The Impact of Cognitive Flexibility and Cognitive Control on Turnover Intention: The Roles of Impulsivity and Anger Expression Among Emergency Nurses.

objectiveThe objective of this study is to examine the relationships between cognitive flexibility, cognitive control, impulsivity and anger expression and intention to leave among emergency department nurses.

methodThis descriptive and cross-sectional study was conducted with 295 nurses working in the emergency departments of seven hospitals in Ankara for at least 1 year. Data were collected using a personal information form, the Impulsivity Scale, the Cognitive Control and Cognitive Flexibility Scale, the Anger Expression Scale and the Job Intention Scale. Descriptive statistics, independent group t-test, one-way analysis of variance (ANOVA), Pearson correlation and multiple regression analyses were used.

resultsRegression analysis revealed that impulsivity, anger expression style and cognitive control-flexibility together accounted for 5.3% of the variance in intention to leave, suggesting that additional organisational and environmental factors likely contribute to turnover intention. Impulsivity (β = 0.138) and anger expression level (β = 0.131) were positively associated with intention to leave, whereas higher cognitive control and flexibility were negatively associated with intention to leave (β = -0.121). Correlation analyses similarly indicated significant positive associations between impulsivity and anger expression and intention to leave and significant negative associations between cognitive control and flexibility and intention to leave.

conclusionThe findings suggest that impulsivity and anger expression patterns among emergency department nurses are associated with higher intention to leave. Cognitive control and cognitive flexibility may serve as important psychological resources potentially related to reduced turnover intention. Interventions aimed at strengthening nurses' cognitive and emotional regulation skills in high-stress work environments such as emergency departments may contribute to workforce continuity; however, given the cross-sectional design, causal interpretations should be made with caution. IMPLICATIONS FOR NURSING MANAGEMENT: Emergency department nurse managers should consider strategies that enhance nurses' cognitive control and cognitive flexibility as potential resources against turnover intention. Structured interventions such as stress management programs, emotional regulation training and leadership practices that foster supportive and psychologically safe work environments may help mitigate impulsivity and maladaptive anger expression. Integrating these approaches into workforce management and professional development plans could contribute to improved staff retention and organisational stability in high-pressure clinical settings.