Aim: To examine the direct and indirect predictors of thriving at work and its impact on intention to leave the organisation or profession among early career nurses. Design: A repeated cross‐sectional design. Methods: A sub‐study of early career nurses as part of an Australian longitudinal follow up study, commenced in 2018, was conducted. The sub‐study asked early career nurses between their second and sixth year after graduating to complete a structured online questionnaire assessing thriving at work and several predictor variables. Data were analysed using Pearson's correlation, multiple linear regression, and path analysis. Results: Among the 67 participants (response rate of 42.9%), thriving at work was positively correlated with occupational hardiness, social support from colleagues, and wellbeing, while negatively correlated with compassion fatigue. Thriving at work and perceived organisational support were the significant predictors of intention to leave the organisation, while perceived organisational support was the only significant predictor of intention to leave the profession. Conclusion: The importance of strong collegial relationships, compassion fatigue, and improving wellbeing to enhance thriving at work are highlighted. Fostering an environment where employees can thrive is crucial to reduce the intentions to leave an organisation. Relationships with the managers and quality of care provision also play a crucial role in reducing turnover and leave intentions. Perceived organisational support enhances employee wellbeing, thereby reducing turnover intentions. Future strategies should focus on comprehensive support systems to retain nurses in their organisation and the profession. Implications for the Profession: Enhancing thriving at work and perceived organisational support can reduce early career nurses' intention to leave their organisation. However, job stressors and interpersonal conflicts also influence professional leave decisions. Reporting Method: This study has adhered to the STROBE guidelines. Patient or Public Contribution: No Patient or Public Contribution.

This study aimed to explore what changes rural placement had on the perceptions of nursing students and the impact of placement frequency and duration on student considerations for rural practice. A strong rural healthcare workforce is a global concern and has led countries to look for creative ways to address this challenge. One approach is to train more health professionals, however, nursing students who grew up or lived in metropolitan or urbanised areas are suggested to be less inclined to pursue a rural career. As such it is posited that recurrent exposure to rural settings may exert a positive impact on future intention for rural practice. However, there is a need to explore the specific thresholds related to both the frequency and duration of rural placement exposure, as well as the cumulative impact multiple rural placements may have on the intention to engage in rural practice. A repeated cross-sectional design. All nursing students from an Australian regional university were invited to complete an online questionnaire between 2019 and 2023. Demographic and placement specific questions were included. A modified version of the Nursing Community Apgar tool also measured the importance of key variables in rural career decision-making. Data were analysed using independent sample t-tests and one-way ANOVAs. Significance was determined at two-tailed p≤.05. Among the 835 respondents (response rate 15.4%), the average number and duration of rural placements was 2.45 placements and 3.01 weeks respectively. Rural placements did not have an impact on students who resided rurally or regionally. However, among metropolitan students who had experienced more than three rural placements, or more than sixteen cumulative weeks of placement, were significantly more likely to consider rural employment. Greater number of rural placements and longer cumulative duration had the greatest impact. Issues related to the nursing rural workforce are dynamic and complex. Understanding the unique drivers that improve the rural experiences among students, particularly metropolitan students, can have an impact on decision-making to pursue employment in rural environments. Importantly, whilst professional and clinical motivation and experiences are influential factors, the socialisation, environment and community features are essential elements that influence students' decisions to pursue a career in rural practice. Undertaking a nuanced approach that facilitates rural practice understanding among students may help shape future employment decision-making.

Background: Healthcare is a dynamic environment for nurses, with early career nurses (ECNs) needing to adapt and learn while also meeting care demands. Effective support systems, mentorship, and continuous professional development are vital in facilitating their transition while navigating competing demands. The aim of this study is to interpret and understand the meaning of ECNs’ professional experiences four years after completing their bachelor’s degree in Australia. Method: A qualitative descriptive design using a hermeneutic phenomenological approach was used as part of a longitudinal study. Follow-up semi-structured interviews were conducted among twenty-five ECNs between 2022 and 2024 using purposive sampling to recruit ECNs who had graduated four years ago. Thematic analysis was used to analyse data while adhering to the consolidated criteria for reporting qualitative research (COREQ) guidelines. Results: Four themes emerged among participants, which encompassed professional growth and unwavering commitment, ongoing professional adaptability, feeling stuck with limited choices, and continual learning amid career challenges and personal life demands. Conclusions: Change is needed to ensure professional learning becomes a shared responsibility among policy makers and healthcare leaders and to ensure that professional learning leads to more nurses taking up further study, thus increasing the safety and quality of care delivered in the healthcare environment.

