When feeling “stuck” makes nurses want to quit

What is it about?

Nurses sometimes feel that they have reached a “dead end” in their career, with no real possibility of promotion or advancement. This experience is called a hierarchical career plateau and it can strongly shape how they feel about their job and their future. In this study, we surveyed hospital nurses to examine how their individual and occupational characteristics, together with their perceptions of being stuck in the hierarchy, are related to their intention to leave their job. We used standardized questionnaires to assess nurses’ perceptions of hierarchical career plateau and turnover intention and applied statistical analyses to identify the most influential factors. The results showed that nurses who more strongly felt they were stuck at a certain level in the organizational hierarchy were also more likely to think about quitting. In contrast, some characteristics—such as working in particular types of institutions or having chosen nursing voluntarily—were associated with lower turnover intention. These findings underline the importance of career structures, promotion opportunities, and supportive work environments in retaining nurses.

Featured Image

Why is it important?

High nurse turnover threatens the quality, safety, and continuity of patient care, while also increasing costs for healthcare organizations. Our findings highlight that not only workload or salary, but also how nurses see their future in the organization—whether they feel they can still progress—plays a key role in their decision to stay or leave. By showing that stronger perceptions of hierarchical career plateau are linked to higher turnover intention, this study provides clear evidence that career development opportunities are a powerful retention lever for hospitals. Policies that regularly review promotion pathways, tailor interventions to different types of institutions, and support nurses in choosing and shaping their careers can help reduce turnover intention. Ultimately, improving career prospects for nurses is likely to benefit not only staff well-being, but also patient outcomes and the overall performance of health systems.

Perspectives