Motivations to Enter and Remain in Community Nursing: Implications for Workforce Sustainability.

چکیده اصلی

AIM: To explore what motivates nurses to enter and remain in community nursing within Austria's national pilot project and to examine how autonomy, competence and relatedness shape their professional experiences and retention intentions. BACKGROUND: Community nursing has been introduced in Austria as an innovative, preventive, community-based model of care. As nursing systems face growing workforce shortages, understanding why nurses choose to transition into and remain in new nursing roles is critical for workforce sustainability and effective service implementation. METHODS: A qualitative study guided by self-determination theory was conducted. Semistructured interviews were carried out with 15 community nurses working in Austria's community nursing pilot project. Data were analysed using qualitative content analysis, combining inductive coding with a theory-informed analytical framework. RESULTS: Nurses reported high levels of motivation when their needs for autonomy, competence and relatedness were met. Autonomy was supported through flexible scheduling, independent decision-making and opportunities to shape emerging service structures. Competence was strengthened through direct client contact, diverse responsibilities, interprofessional collaboration and professional development. Relatedness emerged from strong connections with local communities, professional networks and interdisciplinary partners. While intrinsic motivation was driven by meaningful work and contribution to preventive care, extrinsic motivation was strongly influenced by dissatisfaction with previous working conditions. CONCLUSIONS: Community nursing offers an attractive alternative career pathway for nurses by providing working conditions that support psychological needs and professional fulfilment. However, the discontinuation of the pilot project threatens the long-term sustainability of this role. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers and policymakers should prioritize work environments that support autonomy, competence and relatedness to enhance nurse retention. Integrating community nursing into long-term workforce and primary care strategies may strengthen workforce stability and support sustainable, community-based care delivery.

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