Exploring Retention Strategies for Mid-Career Nurses: A Scoping Review and Thematic Analysis.

Abstract

BackgroundHealthcare systems face difficulties in retaining nurses due to the demanding nature of the work. Turnover among mid-career nurses is of particular concern, as it diminishes the pool of experienced staff available to provide patient care and mentorship. While retention strategies for early-career nurses are well-documented, less is known about interventions targeting mid-career nurses.MethodsWe conducted a scoping review following Arksey and O'Malley's framework, systematically searching PubMed and CINAHL, including grey literature sources, for studies on mid-career nurse retention published between January 2014 and February 2025. Our goal was to map the scope, nature, and focus of the existing research, and to identify key knowledge gaps.ResultsTwenty-two studies from 10 countries met the inclusion criteria, with 16 examined interventions tailored for mid-career nurses. Among these, ten focused on retaining nurses within their current roles, while six aimed to reduce attrition from the organization entirely. The interventions were grouped into three thematic areas: optimizing role satisfaction, work culture, and customized retention strategies. While these strategies appear promising, their actual impact on retention remains unclear. Many studies provided limited outcome data, lacked consistent measures at both individual and organizational levels, and rarely addressed potential unintended effects. Moreover, there is no widely accepted definition or clear conceptualization of what constitutes a mid-career nurse.ConclusionsOur findings highlight the lack of focused initiatives to retain mid-career nurses and point to an urgent need for innovation in this space. Future efforts should prioritize the formal evaluation of existing programs to assess their effectiveness.