Ranking retention factors and exploring preferred actions for retention across nursing subgroups: a cross-sectional study in two university hospitals

BACKGROUND: To enhance nurse retention amidst rising patient care demands and the current nursing shortage, it is essential to understand nurses' views and preferred actions. There are various relevant retention factors at the individual, team, and organizational levels. However, it is not known what priority nurses give to the factors. Understanding this is crucial, as unmet needs, along with rising demand for care and a tight labour market, increase the likelihood that nurses will seek better working conditions elsewhere. This study aims to explore how nurses working in university hospitals across different age and educational categories rank factors that are important for their retention, and to identify their preferred action for retention. METHODS: We performed a cross-sectional study among nurses from two university hospitals, using an online survey. The survey included the ranking of retention factors from most to least important, along with an open-ended question about nurses' preferred action for retention. Data analysis involved descriptive statistics, Kruskal-Wallis tests to examine differences in rankings across age and education groups, and a Direct Content Analysis of open-ended responses. RESULTS: In total 483 nurses (12.6%) responded. Nurses identified competitive salaries, career advancement, and a positive team environment as the most important factors for their retention, with significant differences between age and educational groups. Younger and higher-educated nurses prioritized career advancement, while older nurses ranked work-life balance, supportive supervision, and professional autonomy higher. Nurses' responses to the open-ended question about preferred actions spanned all retention factors. CONCLUSIONS: Hospital nurses' retention priorities differ by age and education. This emphasizes the need for targeted strategies that address the specific priorities of nurses, in alignment with organizational goals and changes. Balancing nurses' priorities, such as competitive salaries and career development, with organizational constraints is a challenge. By integrating nurses' voices and preferences into retention strategies and understanding the underlying dynamics, healthcare leaders can develop flexible strategies that foster sustainable employability, creating a resilient and motivated nursing workforce that enhances patient care outcomes and drives organizational success.