Understanding the factors which promote registered nurses' intent to stay in emergency and critical care areas

J Clin Nurs. 2018 Mar;27(5-6):1209-1215. doi: 10.1111/jocn.14167. Epub 2018 Jan 10.

Abstract

Aims and objective: To explore the influential factors and strategies that promote an experienced nurse's intent to stay in their emergency or critical care area.

Background: Turnover among registered nurses (herein referred to as nurses) working in specialty areas of practice can result in a range of negative outcomes. The retention of specialty nurses at the unit level has important implications for hospital and health systems. These implications include lost knowledge and experience which may in turn impact staff performance levels, patient outcomes, hiring, orientating, development of clinical competence and other aspects of organizational performance.

Design: This qualitative study used an interpretive descriptive design to understand nurses' perceptions of the current factors and strategies that promote them staying in emergency or critical care settings for two or more years.

Methods: Focus groups were conducted with 13 emergency and critical care nurses. Data analysis involved thematic analysis that evolved from codes to categories to themes.

Results: Four themes were identified: leadership, interprofessional relationships, job fit and practice environment. In addition, the ideas of feeling valued, respected and acknowledged were woven throughout.

Conclusions: Factors often associated with nurse attrition such as burnout and job stresses were not emphasised by the respondents in our study as critical to their intent to stay in their area of practice. This study has highlighted positive aspects that motivate nurses to stay in their specialty areas.

Relevance to clinical practice: To ensure quality care for patients, retention of experienced emergency and critical care nurses is essential to maintaining specialty expertise in these practice settings.

Keywords: critical care; emergency; focus groups; interpretive research; nurse-physician relationships; registered nurse; specialist nursing; teamwork.

MeSH terms

  • Adult
  • Burnout, Professional / psychology*
  • Clinical Competence
  • Critical Care / statistics & numerical data*
  • Female
  • Focus Groups
  • Humans
  • Intention*
  • Job Satisfaction*
  • Leadership
  • Male
  • Nursing Staff, Hospital / organization & administration
  • Nursing Staff, Hospital / psychology*
  • Personnel Turnover / statistics & numerical data*
  • Quality of Health Care
  • Workplace / psychology