Background
A global nursing shortage is impacting countries worldwide, leading to competition across and within healthcare systems. In the Kingdom of Saudi Arabia (KSA), nurse turnover is a major challenge, with an estimated rate of 20%, significantly higher than in the United Kingdom, United States, and Australia. KSA is undergoing a significant transformation under Vision 2030, and nurse retention plays a central role in these efforts. Like other hospitals in KSA, King Fahad Armed Forces Hospital (KFAFH) faces shortages due to high turnover. The aim of this research was to investigate the factors contributing to nurse turnover intention and develop evidence-based retention strategies for the nursing workforce within KSA healthcare settings.
Methods
A multiple methods research design was employed. First, a Qualitative Evidence Synthesis (QES) was conducted to identify research gaps and inform research design. Then semi-structured interviews were conducted with thirteen staff nurses and six nurse leaders at KFAFH. Thematic analysis was conducted at both stages of the research. Findings were interpreted through comparison with current models to assess theoretical fit. Finally, a novel model was constructed and evaluated, and recommendations for potential interventions were developed.
Findings
Three main themes arose from the analysis: Institutional, Leadership, and Personal Factors, with 14 subthemes. Saudi and non-Saudi nurses differed across Diversity Issues, Families, Workload, Lifestyle, and Opportunities. Leaders and staff differed only in relation to Leadership Positions. A novel nurse turnover intention model was developed, emphasising hierarchical and interconnected relationships among Institutional, Leadership, and Personal Factors.
Recommendations
Recommendations include affording special status under Vision 2030 for non-Saudis and their families with rights to housing, education, and business opportunities. Separate Continuing Professional Development (CPD) pathways for Saudi and non-Saudi nurses are also recommended. These recommendations are expected to address turnover intention among staff and leadership in the nursing workforce and thereby improve retention.