Healthcare workers (HCWs) play a crucial role in the delivery of much-needed healthcare services globally. Outside major metropolitan centres (i.e., non-metropolitan areas including regional, rural, remote, and very remote), recruiting and retaining HCWs continues to be a challenge. Rural Australia already faces significant healthcare challenges and inequities. Stabilizing the healthcare workforce in these underserved areas is a national priority. This study aimed to examine median retention timeframes across medicine, nursing, midwifery, and allied health professions in the public health sector in rural southern Queensland (Australia). Further, it also aimed to understand the demographic, employment, and geographical variables that influence retention of the rural healthcare workforce. A 12-year administrative dataset from two public health services, servicing rural Queensland in Australia were examined. De-identified data were analyzed through descriptive statistical tests, survival analyses, and Andersen-Gill Cox proportional hazards regression. Data from 6651 records linked to 5527 employees were included in the analysis. Sampled employees were predominately female (70.4%), employed permanently (86.3%), in a clinical role (97.6%), and in the public hospital sector (87.5%). The overall median survival time (i.e., time employed in one location) was 1.46 years [95% CI, 1.35–1.52 years], with 41% of employees remaining in employment in location after two years. Compared to those in nursing and midwifery, those employed in medical (HR: 1.91, 95% CI: 1.75–2.09) and allied health (HR: 1.38, 95% CI: 1.26–1.51) streams were at greater risk of leaving location. This effect was relatively small, though, compared to: (a) geographic location of employment, where, compared to those working in the regional city, there was greater risk of leaving location if working in rural (HR: 1.79, 95% CI: 1.66–1.94) or remote communities (HR: 2.64, 95% CI: 2.40–2.91); and (b) employment type, where compared to being employed in permanent part-time roles, there was greater risk of leaving location if employed in casual (HR: 1.76, 95% CI: 1.56–1.99), full-time (HR: 1.65, 95% CI: 1.51–1.79) or temporary roles (HR: 2.13, 95% CI: 1.78–2.55). Understanding retention patterns of the healthcare workforce is crucial to developing and implementing supportive interventions to enhance HCW retention in rural areas. Our findings show that the overall retention rate in this population is comparable to international evidence and may be slightly better than some previously reported rates from other Australian studies. Our findings suggest that profession, employment type, sector type, age, and geographical remoteness influenced employee retention. Further research is needed to fully explore and understand the reasons for HCWs leaving their roles and supportive measures that enable reasonable HCW retention rates.

The main objective of this umbrella review is to synthesise available evidence from systematic reviews on the effectiveness of interventions for the management of occlusions in central venous access devices. CVADS have been extensively utilised among the critically ill since the 1950s however have also been linked to an increase in catheter complications. CVAD occlusion can occur in 14%–36% of patients within 1–2 years of catheter placement and is a longstanding complication. Umbrella methodology was applied to review five healthcare databases. Databases were searched for publications from 2009 and 2022 and electronic keywords searches were conducted. The authors searched for reviews that reported on any intervention to prevent, maintain or manage patency of the central venous access devices within an acute care setting. Of the 278 articles identified from the initial search a total of 11 articles were identified. This umbrella review concluded that education enhances patient outcomes and decreases occlusion rates. Further studies are required to explore occlusion reduction strategies in relation to flushing and locking.

To explore the lived experience of Early Career Nurses four years post-graduation and identify factors influencing their decision to stay in or leave the profession. The retention of Early Career Nurses is a critical issue globally, with many leaving the profession within the first few years. Various interventions have been implemented to support Early Career Nurses, but the complexities of retention require a more nuanced understanding, particularly for those in the latter stages of their transition. A qualitative descriptive study. Early Career Nurses who participated in a longitudinal study as undergraduate nursing students were interviewed 48 months after graduation. The study used phenomenological approach to explore key experiences and phenomena. Data were analysed using Thematic Analysis, adhering to COREQ guidelines. Among the 25 participants, key themes identified included being 'Overworked and undervalued' and being 'Anchored by care.' Early Career Nurses experienced significant pressures, including incivility, poor management and staffing shortages, leading to a desire to leave the profession. However, a strong commitment to patient care and support from peers and family helped some Early Career Nurses remain in the profession. The study highlights the need for systemic changes to support Early Career Nurses, including empathetic leadership, adequate training and supportive work environments. Addressing these issues is essential for the wellbeing of Early Career Nurses and maintaining high standards of patient care. Understanding the unique challenges faced by Early Career Nurses can inform strategies to improve retention and support their professional development.