Between pride and frustration: why committed public healthcare workers consider exiting

Abstract

Purpose This study examines why healthcare professionals in public hospitals may still express intentions to leave their organizations despite reporting favorable levels of workplace well-being and affective commitment. It introduces ambivalent identification as a mediating mechanism that helps explain turnover intention in the public sector. Design/methodology/approach Drawing on the job demands–resources model and social identity theory, survey data were collected from 520 administrative and healthcare personnel in two Colombian public hospitals. Partial least squares structural equation modeling (SmartPLS) was used to test the relationships among workplace well-being, affective commitment, ambivalent identification, and turnover intention. Findings Results show that workplace well-being and affective commitment are negatively associated with ambivalent identification, while ambivalent identification is positively related to turnover intention. Mediation analyses confirm that ambivalence transmits the effects of well-being and commitment on turnover intentions. These findings highlight that even committed and engaged employees may consider leaving when organizational identification is marked by unresolved tensions. Originality/value The study advances public management research by integrating ambivalent identification into turnover models, extending the job demands–resources framework, and applying social identity theory to a Latin American public healthcare context. It highlights identity-based mechanisms that help explain why traditional retention resources may be insufficient in public hospitals and offers practical guidance for managers seeking to detect and address ambivalence to strengthen workforce stability.