Values and workplace expectations to facilitate retention: perspectives from nurses at two ends of the career spectrum

Background: Nursing shortages are detrimental to healthcare services due to the loss of skills and experience in patient care. In England, the retention of NHS nurses in their early- and late-career stages is of particular interest because they have the highest leaver rates. Aim: To explore in detail what early- and late-career NHS nurses value and expect from their employers to retain them in their jobs and the profession. Insights from nurses at two ends of the career spectrum could offer a new perspective and shed light on seemingly persistent and detrimental factors for retention. Methods: Semistructured focus groups and interviews, using Microsoft Teams, were conducted between April 2023 and February 2024 with early-career nurses (i.e., first registration between 2019 and 2024) and late-career nurses (i.e., 55 years and over). We also analysed open-text comments from a related survey (2023), which explored nurses' working lives and retention. Results: 27 nurses participated in the qualitative study, and 784 nurses provided open-text comments from the cross-sectional survey. Except for tailored support when entering the profession and adequate remuneration when leaving nursing, the organisational factors cited by nurses as key to their retention were similar for both groups. Some of these 'persistent' factors potentially detrimental to retention across both groups included a negative work culture, lack of adequate resources and limited opportunities for career development. Perceived inadequate remuneration should not be underestimated either. Conclusion: Support from the leadership team and/or colleagues seems to partially alleviate the stress of working in strenuous environments. However, addressing 'persistent' and detrimental organisational factors throughout nurses' careers should continue to be a priority to retain them, safeguard their well-being and enable them to deliver the standard of care they aspire to. Nursing Management Implications: The findings have significant implications for improving the retention of early- and late-career NHS nurses.