Nursing Servant Leadership: An Exploratory Study of Attributes and Characteristics that Foster Retention of Multi-Generational Work Teams

Among 11 developed countries, the U.S. healthcare system ranks last in overall performance rating of healthcare outcomes. The U.S. also has the highest healthcare expenditures, exceeding 17% of the U.S. Gross Domestic Product. With 25% of new Registered Nurses (RNs) leaving their organization within the first year, the turnover cost of RN early careerists was nearly $1.1 billion in 2017. If nothing changes, healthcare costs will cripple the U.S. economy and diminish quality of life. The challenge to transform healthcare lies within nursing leadership. The purpose of this study was twofold: (1) explore for the presence of Servant Leadership attributes exhibited by nursing leaders in U.S. hospitals; and (2) identify optimal nurse-leader characteristics that foster a culture for retention of multi-generational work teams. Guided by a derived model based on Social Exchange Theory (SET) and Social Learning Theory (SLT), an exploratory, descriptive research design was used in this Academy for Medical-Surgical Nursing membership. Servant-leadership attributes were highly correlated for RN intent-to-stay > 5 years with their current employer. Nurses across three generations (Millennials, Generation X, Baby Boomers) reported Covenantal Relationship as the most important (M= 4.08) servant-leader attribute influencing their intent-to stay plans.

Date of publication

Fall 12-20-2019

Document Type

Dissertation (Local Only Access)



Persistent identifier


Committee members

Dr. Barbara Haas(Chair); Dr. Danita Alfred; Dr. Kerri Camp; Dr. Colleen Marzilli


Doctor of Philosophy in Nursing