Work experiences of healthcare professionals in a shortage context: analysis of open-ended comments in a Swiss cohort (SCOHPICA).

BACKGROUND

Healthcare systems worldwide face critical shortages of healthcare professionals (HCPs), threatening care quality and system sustainability. In Switzerland, limited training capacities further worsen the situation. While factors, such as job satisfaction, work-life balance, and burnout, are well-documented, most studies focus on specific professions, limiting their generalizability. This study provides an interprofessional analysis of HCPs' experiences regarding their working conditions in the context of workforce shortages, identifying key challenges that could inform retention strategies.

METHODS

Open-ended comments from 1,811 participants in the HCPs part of the Swiss Cohort of Healthcare professionals and Informal caregivers (SCOHPICA-HCP), covering over 30 healthcare professions, were analyzed using computer-assisted textual analysis (IRaMuTeQ). Thematic classes were identified through hierarchical classification, and chi-square tests were conducted to examine associations with participant characteristics (e.g., profession, work setting, job satisfaction).

RESULTS

Three main themes emerged. First, participants highlighted gaps in training, including inadequate preparation for professional realities, limited career development opportunities, and challenges in diploma recognition. Second, systemic failures -such as staff shortages, inadequate wages, and administrative overload - were linked to stress, burnout, and declining care quality. Many participants perceived a disconnect between political decisions and frontline realities, further fueling dissatisfaction. Third, irregular working schedules, particularly night shifts, were seen as barriers to work-life balance and physical health, while also negatively impacting social and family responsibilities. Frustration over the lack of professional influence in shaping healthcare policies was a recurring concern.

CONCLUSIONS

This study identifies key challenges influencing HCP retention, emphasizing the importance of restoring trust through transparent communication and professional engagement in policy making. Rather than relying on overly generalized approaches, retention efforts should be tailored to clusters of professionals with shared working conditions. Additionally, this study highlights three key insights: the growing distrust in the healthcare system and in policy makers as significant aspect in HCPs' experience, shifting generational attitudes toward work commitment, and the need for collaborative programs between professional schools and employers to enhance work preparedness. These findings underscore the need for systemic changes to support workforce sustainability.