Coming and going: a narrative review exploring the push-pull factors during nurses’ careers
Coming and going: a narrative review exploring the push-pull factors during nurses’ careers
Background: 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.
Objective: 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).
Methods: 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.
Results: 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.
Conclusions: 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.
Career cycle, Career theory, Micro-level, Motivation, Nursing staff, Push-pull factors, Retention
Ejebu, Ourega-Zoé
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Philippou, Julia
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Turnbull, Joanne
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Rafferty, Anne Marie
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Palmer, William
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Prichard, Jane
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Atherton, Iain
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Jamieson, Michelle
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Rolewicz, Lucina
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Williams, Matthew
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Ball, Jane
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20 September 2024
Ejebu, Ourega-Zoé
4f545ae3-4823-44ab-8d59-185d30929ada
Philippou, Julia
e044b13b-8a23-4ea8-8207-7ca4545bdf26
Turnbull, Joanne
c9480b0e-ad76-481c-8110-5936744c8e71
Rafferty, Anne Marie
ffa430c1-b88e-4028-96e2-bb458cebf5d9
Palmer, William
bedec86f-bf3a-44f4-903d-744165292c4f
Prichard, Jane
64ba5e39-0b0f-4529-877f-aa6ecc7e7e2e
Atherton, Iain
66a18532-f1ea-4ce8-a931-fc831f96a558
Jamieson, Michelle
8efb089d-d647-40a0-bd6c-49a019bb40ce
Rolewicz, Lucina
616de9ff-1b17-446b-ac10-37a51d0f0cfa
Williams, Matthew
b0f899a3-e291-4085-9565-b141d79069dc
Ball, Jane
85ac7d7a-b21e-42fd-858b-78d263c559c1
Ejebu, Ourega-Zoé, Philippou, Julia, Turnbull, Joanne, Rafferty, Anne Marie, Palmer, William, Prichard, Jane, Atherton, Iain, Jamieson, Michelle, Rolewicz, Lucina, Williams, Matthew and Ball, Jane
(2024)
Coming and going: a narrative review exploring the push-pull factors during nurses’ careers.
International Journal of Nursing Studies, 160, [104908].
(doi:10.1016/j.ijnurstu.2024.104908).
Abstract
Background: 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.
Objective: 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).
Methods: 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.
Results: 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.
Conclusions: 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.
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Accepted/In Press date: 9 September 2024
e-pub ahead of print date: 13 September 2024
Published date: 20 September 2024
Keywords:
Career cycle, Career theory, Micro-level, Motivation, Nursing staff, Push-pull factors, Retention
Identifiers
Local EPrints ID: 495907
URI: http://eprints.soton.ac.uk/id/eprint/495907
ISSN: 0020-7489
PURE UUID: 44952d59-3280-4fb0-8394-9359c1a0042e
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Date deposited: 27 Nov 2024 17:35
Last modified: 28 Nov 2024 02:59
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Contributors
Author:
Julia Philippou
Author:
Joanne Turnbull
Author:
Anne Marie Rafferty
Author:
William Palmer
Author:
Iain Atherton
Author:
Michelle Jamieson
Author:
Lucina Rolewicz
Author:
Matthew Williams
Author:
Jane Ball
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