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How could we improve nurse retention?


When clinical lead, Shelley Pringle retired from the district nursing service, taking her extensive skills with her, she questioned whether there is more that could be done to retain long-standing expertise and experience

I began my nursing career in the early 1980s, working across acute and community services for nearly 40 years. I loved learning and teaching, and my path took me to nursing education, working as a practice educator for community nursing, and supporting all types of learners in community nursing. I was passionate and endeavoured to facilitate others in their own development. But I planned to take early retirement, as I began my career at the age of 17 and had not taken any opportunities for career breaks, for travel or other adventures.

Then of course, in 2020, the Covid pandemic took hold. This had a huge impact on the NHS. In my area, this also coincided with a reconfiguration of the district nursing services, which resulted in my role as practice educator being decommissioned.

Maybe it was in response to the changes in NMC standards and learning in practice (NMC, 2019) that facilitated the changes for community nursing within our area. New roles were commissioned, and experienced nurses were put into lead roles without training or support.

Concerns were raised with heads of nursing that the introduction of new leadership roles to inexperienced nurses, without sufficient support and training, would lead to an overwhelmed workforce. Poor communication and lack of transformational leadership and management did result in both experienced and newly qualified nurses leaving in droves.

Change is always difficult within any organisation (see Lewin’s change theory, 1947), though I was an nurse experienced in teaching, managing and leadership. This new role as a clinical lead was a new role introduced into the community teams with different skill needed. I tried to adapt and learn new skills and support others along the way in the changes in our service. This was one of the most difficult and challenging times of my career, as we were all struggling with the changes in roles alongside the day-to-day workload pressures.

We felt that lack of both support and communication was the biggest issue at this time. If structures and support had been put in place to support this change, it may have led to more retention of nurses.

After 18 months, I decided to offer my resignation and retire, alongside my colleague, who had been through the same career restructuring as myself.

So, after nearly 40 years, we both left without any recognition for our dedicated services or discussion around adaption to our roles. There was no attempt of retention from our employer.

I personally felt let down and bereft after my last shift. We were not recognised at all or received any ‘goodbyes’ from across the extensive localities and staff we had supported. There was not even a thank you from any of our leaders.

How can we expect nurses to remain within the NHS if they see the lack of recognition from those who lead us? Our frontline staff are already feeling undervalued due to the pressures on the health service, as well as the anger, and, often valid, comments from patients and carers who have to wait so long to see a professional.

It’s a heart-breaking situation. Surely, we need to value and recognise those with experience if we aim to attract others into the profession?

What is the solution? An increase in salaries would most certainly be beneficial, especially in light of the current climate we live in and the increased cost of living.

But in my view, we also need to value the nurses we have and all the experience they have accrued through years of study and practical experience in the field. Managers and leaders should really listen to the staff about improvements to our services, not just pay lip service to proposed suggestions and make their own changes anyway.

Why do they let experienced nurses walk away? Is it down to the inexperience of those in leadership positions who fail to value and recognise the unique skills of the nurses within their specialities?

I am now in another position where I can use my skills in palliative care, and I do feel valued and supported.

I just hope and pray that there is enough insight within the NHS for change to happen in the right way, for the right reasons, to meet the complex needs and situations that the UK now finds itself in.