How local, first-line nurse leaders can positively influence nurse intent to stay and retention: A realist review

Abstract

Aims and Objectives: To explore evidence on how local nurse leaders can positively influence nurse retention. Background: Nurse turnover and retention is a wicked problem with multiple interrelated factors and no one solution. Local nurse leadership has the potential to positively influence nurse intent to stay directly or via various factors. Design: A realist review. Methods: Having designed a search strategy based on a tentive programme theory, 1386 initial hits in three databases were screened and reduced to 48 research articles published between 2010–2021. The articles' content were coded for findings that supported, refined or contradicted four ContextMechanismOutcome configurations. Results: Sufficient evidence was found to support four guiding lights encouraging local nurse leaders to: (1) foster relational connectedness; (2) enable professional practice autonomy; (3) cultivate healthful workplace cultures; (4) support professional growth and development. Mutuality and reciprocity is also key if leaders themselves are to experience wellbeing and growth. Conclusions: Person-centred, transformational and resonant local nurse leaders can positively influence nurse intent to stay within the workplace or organisation. Reporting Method: Conform JCN guideline ‘What to cover in the main tekst by article type’ for reviews. Patient or Public Contribution: No Patient or Public Contribution.