THE “PUSH” AND “PULL” FACTORS FOR NURSES WORKING IN A COMMUNITY PALLIATIVE CARE SETTING: A QUALITATIVE STUDY

Abstract

Background: Majority of Singaporeans prefer to be cared for at home in the end stages of illness and supported by their family. With Singapore’s ageing population, the demand for palliative care at home will continue to rise. In view of global and local shortage of nurses, it is vital that research looks into ways to retain nurses, especially so in home palliative care. Therefore, it is imperative that we explore factors that push the nurses to leave and pull the nurses to stay in home palliative nursing. Aim: To explore the push and pull factors that affect home palliative nurses to stay or leave. Design: A descriptive qualitative study was adopted. Methods: A purposive sample of 12 home palliative care nurses at a registered charity in Singapore was invited to be interviewed face-to-face, using a semi-structured interview guide. The audiotaped interview data were transcribed verbatim and thematic analysis was performed to identify significant themes and sub-themes. Results: Participants have reported different push and pull factors that affect their intention to stay or leave home palliative nursing. For every push factors discussed, they have also suggested ways to overcome them. The six themes emerged from the nurses’ narratives are: (1) the essence of work, (2) the atmosphere of workplace, (3) pillars of strength, (4) a balancing act, (5) harmony of self and job, and (6) state of health. Conclusion: Findings from this study highlight that home palliative service providers should strengthen the nurses’ coping skills while improving the working environment as coping mechanisms build resilience and increase commitment which are instrumental in managing the demands of home palliative nursing.