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What might make nurses stay? A protocol for discrete choice experiments to understand NHS nurses preferences at early-career and late-career stages

Por: Ejebu · O.-Z. · Turnbull · J. · Atherton · I. · Rafferty · A. M. · Palmer · B. · Philippou · J. · Prichard · J. · Jamieson · M. · Rolewicz · L. · Williams · M. · Ball · J.
Introduction

Like many countries, England has a national shortage of registered nurses. Employers strive to retain existing staff, to ease supply pressures. Disproportionate numbers of nurses leave the National Health Services (NHS) both early in their careers, and later, as they near retirement age. Research is needed to understand the job preferences of early-career and late-career nurses working in the NHS, so tailored policies can be developed to better retain these two groups.

Methods and analysis

We will collect job preference data for early-career and late-career NHS nurses, respectively using two separate discrete choice experiments (DCEs). Findings from the literature, focus groups, academic experts and stakeholder discussions will be used to identify and select the DCE attributes (ie, job features) and levels. We will generate an orthogonal, fractional factorial design using the experimental software Ngene. The DCEs will be administered through online surveys distributed by the regulator Nursing and Midwifery Council. For each group, we expect to achieve a final sample of 2500 registered NHS nurses working in England. For early-career nurses, eligible participants will be registered nurses who graduated in the preceding 5 years (ie, 2019–2023). Eligible participants for the late-career survey will be registered nurses aged 55 years and above. We will use conditional and mixed logit models to analyse the data. Specifically, study 1 will estimate the job preferences of early-career nurses and the possible trade-offs. Study 2 will estimate the retirement preferences of late-career NHS nurses and the potential trade-offs.

Ethics and dissemination

The research protocol was reviewed and approved by the host research organisation Ethics Committees Research Governance (University of Southampton, number 80610) (https://www.southampton.ac.uk/about/governance/regulations-policies/policies/ethics). The results will be disseminated via conference presentations, publications in peer-reviewed journals and annual reports to key stakeholders, the Department of Health and Social Care, and NHS England/Improvement retention leaders.

Registration details

Registration on OSF http://doi.org/10.17605/OSF.IO/RDN9G.

A meta‐synthesis exploring nurses' experiences of assisted dying and participation decision‐making

Abstract

Aims and Objectives

To explore nurses' experiences of assisted dying and understand how their perspectives inform their participation decision-making.

Background

Assisted dying is a complex and contentious issue with the potential to create moral unrest for nurses. The nursing role in assisted dying varies between jurisdictions.

Design

Systematic review. A meta-synthesis using thematic analysis.

Methods

Three electronic databases were searched for primary qualitative studies published in English, from New Zealand, Australia or Canada, up to October 2022. Seven articles were included; themes were analysed and key themes were established. Reporting adhered to PRISMA.

Results

The findings highlight the complexity of nurses' decision-making about participation or non-participation in assisted dying and the moral, philosophical and social influences that impact on their decision-making. This is presented as a spectrum of influence which persuades or dissuades nurses to participate in assisted dying. The 12 themes have been categorised into four key themes: personal persuaders, personal dissuaders, professional persuaders and professional dissuaders.

Conclusions

The findings suggest that nurses should be involved in policy and procedure guideline development and be offered education and training programmes to ensure safe, confident and informed practice. The need for mentorship programmes was also prevalent in the research.

Relevance to Clinical Practice

It is crucial that nurses be offered education and training in assisted dying. Clear policy and procedure guidelines are essential, and nurses should be involved in the development of these.

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