Leading unique cultures in departments with low turnover of nurses. A positive deviance approach study

To investigate nurse leaders' experiences and strategies for turnover in relation to culture and work environment in hospital departments with low nurse turnover.

Nursing shortage is a global problem, and numerous turnover strategies have been utilized to attempt to address this shortage.

Four regional hospital departments with the lowest nurse turnover were included. Data were constructed with nine nurse leaders through individual interviews and were analysed using directed content analysis.

The findings presented in two categories, 'The culture is unique' and 'Maintaining, protecting or re-establishing a unique culture', summarize how leaders navigated authentically in different contexts, operationalizing clear values and visions both for their departmental culture and in turnover strategies.

Even though all the nurse leaders interviewed were concerned about the current recruitment situation, they were confident in their leadership roles, targeted towards supporting the unique culture in their departments.

Leaders with clear cultural awareness and visions for the context in which they operate may be positively associated with lower turnover of nurses. Including the perspectives of leaders from departments with low turnover of nurses has the potential to create new knowledge about improving nurse retention.