Date of Conferral







Leslie C. Hussey


High rates of turnover and the limited tenure of directors of nursing (DONs) in long-term care creates instability in the nursing workforce and the quality of care provided. Organizations, industry, and stakeholders have made little progress to change this turnover crisis. The purpose of this quantitative study, guided by organizational role and social exchange theories, was to determine if there was a difference in levels of affective organizational commitment and intent to stay mediated by leader-member exchange in long-term care DONs with different levels of role conflict and role ambiguity. The key variables were measured with the Role Questionnaire, Leader-Member Exchange Scale 7, Affective Commitment Questionnaire, and the Intent to Stay Scale. DONs were recruited via e-mail and social media, and 126 participants completed the surveys with 42 experiencing high role conflict and 13 experiencing high role ambiguity. Results revealed no differences in the levels of affective organizational commitment or intent to stay between DONs with high versus low levels of role conflict or role ambiguity. However, role ambiguity and leader-member exchange, but not role conflict, significantly predicted a DON's affective organizational commitment and intent to stay. Future research could consider the levels of role conflict and role ambiguity experienced by the DON and the tenure of the DON and the effect on the quality of resident care provided. The results of this study could impact positive social change by being used to advocate for role clarity and improve relationships with leaders to increase DON tenure, which would improve nurse workforce turnover and the quality provided in long-term care.