The Role of Job Satisfaction in Mediating the Influence of Compensation Fairness and Career Opportunities on Nurse Turnover Intentions

Abstract

KSI Hospital, Kedonganan, Bali, experienced a nurse turnover rate of 13.6% (2023–2025),  with a predominance of junior nurses (62.6%), indicating a systemic brain drain. This study aimed to analyze the mediating role of job satisfaction in the influence of compensation justice and career opportunities on nurse turnover intention. A quantitative causal approach with a cross-sectional design was employed. The entire population of nurses (n=75) was selected as the saturated sample. Data were collected using a 5-point Likert scale questionnaire (53 items) and analyzed using SEM-PLS with SmartPLS 4.0. The results showed that compensation justice had a significant positive effect on job satisfaction (β=0.311) and a significant negative effect on turnover intention (β=-0.513). Career opportunities had a significant positive effect on job satisfaction (β=0.664). Two major findings emerged: (1) career opportunities had a significant positive effect on turnover intention (β=0.163); and (2) job satisfaction also had a significant positive effect on turnover intention (β=0.104), which is contrary to general theory. Job satisfaction only partially mediated the effect of compensation justice, while it did not mediate the effect of career opportunities. The model explained only 12.9% of the variance in turnover intention (R²=0.129). The implication of these findings is that compensation justice remains the strongest protective factor, whereas career opportunities, if not accompanied by targeted retention strategies, paradoxically risk increasing the intention to leave. Hospital management should improve the remuneration system and develop more structured retention programs, rather than relying solely on enhancing job satisfaction.