Preventing Nurse Attrition: Qualitative Insights Into Professional Identity, Education and Workforce Sustainability

AIM: To explore the experiences, needs, and recommendations of Italian nurses who had left the profession or were seriously considering doing so, in order to identify strategies to prevent or mitigate attrition, professional disengagement and behaviours consistent with quiet quitting. DESIGN: Descriptive qualitative study. METHODS: Semi-structured interviews were conducted between February 2023 and November 2024 with nurses who had resigned or expressed intention to leave. Purposive sampling captured diverse experiences across care settings. Data were audio-recorded, transcribed verbatim and analysed thematically by multiple researchers. RESULTS: Two interconnected areas for prevention emerged: professional reform and educational reform. Participants identified strategies to strengthen retention, including improving professional recognition, autonomy, collective advocacy, psychological support and peer solidarity. Educational recommendations included establishing formally recognised specialisation pathways, strengthening undergraduate preparation, increasing nursing academic leadership, integrating preparation for the emotional demands of practice and promoting interprofessional education. These recommendations reflected broader concerns about professional identity erosion, emotional burden and limited career development as contributors to disengagement and intention to leave. CONCLUSION: Preventing nurse attrition requires systemic strategies that extend beyond reactive workforce management. Strengthening professional identity, improving emotional sustainability and aligning educational pathways with meaningful career development are likely to strengthen retention and reduce disengagement. IMPLICATIONS FOR THE PROFESSION: Retention strategies should prioritise structural reforms that support recognition, autonomy, professional development and psychological well-being. Nurses should be actively involved in organisational, educational and policy decision-making to ensure sustainable workforce interventions. IMPACT: This study provides qualitative insight into nurse-informed strategies to prevent attrition and disengagement in the Italian post-pandemic context. Findings offer actionable recommendations for healthcare leaders, educators, professional bodies and policymakers seeking to strengthen workforce sustainability. REPORTING METHOD: The study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. PATIENT OR PUBLIC CONTRIBUTION: Nurses contributed through interviews to the study but were not involved in the study design, conduct, or dissemination.