School of Health Sciences, University of Southampton, UK; NIHR Applied Research Collaboration Wessex, Southampton, UK.
Florence Nightingale School of Nursing and Midwifery, King's College, London, UK. Electronic address: https://twitter.com/julia_philippou.
Int J Nurs Stud. 2024 Dec;160:104908. doi: 10.1016/j.ijnurstu.2024.104908. Epub 2024 Sep 13.
Shortages of nurses are one of the biggest challenges healthcare systems face around the world. Given the wide range of contexts and individuals working in nursing, a 'one-size-fits-all' retention strategy is unlikely to be effective. Knowing what matters most to nurses at different career stages would help employers and policy-makers who want to enhance nurse retention to design tailored strategies.
To review and synthesise findings from recently published literature on the push-pull factors influencing nurses' decisions at the micro level, to enter and stay (or leave) at key career stages (i.e. pre-career, training, early-, mid- and late-career, and return to practice).
We undertook a set of structured searches of the literature and a narrative synthesis to explore factors that motivate individuals to enter the nursing profession and the push-pull factors influencing nurse retention at different career stages. Electronic databases CINAHL, Medline, Scopus and Embase were searched in December 2022 (and updated in November 2023) for English language publications. Additional health workforce sources, such as King's Fund and Nuffield Trust, were also searched.
227 articles met the criteria for inclusion in the narrative review. Some push-pull factors were common to nurses across all career stages, including workplace support, flexible schedule patterns, opportunities for career advancement, fair treatment and salaries. In contrast, some challenges and push-pull factors were unique to each career stage. Students experienced difficulty in adjusting and balancing education and life; early-career nurses experienced transition shocks; mid-career nurses were frustrated by the lack of career advancement; late-career nurses desired more recognition; nurses returning to practice were discouraged by their lack of confidence and the cost of return-to-practice courses.
Our findings reinforce the view that factors influencing nurses' choices about whether to enter, continue or leave nursing jobs are multi-factorial and multi-dimensional. Policy and employment practices should be informed by research that has a more nuanced insight into what matters most to whom and at what career stage.
Nuanced insight into motivations is needed to attract and retain a mix of nurse throughout their careers @ZEjebu @julia_philippou @JaneEball.
护士短缺是全球各地医疗保健系统面临的最大挑战之一。鉴于护理工作者所处的背景和个人情况各不相同，因此，“一刀切”的保留策略不太可能有效。了解不同职业阶段的护士最关心的问题将有助于希望提高护士保留率的雇主和政策制定者设计有针对性的策略。
综述和综合近期发表的文献中关于影响护士在微观层面上进入和留任（或离职）关键职业阶段（即职业生涯前期、培训、早期、中期和晚期以及重返实践）的推拉因素的研究结果。
我们进行了一系列文献检索，并进行了叙述性综合，以探讨促使个人进入护理行业的因素，以及影响不同职业阶段护士保留率的推拉因素。2022 年 12 月（并于 2023 年 11 月更新），我们在 CINAHL、Medline、Scopus 和 Embase 电子数据库中搜索了英文文献，并搜索了 King's Fund 和 Nuffield Trust 等其他卫生人力资源来源。
有 227 篇文章符合叙述性综述的纳入标准。一些推拉因素在所有职业阶段的护士中都很常见，包括工作场所支持、灵活的工作时间模式、职业发展机会、公平待遇和薪酬。相比之下，一些挑战和推拉因素在每个职业阶段都是独特的。学生在适应和平衡教育和生活方面存在困难；早期职业护士经历过渡冲击；中期职业护士对缺乏职业发展感到沮丧；晚期职业护士希望得到更多认可；重返工作岗位的护士因缺乏信心和重返工作岗位课程的费用而受挫。
我们的研究结果证实了这样一种观点，即影响护士是否进入、继续或离开护理工作的因素是多方面的。政策和就业实践应借鉴对谁最重要以及在哪个职业阶段最重要的更细致入微的研究。
需要深入了解动机，以吸引和留住各类护士在整个职业生涯中留任@ZEjebu @julia_philippou @JaneEball。
