A strengths-based qualitative exploration of critical care nurses' reasons for remaining in critical care

Abstract

Aims: Globally, the nursing shortage is a growing concern. Much of the research on retention of nurses focuses on the experience of those who left positions. In this study, we set out to listen to critical care nurses (CCRNs) who have chosen to remain in their positions to understand the factors retaining them in critical care.

Design: This interpretive descriptive study was guided by the following research question: 'what factors influence CCRN's decision to continue to work in critical care?'

Methods: Digitally recorded interviews and a focus group were conducted between July 2022 and January 2023 using a semi-structured, strengths-based interview guide with CCRNs from three critical care units at a tertiary hospital in a city in a central Canadian province. Transcribed interviews were analysed using open, axial and selective coding and constant comparative analysis.

Results: Twenty-two CCRNs participated in interviews and three in a focus group. The theme of Respect, demonstrated through the interconnected concepts of Working to Full Scope, Team, Rotations and Compensation was identified. Working to Full Scope was described as providing nursing care aligned with how each nurse envisions what nursing is. Being part of a Team led by strong nurse leaders that provides opportunities and supports the sharing of their perspectives was also found. Respect was also found to be demonstrated through Rotations that recognize that work is one part of these nurses' lives. Compensation that reflects the increased education, knowledge and skills required in critical care was the final concept of Respect.

Conclusion: Organizations should focus their efforts across the identified concepts to demonstrate Respect for CCRNs and retain them.

Implications for practice: The findings of this study provide ways to support the retention of CCRNs.

Impact: This research will have an impact on nursing leaders by providing tangible ways to retain CCRNs.

Reporting method: Reporting of this work was guided by the Standards for Reporting Qualitative Research.

Patient or public contribution: No patient or public contribution.

Keywords: critical care; intensive care; respect; retention; vacancy.