How to Position, Attract and Retain Registered Nurses in Nursing Homes: A Qualitative, Explorative Study

Context: In most countries, registered nurse retention and role development in nursing homes is a challenge. Objective: To obtain insight into factors contributing to successful retention of registered nurses in nursing homes and into how to differentiate the role of vocationally trained registered nurses and baccalaureate-educated registered nurses. Method: A qualitative, descriptive, explorative study. In June 2019, World Cafe was held, a method for hosting group dialogs, in which direct care professionals, managers, human resources employees, and teachers participated. A theme-based content analysis was used to analyze data. Findings: Identified factors expected to contribute to retention were role clarity, role content, role model availability, room for professional development, learning on the job, a match between education and actual work, management and board-level support, adequate salaries, and a positive image of working in nursing homes. Vocationally trained registered nurses were considered to perform a key role resident care by serving as case managers. Baccalaureate-educated registered nurses were considered to focus on indirect care (e.g., coaching staff, stimulating evidence-based practices, implementing innovations). Limitations: Due to the limited sample size and the qualitative, explorative nature of the study, findings can only be generalized with caution. Implications: To refine registered nurse roles in nursing homes, it seems crucial to rethink the current roles and hierarchies. Even though management and human resources departments are considered responsible for contributing to role clarity and the creation of supportive practice environments, the registered nurses themselves are also expected to come up with their role.