The Cost of Caring Exploring How Work Environment, Leadership, and Employer Branding Shape Nurses' Attitudes and Turnover-Related Behavior

Sammanfattning

The nursing profession is progressively portrayed in Swedish media as being in a state of crisis, marked by staff shortages, high turnover, heavy workload, and emotionally demanding working conditions. Simultaneously, nursing is among the most important professional groups within healthcare, where organizational stability and employee retention are fundamental for maintaining patient safety and the quality of care. Therefore, this thesis examines how organizational and internal marketing-related factors influence nurses' attitudes and turnover-related behavior across hospital and primary healthcare settings, as well as why nurses ultimately choose to stay within or leave their workplace or the profession as a whole. Particular attention is given to how organizational structures, workplace relationships, and external portrayals of the profession shape nurses' experiences. Utilizing an exploratory qualitative design, data was gathered through 20 semi-structured interviews with registered nurses across Swedish hospital and primary care settings. The findings indicate that nurses' willingness to stay is strongly connected to whether organizational conditions allow them to provide meaningful and sustainable care. While social support, patient interactions, and high levels of intrinsic motivation function as important resources, the daily work also involves high demands including high workload, understaffing, administrative burden, and dissatisfaction with leadership. This contributes to stress, moral distress, and turnover-related behavior. The study concludes that nurse turnover is primarily driven by weak organizational and managerial conditions instead of a lack of professional commitment, resulting frequently in horizontal mobility rather than a complete withdrawal from the field.