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Perceptions of experienced nurses to what influenced their decision to leave clinical practice Hayward, Dana Alyson Marie


Nursing turnover (the loss of experienced nurses from a clinical setting) remains a pressing problem for healthcare delivery in acute care inpatient settings. Turnover contributes to increased recruitment and orientation cost, reduced quality patient care, and the loss of mentorship for new nurses. The purpose of this research was to critically examine the factors that contribute to turnover of experienced nurses’ including their decision to leave clinical practice settings and seek new employment in another nursing position. The study objectives were to explore experienced nurses’ decision-making processes in leaving current clinical practice settings and to examine the personal and environmental factors experienced nurses’ perceive that influenced their decision to leave. An interpretive descriptive approach was used to guide the study. Interviews were conducted with 12 nurses, averaging 16 years in clinical practice. Participants were equally represented from clinical units, which included critical care and medical-surgical areas. The sample drew on perspectives from point-of-care nurses and nurses in leadership roles, primarily charge nurses and clinical nurse educators. The findings indicated that nurses’ decisions to leave clinical practice were influenced by several interrelated environmental and personal factors such as higher patient acuity, increased workload demands, ineffective working relationships among nurses and with physicians, gaps in leadership support, and significant impact to nurses’ health and personal well-being. When participants experienced ineffective working relationships with other nurses and a lack of leadership support, they described being ill equipped to perform their job and reported a loss of job satisfaction. The impact of high stress was evident on the health and emotional well-being for those who stayed, and family relationships and lifestyles were adversely affected. It is vital that healthcare organizations learn to minimize turnover and retain the wealth of experienced nurses in acute care settings to maintain quality patient care and contain costs. The study highlights the need of healthcare leaders to reexamine how they promote collaborative practice, enhance supportive leadership behaviours, and reduce nurses’ workplace stressors in order to retain the wealth of skills and knowledge offered by experienced clinical practice nurses.

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