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Exploring Nurse Retention: Class and Culture Intersection

October 9, 2025
in Medicine
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In recent years, the healthcare sector has faced significant challenges regarding the retention of nursing staff, particularly within the context of general practice. This pressing issue has prompted numerous studies aimed at understanding the multifaceted factors influencing nurse retention, a critical component that directly impacts patient care and healthcare delivery. The qualitative interview study conducted by researchers Anderson, Brady, and Adamson has become a landmark investigation into the intricate interplay of cultural and structural issues that shape the experiences of nurses within this system.

The researchers embarked on their study against a backdrop of rising nurse turnover rates, which have placed immense strain on healthcare facilities. With an increasing demand for healthcare services, particularly in the wake of the COVID-19 pandemic, the importance of retaining skilled nurses has never been more apparent. Their study delves into the experiences of nurses, drawing attention to the intersections of their cultural identities and the societal structures that govern their working lives.

What sets this study apart is its nuanced exploration of identity. By conducting in-depth qualitative interviews, the researchers sought to uncover how factors such as class, ethnicity, and professional culture inform the experiences of nurses in general practice. This approach illuminates the complexity surrounding retention issues in nursing, revealing that feelings of belonging, recognition, and respect play critical roles in the decision-making processes of these medical professionals.

The findings of Anderson, Brady, and Adamson suggest that many nurses operate at the intersection of multiple social identities. Some described themselves as “a bit middle class, a bit working class, a bit white and a bit Caribbean.” This layered understanding of identity highlights the diversity within nursing and underscores the challenges that arise when societal perceptions clash with professional expectations. It becomes evident that these identities are not merely personal characteristics; instead, they shape experiences and influence workplace dynamics.

Additionally, the study reveals a formidable barrier that many nurses encounter: the lack of institutional support, which exacerbates feelings of alienation and disconnection. Nurses expressed frustration over inadequate resources and emotional support from management, elements that are essential for fostering a healthy work environment. The researchers emphasize that without strategic interventions aimed at improving institutional frameworks, the capacity to retain nursing staff will remain precarious.

Moreover, structural issues within the healthcare system often contribute to the dissatisfaction that leads to high turnover rates. Nurses frequently reported experiences of burnout, stemming from overwhelming workloads and insufficient staffing levels. The study notes that such structural factors not only diminish job satisfaction but also have broader implications for patient care. The ripple effect of nurse retention impacts the entire healthcare ecosystem, ultimately jeopardizing patient safety and health outcomes.

As the study unpacks these challenges, it becomes clear that intersectionality plays a critical role in understanding retention. The personal and professional struggles faced by nurses cannot be disentangled from the broader socio-economic and cultural policies that govern healthcare practice. This insight calls for a re-evaluation of the approaches taken to support nurses within their working environments, acknowledging that effective strategies must accommodate the diverse identities nurses inherently possess.

Furthermore, the qualitative nature of this research allows for a rich exploration of the emotional landscape of nursing work. Participants recounted anecdotes that painted a vivid picture of their lives, underscoring moments of pride, frustration, and, at times, despair. Such narratives bring to life the human element of nursing, which is often lost in quantitative studies that focus solely on metrics and numbers.

The implications of this study extend beyond the immediate context of general practice. They challenge policymakers and healthcare leaders to recognize the pressing need for culturally competent and responsive workplace initiatives. As healthcare becomes increasingly diverse, tailored strategies that honor the unique backgrounds and experiences of nurses are paramount. Importantly, the voices of the nurses themselves should guide the development of these strategies, ensuring they are relevant and effective.

In a broader context, the research emphasizes that the retention of healthcare professionals is not merely an organizational issue but a societal concern. As communities grapple with healthcare disparities, the stability of the nursing workforce is crucial for delivering equitable care. The study underscores the necessity of cultivating inclusive environments where nurses can thrive, bridging the gap between professional fulfillment and personal identity.

In conclusion, the study by Anderson, Brady, and Adamson does not just shed light on the complexities of nurse retention in general practice; it also serves as a clarion call for the healthcare industry to address the cultural and structural factors that destabilize the nursing workforce. To move forward, the integration of diverse perspectives in shaping healthcare policies will be essential in fortifying the systems that support nurses. The findings serve as both a warning and an opportunity for transformation—an invitation to rethink how healthcare can be restructured for the benefit of both providers and patients alike.

Subject of Research: Retention of nurses in general practice and the intersection of professional and societal level cultural and structural issues.

Article Title: “I’m a bit middle class, a bit working class, a bit white and a bit Caribbean” – the retention of nurses in general practice and the intersection of professional and societal level cultural and structural issues: a qualitative interview study.

Article References: Anderson, H., Brady, L. & Adamson, J. “I’m a bit middle class, a bit working class, a bit white and a bit Caribbean” – the retention of nurses in general practice and the intersection of professional and societal level cultural and structural issues: a qualitative interview study. BMC Health Serv Res 25, 1339 (2025). https://doi.org/10.1186/s12913-025-13420-2

Image Credits: AI Generated

DOI: 10.1186/s12913-025-13420-2

Keywords: nurse retention, structual issues, cultural identity, qualitative study, healthcare workforce, intersectionality, professional fulfillment, healthcare disparities.

Tags: cultural identity in nursingeffects of COVID-19 on nursingexperiences of nurses in general practicehealthcare delivery and patient carehealthcare workforce challengesimpact of class on nursing experiencesintersectionality in nursingnurse retention strategiesnurse turnover ratesnursing professionalism and culturequalitative research in healthcaresocietal structures in healthcare
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