Edinburgh Napier University

  Background

There is evidence of a nursing workforce crisis with increasing intention to leave (Royal College of Nursing, 2021), yet little is known about the experience of leaving the profession or direct nursing care. Actual nursing turnover needs further exploration (Hallaran et al., 2020; Halter 2017). Early career nurse retention is a priority due to significant investment in nurse education and the high incidence of nurse turnover in the first few years of qualification (Buchan et al., 2018; Collard et al., 2020). This study explores actual nursing turnover experience in the UK context.

Aim

To gain in-depth understanding of the experience of leaving nursing focusing on early career nurses who worked in the NHS and left direct care nursing, or the profession itself, within 5 years of registration as a nurse.

Methods

This qualitative study uses a narrative approach to focus on individual stories of leaving nursing to elicit in-depth first-hand experiences. Participants were recruited via social media and professional networks, for this hard-to-reach group. Phase one was carried out in January-March 2024, 8 participants had in-depth online video interviews.

Results and discussion

Preliminary findings in phase 1 of this study offer contextual evidence and add to current knowledge based on actual turnover experiences. Numerous complex factors shape individual narratives and shared elements can inform discussion about current nursing workforce challenges. Key findings include:

Becoming a nurse: motivations to nurse; strategic career choices; nursing identity.

Experiences as a nurse: dissonance between values and reality of nursing; lack of autonomy to improve care; negotiating peer support; poor mental health; high-pressure workloads; COVID experiences; incivility in practice.

Leaving nursing: impact of loss of nursing identity; sense of failure; reshaping personal and professional identities.

Conclusions

This UK wide study offers insight into reasons for actual professional turnover of nurses in the NHS, of interest to policymakers, NHS leaders, and researchers.

References
Buchan J (2018) Policy brief: Nurse Retention. International Centre on Nurse Migration. Available at: https://www.icn.ch/sites/default/files/inline-files/2018_ICNM%20Nurse%20retention.pdf

Collard SS, Scammell J, and Tee S. (2020) Closing the gap on nurse retention: A scoping review of implications for undergraduate education. Nurse Education Today. 84. 104253–104253. doi.org/10.1016/j.nedt.2019.104253

Hallaran AJ, Edge DS, Almost J, & Tregunno D (2020) New Registered Nurse Transition to the Workforce and Intention to Leave: Testing a Theoretical Model, Canadian Journal of Nursing Research. doi.org/10.1177/0844562120957845

Halter M, Boiko O, Pelone F, Beighton C, Harris R, Gale J, Gourlay S and Drennan V (2017). The determinants and consequences of adult nursing staff turnover: a systematic review of systematic reviews. BMC Health Services Research 17. 824. doi.org/10.1186/s12913-017-2707-0

Royal College of Nursing (2021) RCN Employment Survey 2021. Available at:
https://www.rcn.org.uk/professional-development/publications/Employment-Survey-2021-uk-pub-010-075#detailTab