Understanding Nurse Retention at a Mental Health and Addictions Facility During a Dual Pandemic.

Background: The COVID-19 pandemic exposed nurses to new and more severe workplace stressors; exposure to these workplace stressors has exacerbated nurse turnover. Nurses working in mental health and substance use (MHSU) have also experienced the unique stressor of the overdose crisis in British Columbia (BC). MHSU nurses have been at the forefront of working to manage these dual emergencies. There is limited evidence related to the compounding effect of COVID-19 and the overdose crisis on nursing turnover. Understanding the unique conditions that MHSU nurses are currently experiencing and what factors influence a nurse's intention to stay in or leave a healthcare facility is essential in developing strategies to minimize turnover and maximize retention.

Purpose: To explore the factors that affect nurse turnover while working through the dual emergencies within a MHSU facility in BC, Canada.

Methods: A qualitative descriptive approach with an inductive, descriptive thematic analysis guided this quality improvement project.

Results: Findings were grouped into two main themes: reasons for leaving and reasons for staying. Reasons for leaving included workplace safety, seeking new opportunities, lack of support, and being short-staffed. Reasons to stay encompassed connections with clients, leaders and colleagues, support from colleagues and leaders, and feeling valued, safe, and heard.

Conclusions: Perceived personal safety and protection from workplace violence were found to increase the likelihood of intent to leave and turnover among nurses. Further, psychosocial safety and connection among nurses and health leaders were found to decrease the likelihood of turnover.