Perspectives on Nurse Retention in Hospitals in the Netherlands: A Qualitative Study

Abstract

Aim. To explore hospital nurses’ perceptions of working conditions that affect their retention and to identify preconditions for retention across nursing subgroups and informants directly involved in the work that nurses do. Introduction. Understanding why nurses want to stay in their job is essential for hospitals to improve retention and develop policies to combat nursing shortages. Retention barriers are known, but mostly pre-COVID-19 and in specific nursing subgroups, while nursing teams are diverse in life phase, education, and expertise. Materials and Methods. A qualitative study with semistructured focus group interviews with nurses from different hospitals. We held interviews with nursing students and with newly graduated, experienced, specialized, and master-educated nurses. In addition, we held interviews with informants directly involved in the work that nurses do. Results. Three themes concerning the perceptions of working conditions and retention preconditions were identified among subgroups: (1) nurses finding their personal pathway, indicating work that fits individual challenges during the life course and work that matches personal motives and authority and control over professional practice; (2) constructive collaboration within the nursing team and with their manager and physicians; and (3) availability of supportive facilities, e.g., development, professionalization, working environment, and rewards. Conclusion. Elements for retention occur at individual, team, and organizational levels. Nurses find it important that their profession aligns with their personal pathway and are motivated by constructive collaboration in a stimulating team. They emphasized organizational support in realizing career tracks and in active participation in decision-making. These themes are consistent across subgroups and encompass multiple interacting elements. Implications for Nursing Management. By recognizing and understanding what takes place at these different levels, policymakers and managers can develop effective strategies to promote nurse retention and improve healthcare quality. While implementing and monitoring a broad retention program, managers must remain attentive to nurses’ perceptions of retention preconditions amidst changing demographics and the impact of COVID-19.