Background: Systems thinking (ST) is an approach to problem-solving that views systems through a holistic perspective, focusing on the interconnections and relationships between various elements. In healthcare, the World Health Organization’s 2009 report marked a paradigm shift toward ST, prompting the development and use of ST tools to address complex challenges. Despite this, limited attention has been given to ST’s application in healthcare human resource management (HRM). This paper aims to provide a scoping review of ST application in healthcare HRM to explore its value in workforce management. Methods: Following Arksey and O’Malley’s framework, a scoping review was conducted to map how ST has been applied in healthcare HRM. Peer-reviewed articles published between 1999 and December 2024 were identified through Scopus and PubMed, using search terms such as systems thinking, human resources, and workforce. Data were extracted using a structured tool, and findings were analyzed through the lens of the system level of application. Results: The review identified 19 studies from 15 countries, with the majority using qualitative or mixed methods approaches across diverse settings. Core applications were applied at the macro, meso, and micro system levels to address workforce challenges, map feedback loops, identify leverage points, and strengthen stakeholder collaboration. ST was commonly applied at regional and national levels and supported improved workforce planning, policy development, and service coordination. Most studies employed soft systems modeling. Conclusions: This review highlights ST’s potential to enhance HRM by recognizing interdependencies across workforce functions. Findings suggest that ST enables more integrated strategies, promotes collaboration, and supports systemic decision-making. The adoption of ST in healthcare HRM may address persistent workforce challenges, though implementation remains limited by reductionist perspectives and unfamiliarity with ST tools.

Background: Healthcare systems face difficulties in retaining nurses due to the demanding nature of the work. Turnover among mid-career nurses is of particular concern, as it diminishes the pool of experienced staff available to provide patient care and mentorship. While retention strategies for early-career nurses are well-documented, less is known about interventions targeting mid-career nurses. Methods: We conducted a scoping review following Arksey and O’Malley's framework, systematically searching PubMed and CINAHL, including grey literature sources, for studies on mid-career nurse retention published between January 2014 and February 2025. Our goal was to map the scope, nature, and focus of the existing research, and to identify key knowledge gaps. Results: Twenty-two studies from 10 countries met the inclusion criteria, with 16 examined interventions tailored for mid-career nurses. Among these, ten focused on retaining nurses within their current roles, while six aimed to reduce attrition from the organization entirely. The interventions were grouped into three thematic areas: optimizing role satisfaction, work culture, and customized retention strategies. While these strategies appear promising, their actual impact on retention remains unclear. Many studies provided limited outcome data, lacked consistent measures at both individual and organizational levels, and rarely addressed potential unintended effects. Moreover, there is no widely accepted definition or clear conceptualization of what constitutes a mid-career nurse. Conclusions: Our findings highlight the lack of focused initiatives to retain mid-career nurses and point to an urgent need for innovation in this space. Future efforts should prioritize the formal evaluation of existing programs to assess their effectiveness.