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Leadership and managerial factors influencing nurse retention: a qualitative study of clinical nurses in Iran
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DOI：10.1186/s12912-026-05234-2.png)
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Abstract
En 中文
The global nursing shortage and the tendency to leave the profession, especially in middle-income countries, are recognized as critical challenges in the healthcare system. Without effective strategies to increase nurse retention, the global nursing shortage will not only persist but is likely to worsen over time. This qualitative study aimed to explain leadership and managerial factors affecting nurse retention as perceived by clinical nurses. A qualitative study using conventional content analysis was conducted. Fifteen clinical nurses were purposively recruited from public and private hospitals in Iran, and sampling continued until theoretical data saturation was achieved. Data were collected through semi-structured interviews and analyzed using Graneheim and Lundman’s conventional content analysis. Data analysis revealed three categories representing leadership and managerial factors that reinforced nurse retention: “Human-Centered Leadership,” “Structuring for Resilience,” and “Value Reflection.” Five categories represented leadership and managerial factors that weakened nurse retention: “Systemic Invisibility,” “Hierarchical Disconnect,” “Context-Blind Policy Imposition,” “Relationship-Based Discrimination,” and “Blaming Culture.” Nurse retention depends not only on adequate staffing but also on leadership practices that foster fairness, professional dignity, and organizational support. For the Iranian healthcare system, strengthening empathetic leadership and eliminating discriminatory and blame-oriented management practices should be a priority for improving nurse retention. These findings provide context-specific evidence to inform leadership development and retention policies in Iran and other resource-constrained healthcare systems.
Keywords:
Nurses
Retention
Leadership
Management
Qualitative research
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