Abstract
The UK National Health Service (NHS) despite of ongoing investments in retention strategies face nursing shortages. Prior research has revealed a number of factors associated to nurse turnover, where retention is often seen as a distinct outcome rather than an ongoing process being shaped by employees lived experiences. This study employs the Job Demands Resources (JD-R) model and sensemaking theory to explore what influences nurses’ decisions about staying and leaving the high demand hospital setting. The analysis of this study is based on qualitative interviews with 19 nurses employed at a large NHS Trust in England.
The findings show retention as a dynamic and interpretive process occurring over time, rather than a single one-time decision. Job demands, like workload intensity and emotional labour, are widely perceived as normal components of daily work. Access to crucial employment resources, such as career progression, recognition, and leadership support, are frequently perceived as inconsistent and, in some cases, discriminatory, predominantly among Black, Asian, and Minority Ethnic (BAME) and internationally recruited nurses.
A pattern of reluctant retention, in which nurses remain in their positions for reasons of security and necessity whilst becoming psychologically detached is revealed through this research. This study builds on the JD-R model and contributes to ongoing HRM debates on wellbeing, inclusion, and workforce sustainability in public healthcare. It does this by reframing employee retention as a sensemaking process and showing that job resources support retention only when employees perceive them as fair and accessible.