When Nurses Leave: A Critical Incident Study of Turnover Intentions

Area of Science:

• Nursing
• Healthcare Management
• Qualitative Research

Background:

• High nurse turnover rates pose significant challenges to healthcare systems.
• Understanding the root causes of nurses' intentions to leave is crucial for effective retention strategies.

Purpose of the Study:

• To identify critical incidents that prompt nurses to consider leaving their practice settings or the nursing profession.
• To explore the complex factors influencing nurses' decisions to depart from their roles.

Main Methods:

• Qualitative design utilizing the Critical Incident Technique (CIT).
• Thematic analysis of 350 critical incidents reported by 187 nurses.
• Adherence to Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.

Main Results:

• Four major themes emerged: working within constraints, feeling abandoned, compromised patient care, and unpredictability of work.
• A pervasive underlying issue was the perception of not being respected or valued by employers.
• Nurses expressed a need to feel valued and be more involved in unit-based decision-making.

Conclusions:

• The decision for nurses to leave is a gradual process, evolving from cumulative challenging situations rather than a single incident.
• Addressing nurses' perceptions of value and involvement is essential for improving retention.
• Findings provide insights for managers to better understand and mitigate nurse turnover.