To identify the combination of variables that explain nurses’ continuation intention in the UK National Health Service. This alternative arena has permitted the replication of a private sector Australian study.Background
This study provides understanding about the issues that affect nurse retention in a sector where employee attrition is a key challenge, further exacerbated by an ageing workforce.Design
A quantitative study based on a self-completion survey questionnaire completed in 2010.Methods
Nurses employed in two UK National Health Service Foundation Trusts were surveyed and assessed using seven work-related constructs and various demographics including age generation. Through correlation, multiple regression and stepwise regression analysis, the potential combined effect of various explanatory variables on continuation intention was assessed, across the entire nursing cohort and in three age-generation groups.Results
Three variables act in combination to explain continuation intention: work–family conflict, work attachment and importance of work to the individual. This combination of significant explanatory variables was consistent across the three generations of nursing employee. Work attachment was identified as the strongest marginal predictor of continuation intention.Conclusion
Work orientation has a greater impact on continuation intention compared with employer-directed interventions such as leader–member exchange, teamwork and autonomy. UK nurses are homogeneous across the three age-generations regarding explanation of continuation intention, with the significant explanatory measures being recognizably narrower in their focus and more greatly concentrated on the individual. This suggests that differentiated approaches to retention should perhaps not be pursued in this sectoral context.
To provide depth and breadth in the analysis of nursing students’ written narratives of ‘most memorable’ professionalism dilemmas.Background
While nursing students are taught professionalism through formal curricula, they commonly experience workplace-based professionalism dilemmas. Although non-UK studies have begun to explore students’ lived experiences of dilemmas, they lack detail about when and where dilemmas occur, who is involved, what students do and why and how students feel.Design
Online survey of healthcare students including 294 nursing students from 15 UK nursing schools.Method
Nursing students provided a written narrative of their most memorable dilemma (December 2011–March 2012) as part of a survey examining the impact of professionalism dilemmas on moral distress. We conducted thematic and discourse analysis of all narratives and narrative analysis of one exemplar.Findings
The most common themes were patient care dilemmas by healthcare personnel or students, student abuse and consent dilemmas. Of the dilemmas, 49·6% occurred over 6 months previously, 76·2% occurred in hospitals and 51·9% of perpetrators were nurses. 79·3% of students reported acting in the face of their dilemma. Of the narratives, 88·4% contained negative emotion talk and numerous significant relationships existed between types of emotion talk and dilemmas. Our narrative analysis demonstrates the impact of dilemma experiences through emotion talk and more subtle devices like metaphor.Conclusion
Findings extend previous research with nursing and medical students. Nurse educators should help students construct emotionally coherent narratives to make sense of their experiences, actions and identities and to better prepare them for future professionalism dilemmas.