“ Healthcare organizations’ administrative policies are just too rigid... “: why nurses leave primary and emergency care

<h3>Context.</h3> Nursing shortage is a major issue for healthcare systems. Primary and emergency care are no exception. Large scale nurse turnover is costly, is associated with both reduced productivity and poorer patient outcomes. Understanding of the reasons for nurse turnover has become a pressing issue. <h3>Objective.</h3> To identify the reasons why nurses leave their primary and emergency care position and compare this with other practice areas. <h3>Study Design.</h3> A descriptive qualitative design using a critical incident technique wase used. Immediately following their resignation, nurses were interviewed to explore the reasons why they had quit their job. <h3>Setting.</h3> Nurses were recruited from 4 organizations in urban and rural regions of Quebec (CANADA). <h3>Population Studied.</h3> N=35 nurses were interviewed; n=6 primary care, n=7 emergency care and n=22 from other areas. <h3>Instrument.</h3> A semi-structured interview guide based on Daouk-Öyry’s (2014) joint model of nurse absenteeism and turnover was used. <h3>Outome Measures.</h3> The individual, interpersonal, occupational, organizational and national considerations underpinning their decision to quit were analysed. <h3>Analysis.</h3> The interviews were subjected to thematic content analysis. Critical incident of primary and emergency care nurses were compared to those of the other nurses. <h3>Results.</h3> All the primary care nurses had at least 5 years’ experience, as did most emergency care nurses, while nurses from other area were less experienced. Primary care nurses were more likely to work as float nurses compared with emergency nurses. Organizational factors (lack of stability, demanding work schedules, work-life balance imbalance) was commonly cited among primary care nurses as to why they resigned from their jobs. Emergency nurses cited individual, interpersonal, and organizational reasons for leaving their jobs. <h3>Conclusions.</h3> Nurses leaving the primary and emergency care are experienced. The loss of expertise that results from their departure is a major challenge for access to care and services. It is therefore important to take account of their professional dissatisfactions to reduce turnover and improve nurses’ attraction.