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The present study explored sickness presenteeism as a linchpin connecting prolonged working hours to elevated turnover intention among hospital nurses (mediation). In addition, we examined the joint moderating effects of organizational health care support and supervisor support on the second stage of the “long working hours-presenteeism-turnover” process (three-way moderated mediation).

We conducted a two-wave survey to collect data over a four-month period from hospital nurses in Taiwan. The final sample for analysis had 294 nurses.

We found that presenteeism partially mediated the elevated turnover intention after working long hours four months later. We also found a significant three-way moderation effect of organizational health care support and supervisor support on the positive relationship between presenteeism and turnover intention. Specifically, nurses reported the lowest turnover intention with high levels of both organizational healthcare and supervisor support, the highest turnover intention with both support being low, and the intermediate level of turnover intention when any one of the support was high.

Organizations should build a positive work environment through organizational health care support and supervisor support to retain talents.

Our findings suggested that support resources of different origins (organization-level vs line supervisor) can compensate for one another to protect the employees in demanding work conditions. Our moderated mediation model exploring the psychosocial context of presenteeism has theoretical contributions pivoting on the interplay of resources at different levels in the organization as well as practical implications for presenteeism management.