Does registered nurse (RN) involvement in improving healthcare services, influence RN retention?

<p dir="ltr">Background: Registered nurse (RN) retention is a priority. Jones, Warren and Davies (2015) propose that RN involvement in improvement increases RN retention. However, published literature highlights an unclear relationship between RN involvement in improvement and RN retention. It is important to clarify any relationship, as the Nursing and Midwifery Council’s (2018) Code includes RN involvement in improvement.</p><p dir="ltr">Method: The aim of this research is to begin to clarify any relationship between RN involvement in improvement and RN retention, using an explanatory sequential mixed methods design. Phase one is a correlational study involving approximately 89,000 RNs across England. Phase two is a case study involving seven RNs from an Acute NHS Trust (NHST). The results from both phases are integrated.</p><p dir="ltr">Results: Phase one describes a statistically significant positive correlation between RNs making suggestions / making improvements happen and RN retention, in Mental Health NHSTs. In Acute NHSTs, a statistically significant negative correlation is identified between RNs making improvements happen and RN retention.</p><p dir="ltr">Phase two highlights that RN involvement in improvement can be rewarding and difficult in an Acute NHST. RN retention intention within an Acute NHST, the NHS and the nursing profession may also be associated with involvement in improvement.</p><p dir="ltr">Integrated findings suggest that the relationship between RN involvement in improvement and RN retention in Acute NHSTs may be complex, involving a combination of positive and negative relationships. This combination could contribute to an overall negative relationship between RNs making improvements happen and RN retention in Acute NHSTs.</p><p dir="ltr">Impact: Understanding my findings is facilitated by Friedson (2001). RN involvement in improvement may connect professionalism, bureaucracy and market (patient need). However, tension may exist between the three, which contributes to overall reduced RN retention in Acute NHSTs. This research has potential implications for national bodies, local Acute services, RNs and for me.</p>