RESEARCH ARTICLE Journal of Multidisciplinary Academic © Copyright Kemala Publisher Science, Engineering and Social Science Series All rights reserved ISSN/e-ISSN: 2541 – 0369/2613 – 988X Vol. 4, No. 5, 2020, Printed in the Indonesia Workload, Workplace Spirituality, Organizational Commitment and Turnover Intention in Nurses at M Hospital of Banten, Indonesia Tobias Reinaldo Toti1, Endang Ruswanti1,*, Rokiah Kusumapradja1 1Department of Hospital Administration, Universitas Esa Unggul Jakarta, Indonesia Turnover nurses it’s one of the main problems in hospitals. Outgoing nurses with significant costs to recruiting a new employee, orientation fees, and training new employees it was very harmful for hospital. Thus, this study aimed to determine the effect of workload and workplace spirituality on turnover intention with organizational commitment as an intervening variable in nurses at M hospital. In this study, we collect the data observation from questionnaires at M hospital with 124 nurse respondents using the convenience sampling method. The explanatory causal research model with Path Analysis was used in this study. The results showed that a Workload, Workplace Spirituality, and Organizational Commitment simultaneously influence Turnover Intention, Workload influences Organizational Commitment, Workplace Spirituality influences Organizational Commitment, Organizational Commitment does not influence Turnover Intention, Workload influences Turnover Intention and Workplace Spirituality does not influence Turnover Intention. The research implication is that to reduce the nurse turnover intention, it is necessary to make a workload analysis, arrange the assignment system and make an amount of staff to reduce the workload of nurses in M hospital. Keywords: Workload, Workplace Spirituality, Organizational Commitment, Turnover Intention. 1. INTRODUCTION a worldwide trend. The 2018 survey report in America Hospitals in Indonesia experienced a significant increase revealed data that the total nurse turnover averaged from 2014-2018. The increase in the number of hospitals 17.2%. Nurse turnover will cause a shortage of trained from 2,406 in 2014 increased to 2,813 in 2018 [1]. An nurses and experts in their field. Nurses who have a desire increase in the number of hospitals raises business to leave (turnover intention) become a concern for competition in health services between hospitals. hospitals because nurses who leave (turnover) spend Hospitals need to pay special attention to the human significant costs from the hospital budget such as the cost resources in their hospitals to be able to survive in the of recruiting new employees, the cost of orientation and current era of globalization. The balance between the training of new employees so that it harms the hospital needs of human resources with the demands of hospital [3]. Turnover intention is positively correlated and is one business development requires the management of human predictor of actual turnover. Turnover in nurses is related resources in a good and professional manner. Hospitals to lack of quality of work life, excessive workload, can develop and grow productively if they achieve this organizational commitment, organizational culture, shift balance. Human resource management with professionals schedule and family conflict with work [4]. The turnover must begin from the recruitment, selection to maintenance phenomenon is also felt by M hospital in 2019, out of 124 of employment relations. Nurses as health workers in employees there was a turnover of nurses who came out hospitals greatly affect the quality of services at the of 15 nurses or 12%. The hospital employees are said to hospital. The quality of service by nurses is important to be normal ranging between 5-10% per year, said to be be improved and maintained in order to achieve cost high if more than 10%. The results of the survey on 10 efficiency in hospitals [2]. The lack of nurses is becoming respondents’ nurses in the M hospital also showed that *Email Address: [email protected] turnover intention tended to increase in nurses with a 263 Content from this work may be used under the terms JoMA, Vol. 04, No. 05, 2020 No.1709/2020/09 of the Creative Commons Attribution 3.0 license. Journal of Multidisciplinary Academic RESEARCH ARTICLE proportion of 63%. Increased turnover intention is shown spirituality has not been able to maintain the nurse's by nurses' perceptions of thinking out of their current jobs commitment to continue working in M Hospital. The in M Hospital and the desire to leave when there are purpose of this study to analyze the influence of better opportunities outside the hospital. These data workload, workplace spirituality and organizational indicate the existence of turnover issues that must be a commitment as an intervening variable on nurse turnover concern of M hospital management. The organizational intention in M Hospital. The research contribution is first, commitment is an important variable that plays a role in used as reading material and a reference for further reducing the level of turnover intention. Organizational researches. Second, it is used as input for hospitals, commitment is divided into three forms including especially the human resources department to make affective commitment, where this commitment arises policies in reducing the nurse turnover. because there is an emotional attachment between employees and their organizations; continued 2. METHODOLOGY commitments, where these commitments relate to profit In order to achieve the work, we proposed four variables and loss considerations when leaving the organization; are used in this research as follows: normative commitment, where this commitment appears a) Turnover Intention is the tendency or intention of related to the employee's obligation to remain in his employees to stop working from work voluntarily or organization. Employees with strong affective move from one workplace to another according to commitments will be emotionally bound, involved in the their own choice. Turnover intention can be used as an organization, and remain in the organization [5]. The initial symptom of turnover in a company. The results of the survey showed the organizational turnover intention dimension consists of thinking of commitment that tends to be less favorable for nurses in quitting, intention to search for alternatives and the M Hospital with a proportion of 57%. Poor intention to quit [8]. organizational commitment is shown by the lack of b) Organizational Commitment is a psychological state activity in the workplace and the lack of being bound to that characterizes employee relations with the the current organization in M Hospital. organization and accepts the goals and values of the Besides organizational commitment, the workload is organization. Employees who have organizational an important variable on employee turnover intention. commitment will work with full dedication to achieve The excessive workload can affect nurses' desire to organizational goals. The organizational commitment change work (turnover intention) because it raises the dimension consists of affective organizational need for a lot of work hours and adds stress to nurses [6]. commitment that refers to employee emotional The results of the survey show that workload tends to tendencies, continuance organizational commitment increase in nurses in the M Hospital with a proportion of that refers to costs accrued during life in the 67%. Through interviews conducted with several nurses organization, and normative commitments that refer to in M Hospital, they complained of excessive workload employee obligations to the organization [9]. due to the increasing number of patients, additional c) Workload is a direct estimation of the subject or workload due to having to double administrative work, comparative assessment of mental and cognitive the number of nurses still lacking and pressure from the workload experienced at a particular time. The leadership to reach the target. Thus, other factors arising workload dimensions consist of the first, time load from turnover intention can be caused by the nature of the which shows the amount of time available in planning, work environment and the opportunity for employees to implementing, and monitoring tasks. Second, mental express their feelings and values. The value trend in effort load which predicts or estimates how much human resource management is known as workplace mental effort in planning is needed to carry out a task. spirituality. Workplace spirituality is the awareness that Third, psychological stress load which measures the everyone has an inner life that grows and is grown by amount of risk, confusion, frustration associated with meaningful work in the context of the community [7]. the performance or appearance of the task [10]. The M Hospital is one of the private hospitals in Banten d) Workplace Spirituality is about expressing one's desire Province that uses Christian vision, mission and spiritual to find meaning and purpose in life and is also a values. The vision of the M Hospital is to become a process of reviving personal values that are highly quality hospital and provide a complete and satisfying held by a person. The workplace spirituality service for people based on love. The spiritual climate of dimensions consist of the first, meaningful work that the organization can be observed from spiritual activities represents an individual level. This is a fundamental and religious symbols