduling Fairness, Nursing Staff Sufficiency and Job Satisfaction on Nurse Loyalty

Nurse retention remains a pressing concern in many healthcare settings. Prior studies have shown that job satisfaction, perceived staffing adequacy, and fair shift scheduling may shape nurse loyalty; however, the evidence has often been mixed and inconsistent. Therefore, this study was conducted to re-examine the influence of Job Satisfaction, Nurse Sufficiency, and Shift Scheduling Fairness on Nurse Loyalty through a more comprehensive approach. This study aimed to assess how these three variables affect Nurse Loyalty and to identify which variable should receive priority in loyalty-enhancement efforts, using the Importance-Performance Map Analysis (IPMA) approach. The study used a quantitative approach with a cross-sectional design using SEM-PLS. The study involved 302 nurses selected through a sampling technique aligned with the characteristics of the targeted population. The results showed that Job Satisfaction had a significant and positive influence on Nurse Loyalty, while Nurse Sufficiency and Shift Scheduling Fairness did not have a significant direct effect. IPMA results further indicated that Job Satisfaction had the highest level of importance, yet its performance remained lower than the other two variables. This positions job satisfaction as the most urgent priority for improving nurse loyalty. The study highlights the need for healthcare organizations to focus on initiatives that strengthen nurse job satisfaction, including improvements in work conditions, managerial support, reward mechanisms, and employee well-being programs. Although adequate staffing and fair scheduling remain operational necessities, their influence on loyalty is indirect, suggesting they function more as supportive factors rather than primary determinants.