Investigating the dynamics of nurse migration in early career: A longitudinal questionnaire survey of variation in regional retention of diploma qualifiers in England

Abstract

Background Increasing mobility of healthcare professionals has led to concerns that certain countries or regions are depleted of sufficient staff to meet healthcare needs. In formulating appropriate strategies to ensure better retention locally, human resource managers are hindered by lack of information about migration patterns. Purpose and aims Purposes included studying movement of diploma nurses qualifying in England and contributing to literature on developing methods for obtaining migration data. Specific aims ascertained: regional variation in retention of locally trained nurses; associations between nurses’ profile and retention in training region; and impact on each region of inter-regional movement of nurses. Method Questionnaires sent to a nationally representative cohort of adult branch nurses at qualification ( n=1596) and at subsequent intervals thereafter provided data on all employment and other activities and geographical location of each. Event histories constructed from chart data were used to analyse length of retention in region of training and movements between regions. Retention was operationalised through developing the construct ‘engagement with nursing’. Results Older entrants and those with children were more likely to nurse in their training region than younger and childless counterparts. Regions differed in retention of locally trained nurses and in the impact on their diplomate workforce of inter-regional movement. Regional variations were insufficiently explained by differences in nurses’ profiles; hence influences of regional characteristics were also considered. Conclusion Retention strategies should include maintaining the policy of recruiting greater diversity of entrants, particularly mature entrants and those who have children. In developing local strategies, each region needs: information about retention of different components of their workforce; and an understanding of how regional characteristics can facilitate or constrain retention. National and international workforce organisations need to plan how best to obtain accurate and comparable nurse migration data.