How local, first-line nurse leaders can positively influence nurse intent to stay and retention: A realist review

Abstract

Aims and objectives: To explore evidence on how local nurse leaders can positively influence nurse retention.

Background: Nurse turnover and retention is a wicked problem with multiple interrelated factors and no one solution. Local nurse leadership has the potential to positively influence nurse intent to stay directly or via various factors.

Design: A realist review.

Methods: Having designed a search strategy based on a tentive programme theory, 1386 initial hits in three databases were screened and reduced to 48 research articles published between 2010-2021. The articles' content were coded for findings that supported, refined or contradicted four ContextMechanismOutcome configurations.

Results: Sufficient evidence was found to support four guiding lights encouraging local nurse leaders to: (1) foster relational connectedness; (2) enable professional practice autonomy; (3) cultivate healthful workplace cultures; (4) support professional growth and development. Mutuality and reciprocity is also key if leaders themselves are to experience wellbeing and growth.

Conclusions: Person-centred, transformational and resonant local nurse leaders can positively influence nurse intent to stay within the workplace or organisation.

Reporting method: Conform JCN guideline 'What to cover in the main tekst by article type' for reviews.

Patient or public contribution: No Patient or Public Contribution.

Keywords: intent to stay; nurse leadership; realist review; retention.