Title
Decision Making Process Of Early-Career Nurse Workers in Recruitment and Retention 

Project Management
Jana Bartakova

INS-Team
Valeria Escudero Lopez
Diana Trutschel

Location of Data Selection
German-speaking part of Switzerland

Duration
2025 bis 2027

Description
Background
Nurse shortages are a persistent global challenge. Attrition is particularly high among early-career nurses: approximately one-third of nurses aged 20–24 leave the profession within two years. Their exit results not only in a substantial loss of training investment but also threatens patient care stability and quality. These trends highlight an urgent need for innovative, evidence-based strategies to both attract and retain early-career nurses.

Overall Aim
The EMPOWER project aims to investigate the factors shaping job attraction and retention among early-career nurses in Switzerland. Central to this objective is a knowledge of implicit (revealed) job preferences and trade-offs, enabling a nuanced understanding of how these priorities and trade-offs evolve over the first years of professional practice. 
Primary Aim (Phase A): To develop and pilot a Discrete Choice Experiment (DCE) questionnaire for Licensed Practical Nurses (LPNs) and Registered Nurses with bachelor’s degrees (RNs with BScN) to understand their job preferences and improve retention strategies. 
Secondary Aim (Phase A): To refine the existing DCE questionnaire for early-career RNs, which we initially developed as part of a Master's thesis.

Methods
The study will define a set of job attributes and their levels for LPNs and RNs with BScN using a literature review, clustering of attributes, creation of an impact/uncertainty matrix, and development of a conceptual framework, supported by ongoing workshops with focus groups of early-career LPNs, RNs with BScN and stakeholders/managers. A D-efficient experimental design will be employed to create job scenarios and develop choice sets, using statistical software R version 4.4.1. The final survey will be entered into the survey software REDCap and pilot-tested with final-year LPN and RNs with BScN students from the Basel Health Education Center and Hochschule Luzern to refine attributes and levels. This will be followed by individual student interviews, analysis and refining experimental design. The existing DCE questionnaire for RNs will be enhanced by incorporating priors into the experimental design equation and applying advanced statistical methods used in the LPN/RNs with BScN questionnaire. 

Expected Outcomes
Phase A will produce validated DCE questionnaires for LPNs, RNs with BScN and RNs, providing insights into factors affecting job satisfaction among early-career nurses. Follow-up phases will include data collection using a mixed-method approach with longitudinal DCE as a central methodology (Phase B), and data analysis and synthesis consensus (Phase C).

Conclusion
The findings from the EMPOWER project will inform policymakers and healthcare organizations on improving working conditions, aiming to address the global nursing shortage, enhance patient care quality, and contribute to the sustainability of the nursing workforce.