A hierarchical model of the internal relationship marketing approach to nurse satisfaction and loyalty

Purpose – The purpose of this study is to empirically test a hierarchical model of the antecedents of nurse job satisfaction and loyalty based on the internal marketing literature. Specifically, the study aims to investigate the degree to which structural, social, and financial bonding activities influence nurses' job satisfaction and retention. Design/methodology/approach – Following a review of the literature, the model was tested via a survey of 200 nurses from three US health care institutions. Findings – The study resulted in key findings pertaining to the hierarchical nature of structural, social, and financial bonding activities and their impact on job satisfaction and loyalty. Practical implications – Service industries that depend on front‐line employees to deliver high quality services are provided with innovative suggestions to improve job satisfaction and loyalty of their employees by employing an internal marketing approach. The study provides organizations with empirical evidence regarding the synergistic effects of bonding activities. Originality/value – To the best of the authors' knowledge, this is the first time a hierarchical/sequential model of the impact that relationship bonds have on satisfaction and retention of health care staff has been empirically tested. The findings that structural bonds have both a direct and indirect impact on job satisfaction and loyalty are of value for interested academics working in this area and are relevant for companies trying to improve job satisfaction and loyalty of their employees.