The dynamic systems view of voluntary turnover rates advocated in context-emergent turnover theory is used to explore how and why human capital flows impact unit performance over time. We examine hiring rates and employee transfer rates as distinct system components that work alongside voluntary turnover rates to affect job demands, and ultimately patient satisfaction. Our work explores this dynamic system of interrelated constructs, and explains and compares their mutual causality over time. The sample examined consists of 12 nursing units in a large hospital over 72 monthly observations, with patient satisfaction as the measure of unit performance.