How local, first-line nurse leaders can positively influence nurse intent to stay and retention: A realist review.

AIMS AND OBJECTIVES: To explore evidence on how local nurse leaders can positively influence nurse retention. BACKGROUND: Nurse turnover and retention is a wicked problem with multiple interrelated factors and no one solution. Local nurse leadership has the potential to positively influence nurse intent to stay directly or via various factors. DESIGN: A realist review. METHODS: Having designed a search strategy based on a tentive programme theory, 1386 initial hits in three databases were screened and reduced to 48 research articles published between 2010-2021. The articles' content were coded for findings that supported, refined or contradicted four ContextMechanismOutcome configurations. RESULTS: Sufficient evidence was found to support four guiding lights encouraging local nurse leaders to: (1) foster relational connectedness; (2) enable professional practice autonomy; (3) cultivate healthful workplace cultures; (4) support professional growth and development. Mutuality and reciprocity is also key if leaders themselves are to experience wellbeing and growth. CONCLUSIONS: Person-centred, transformational and resonant local nurse leaders can positively influence nurse intent to stay within the workplace or organisation. REPORTING METHOD: Conform JCN guideline 'What to cover in the main tekst by article type' for reviews. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.