Vacheron Charles-Hervé, Bras Marlene, Friggeri Arnaud, Manzon Cyril, Vivier Emmanuel, Caillet Anaelle, Wallet Florent
Département d'Anesthésie Réanimation, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France; CIRI-Centre International de Recherche en Infectiologie (Team PHE3ID), Univ Lyon, Université Claude Bernard Lyon 1, Inserm, U1111, CNRS, UMR5308, ENS Lyon, 46 Allée d'Italie, Lyon 69007, France.
Soins Intensifs Neuro-Vasculaire, Hopital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.
Anaesth Crit Care Pain Med. 2025 Jan;44(1):101460. doi: 10.1016/j.accpm.2024.101460. Epub 2024 Dec 20.
Nurse retention is a major concern in healthcare settings, especially among intensive care units (ICU), in which nurses are highly specialized. The objective was to describe the nurse courses after their entrance into the ICU, their motivation for leaving the ICU, and to identify the independent factors that influenced the nurse resignation from their units.
In 3 different centers, every ICU nurse working between 2013 and 2023 was telephonically contacted and was asked to describe their career and, when appropriate, the reasons that influenced their resignation from their units; they rated on a Likert scale of 14 factors that influenced their decision.
Among the 405 nurses who worked in these ICUs between 2013 and 2023, 265 (65.0%) were included in the study, and 93 (35.1%) were still working in their unit. The median time of professional experience of the nurses in their ICU was 5.8 [5.0-7.0] years, and at 10 years, 26.3% [20.4-33.9] of the nurses remained in their unit, 23.8% [17.3-32.8] left the ICU but were still in-hospital nurses, and 22.4% [15.8-31.7] underwent specialization. A minority of nurses resigned and changed their careers (9.5% [5.3-17.0]). The main factors influencing the nurse's resignation from their unit were belonging to Generation Y or Z (HR 1.89 [1.35;2.64]), experiencing symptoms of burnout (2.37 [1.63;3.46]), and pregnancy during the ICU (1.77 [1.41;2.23]). The COVID-19 period was inconsistently associated with nurse resignation depending on the center. The main motivations to leave the unit were organizational (variability of schedule, night shift), personal (willingness to change, personal event), and related to the ICU workload.
Nurse retention is an increasing concern, associated with the generational aspects and increased prevalence of burnout. Structural changes will have to be made to reduce the turnover.
护士留用是医疗机构的一个主要关注点，在重症监护病房（ICU）尤为如此，因为这些科室的护士专业性很强。目的是描述护士进入ICU后的职业历程、离开ICU的动机，并确定影响护士从所在科室离职的独立因素。
在3个不同的中心，通过电话联系了2013年至2023年期间工作的每一位ICU护士，要求他们描述自己的职业经历，并在适当的时候说明影响他们从所在科室离职的原因；他们对影响其决定的14个因素进行了李克特量表评分。
在2013年至2023年期间在这些ICU工作的405名护士中，265名（65.0%）被纳入研究，93名（35.1%）仍在所在科室工作。护士在ICU的专业工作经验中位数为5.8[5.0 - 7.0]年，到10年时，26.3%[20.4 - 33.9]的护士仍在所在科室，23.8%[17.3 - 32.8]离开了ICU但仍是医院护士，22.4%[15.8 - 31.7]进行了专业转型。少数护士辞职并改变了职业（9.5%[5.3 - 17.0]）。影响护士从所在科室离职的主要因素是属于Y或Z世代（风险比1.89[1.35；2.64]）、出现职业倦怠症状（2.37[1.63；3.46]）以及在ICU工作期间怀孕（1.77[1.41；2.23]）。根据不同中心的情况，COVID - 19时期与护士离职的关联并不一致。离开科室的主要动机是组织方面的（排班的多变性、夜班）、个人方面的（希望改变、个人事件）以及与ICU工作量有关。
护士留用问题日益受到关注，这与代际因素和职业倦怠患病率增加有关。必须进行结构性变革以减少人员流动。
