Sustainable Nursing Human Resource Management (SNHRM): A Literature Review and Conceptual Framework for Workforce Sustainability in Indonesian Public Hospitals
Keywords:
Sustainable HRM, Nursing Workforce, Workforce Sustainability, Psychological Safety, Higher Order ConstructAbstract
The global and Indonesian nursing workforce is experiencing a sustainability crisis that conventional, turnover-intention-based human resource management (HRM) approaches have failed to resolve. Prior research predominantly treats nurses' intention to leave as a proximal, episodic proxy for workforce stability, while largely overlooking Workforce Sustainability as a multidimensional, longitudinal, and collective outcome. This paper aims to synthesize the theoretical and empirical literature on Sustainable HRM, Conservation of Resources, Social Exchange, and Organizational Resilience theories to develop an integrative conceptual model, Sustainable Nursing Human Resource Management (SNHRM), that explains how sustainable HRM practices generate Workforce Sustainability among nurses in Indonesian public hospitals. Using a systematic narrative literature review of peer-reviewed studies published mainly between 2015 and 2025, the review is synthesized into the Nursing Sustainability Integration Theory (NSIT), an integrative framework in which SNHRM practices influence Workforce Sustainability through a serial mechanism involving Leadership Climate, Psychological Safety, and Workforce Resilience, which in turn strengthens Commitment Sustainability. Seven theoretical propositions are advanced to guide future empirical testing, particularly through Higher Order Construct modeling in Partial Least Squares Structural Equation Modeling (PLS-SEM). The review contributes an integrative theoretical lens that repositions nursing HRM research from a retention-oriented toward a sustainability-oriented paradigm and offers a conceptual foundation for hospital management and health policy to design HRM interventions within Indonesia's civil-service (ASN) and national health insurance (JKN) context. As a conceptual/literature-review paper prepared for doctoral colloquium purposes, empirical validation of the proposed model remains the agenda of the author's ongoing dissertation research.
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