Nurses Who Feel Respected at Work Are Far Less Likely to Want to Leave, Study Finds

Nurses who feel their profession is treated with dignity are significantly less likely to dream of leaving the country, according to a new cross-sectional study of 424 nurses working in Iran. The research, published in BMC Nursing, examined the relationship between professional dignity, a set of job-related factors, and the intention to migrate, and it arrives at a striking conclusion: the strongest independent predictor of migration intention was not pay, not workload, and not age, but the degree to which nurses perceived their organization respected them. In an era when health systems from Europe to Southeast Asia are scrambling to retain nursing staff, the finding reframes the global workforce crisis as a crisis of respect as much as one of economics.

The study was conducted by researchers affiliated with Kurdistan University of Medical Sciences in Sanandaj, Iran, together with a biostatistician at Hamadan University of Medical Sciences. They set out to answer a question that has become urgent for ministries of health worldwide: why do nurses decide to move abroad, and can anything short of a salary overhaul change their minds? Nurse migration is a double-edged phenomenon. For the country of origin, the departure of trained nurses drains the healthcare system of experienced clinicians who are expensive to replace and slow to substitute. For destination countries, large inflows can ease shortages but also create integration challenges and raise ethical questions about recruiting from systems that can least afford to lose staff. Understanding what drives the decision to leave is therefore crucial for corrective planning on both sides of the border.

To measure the phenomenon, the team used a cross-sectional design, surveying 424 nurses working in Iran. Participants completed three instruments: a demographic information form capturing characteristics such as age, sex, income, professional experience, and whether they had relatives living abroad; the Perceived Clinical Nurses’ Professional Dignity Scale, a validated instrument that quantifies how much dignity nurses feel their profession commands; and a Migration Intention Questionnaire that scores the strength of a nurse’s desire to move to another country. The researchers analyzed the data in SPSS version 16, reporting means, standard deviations, frequencies, and percentages. Because the score distributions were not normally distributed, they relied on non-parametric methods for bivariate comparisons, including Spearman’s correlation coefficient, the Mann–Whitney U test, and the Kruskal–Wallis test, before entering candidate predictors into a multiple linear regression model. A p-value below 0.05 was treated as statistically significant throughout.

The headline numbers tell a story of moderation on both sides. The mean migration intention score was 129.36 with a standard deviation of 28.04, and the mean professional dignity score was 64.27 with a standard deviation of 15.76, levels the authors characterize as moderate. In other words, the average nurse in this sample neither harbors an overwhelming urge to emigrate nor feels fully honored in their professional identity. That middle ground, however, is exactly where retention policy can matter most: nurses sitting at moderate levels of both dignity and migration intention are the ones who could tip either way depending on how their workplaces and health systems treat them.

The regression analysis then isolated which factors independently tracked with migration intention, and the results were revealing. Lower organizational dignity, one of the components of the professional dignity scale, was associated with higher migration intention, with a regression coefficient of −0.87 and a p-value below 0.001, making it the strongest independent factor in the model. Income satisfaction also mattered, but in a nuanced way. Compared with nurses reporting very low income satisfaction, those reporting low satisfaction and those reporting high satisfaction both showed significantly higher migration intention, with p-values of 0.001 and 0.002 respectively. The pattern suggests the relationship between pay and the desire to leave is not a simple straight line; the reference group of very dissatisfied nurses may already feel disengaged, while even highly satisfied nurses may see opportunities elsewhere, leaving the middle of the distribution as the zone of relative stability.

Social ties emerged as a second powerful lever. Nurses who had relatives living abroad scored, on average, 7.39 points higher on migration intention, a difference that was statistically significant at p = 0.002. This finding fits a well-established picture in migration research: established family networks abroad lower the practical and psychological barriers to moving by providing housing, job information, and emotional support in the destination country. Migration, in this sense, is partly a network phenomenon, and a nurse’s decision calculus includes not only workplace conditions at home but also the presence of a ready-made landing pad overseas.

Experience, by contrast, worked in the opposite direction. Nurses with more years of professional experience reported lower migration intention, an association that was highly significant at p < 0.001. The interpretation is intuitive: career longevity tends to anchor clinicians in their professional communities, their workplaces, and their home countries, while younger nurses with portable skills and fewer local ties face lower costs of relocation. For health planners, this implies that the window for retention efforts may be early in a nurse’s career, before the decision to leave has crystallized.

Taken together, the findings demonstrate a significant inverse association between nurses’ professional dignity and their migration intention: the more dignity nurses perceive, the less they want to leave. The authors emphasize that organizational dignity, the sense of being valued by the institution one works for, emerged as the strongest independent factor alongside income satisfaction and the presence of relatives abroad. This carries a practical implication that is both encouraging and demanding. Unlike macroeconomic conditions or exchange rates, organizational dignity is something hospital management can influence directly, through supportive leadership, fair treatment, recognition of professional contributions, and workplace cultures that treat nurses as respected clinicians rather than interchangeable labor. The study’s conclusion underscores the importance of organizational and economic strategies aimed at strengthening professional dignity, particularly through supportive management.

The economic dimension deserves its own reading. The finding that higher income satisfaction was associated with lower migration intention highlights its potential relevance to workforce stability, even if the relationship with migration intention proved more complicated than a simple pay-more-retain-more formula. Compensation policy interacts with dignity: pay that signals genuine professional worth may reinforce a nurse’s sense of being valued, while pay perceived as inadequate can erode it. For countries that are net exporters of nursing talent, the study suggests that retention strategies built solely on financial incentives may miss the deeper driver, and that investments in respectful, dignified working environments could yield returns that salary adjustments alone cannot achieve.

The research comes with the usual caveats of its design. As a cross-sectional study, it captures a snapshot in time and can identify associations, not prove that low dignity causes migration intention; nurses contemplating leaving may, for instance, retrospectively rate their workplace as less dignified. The sample was drawn from nurses in Iran, and while the mechanisms it probes, dignity, income, family networks, and experience, are plausibly general, the specific weights of each factor may differ across health systems and economies. Still, the study’s methodology was rigorous within its scope: it was conducted in accordance with the Declaration of Helsinki, approved by the Ethics Committee of Kurdistan University of Medical Sciences, and all participants gave written informed consent with data anonymity preserved. The authors declared no competing interests and received no external funding. As health systems worldwide continue to lose nurses to wealthier destinations, the message of this study is quietly radical: the cheapest and most powerful retention tool available to any hospital may be the everyday practice of treating its nurses with the dignity their profession deserves.

Subject of Research: The association between nurses' professional dignity, job-related factors, and migration intention

Article Title: Correlation between professional dignity and job-related factors with migration intention in nurses: a cross-sectional study

Article References: Zarei, M. F., Mahmudi, M., Mohammadi, T., & Vatandost, S. (2026). Correlation between professional dignity and job-related factors with migration intention in nurses: a cross-sectional study. BMC Nursing. https://doi.org/10.1186/s12912-026-05465-3

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05465-3

Keywords: nursing, migration intention, professional dignity, organizational dignity, income satisfaction, health workforce, cross-sectional study, Iran, nurse retention, health policy, BMC Nursing, workforce stability