Retaining Those Who Care: Ethical Climate, Leadership, and Workforce Sustainability in Healthcare
Ana Poeira, Lucília Nunes
Abstract
Background/Objectives: The global shortage of healthcare professionals has exacerbated ethical and organizational challenges that threaten the sustainability of health systems. High turnover rates, combined with the emigration and attrition of qualified nurses, make it essential to understand how institutional factors affect professional well-being and workforce retention. This essay examines how organizational ethics—particularly ethical climate, organizational justice, and ethical leadership—influence healthcare professionals’ experiences and their intentions to remain in or leave the sector. Methods: The discussion adopts a conceptual and reflective approach, drawing on key theories and empirical findings from the literature on organizational ethics and turnover. It explores the relationships between ethical environments, professional recognition, and moral well-being within healthcare organizations. Results: Evidence suggests that ethical and fair organizational climates strengthen trust, professional commitment, and long-term retention. Conversely, perceptions of injustice, lack of recognition, or moral distress tend to increase dissatisfaction and the intention to leave the profession. Conclusions: The essay underscores ethics as a central component of workforce sustainability in healthcare and calls for leadership and policy actions that move beyond individual coping strategies toward systemic ethical practices promoting fairness, recognition, and well-being at work.