Investigating factors influencing recruitment and retention of adult community nurses: an exploratory qualitative study across NHS trusts in England.

Abstract

Aim: To investigate factors influencing the recruitment and retention of adult community nurses.

Background: The recruitment and retention of community nurses is a growing global challenge, exacerbated by aging populations and increasing demand for primary and home-based care. Across Europe, nurse shortages threaten healthcare sustainability, with high attrition rates linked to workplace pressures, inadequate staffing, and emotional exhaustion. Despite efforts to strengthen retention, many European countries struggle to maintain adequate staffing levels, particularly in community nursing.

Methods: An exploratory qualitative approach was used with semi-structured interviews. The interview schedule was shaped by the study's aims, a prior integrative literature review, and the 'causal model of turnover for nurses'. Questions explored participants' experiences of recruitment into community nursing and factors influencing retention. The study focused on registered nurses and service managers within adult community nursing organizations across diverse geographical areas.

Findings: The study identified eight main themes influencing recruitment and retention: the perfect job, finding true self and fulfilment, alignment with organizational values, prior development and transitional experience, job dissatisfaction, shift in traditional practices, lack of compassionate leadership, and family commitments. Key factors included workplace flexibility, professional identity, job security, and organizational culture. However, challenges such as staffing shortages, lack of career progression, and increased administrative tasks were significant barriers to retention.

Conclusion: This study highlights the multifaceted challenges surrounding community nurse recruitment and retention, emphasizing the need for targeted strategies that go beyond traditional hospital-focused approaches. While salary improvements remain crucial, broader systemic changes including workplace flexibility, compassionate leadership, and career development opportunities are essential to fostering a sustainable workforce. By addressing these factors through co-designed solutions and evidence-based policy adjustments, healthcare organizations can enhance job satisfaction, reduce attrition, and ultimately strengthen the future of community nursing.