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Key factors associated with nurse retention and how they work: A mixed-methods study.
Neeltje de Vries1,2,3, Peter de Winter3,4,5,6, Sanne Drost-Goossens7
1IQ Health Science Department, Radboud University Medical Centre, Nijmegen, the Netherlands.
International Journal of Nursing Studies Advances
|February 2, 2026
Summary
Nurses want challenging work, opportunities to excel, and to feel valued. Addressing these factors and involving nurses in strategy development is key to improving nurse retention and mitigating shortages.
Area of Science:
- Healthcare Management
- Nursing Studies
- Organizational Psychology
Background:
- The global nursing shortage is a critical healthcare challenge, projected to worsen by 2030.
- High nurse turnover is driven by workload, limited development, and lack of support, impacting care quality and costs.
- Existing retention strategies may be less effective due to a lack of nurse-centered perspectives.
Purpose of the Study:
- To identify key factors influencing nurses' retention in hospitals.
- To understand nurses' perceptions of critical factors impacting their decision to stay.
Main Methods:
- A mixed-methods approach combining Q-methodology and semi-structured interviews.
- 29 nurses (practicing and former) participated in Q-sorts and interviews in Dutch hospitals.
- Quantitative analysis identified shared viewpoints, while qualitative analysis deepened understanding of retention factors.
Main Results:
- Three primary factors emerged: 'Challenging work and inclusive positioning for high-quality care,' 'Room to excel in nursing roles,' and 'Being seen, heard, and valued.'
- These perceptions significantly influenced nurses' intention to remain employed.
- A consistent theme across all factors was nurses feeling structurally unheard within their organizations.
Conclusions:
- Nurse retention is influenced by a complex interplay of challenging work, professional recognition, support, and growth opportunities.
- A systemic approach addressing these multifaceted dimensions is crucial for improving retention and patient care quality.
- Engaging nurses in the design and implementation of retention strategies is essential for their effectiveness.
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