Dynamics of persistence, withdrawal, and dropout intentions in the initial phase of nursing training: a qualitative longitudinal study

Taking the perspective of career choice as a lifelong, iterative, constructive, and agentic process, the present study focuses on the development of vocational aspirations of nursing trainees; that is, thoughts about a long-term perspective in nursing (i.e., persistence), ideas of finishing the training but changing into another profession after some time (i.e., withdrawal), and decisions to terminate the training before completing the programme through a final examination (i.e., dropout). In order to generate detailed insights about the dynamics behind the development of such aspirations during the initial training phase, a qualitative, longitudinal, within-subject study design based on grounded theory was employed. The results mainly show that social interactions with more experienced nurses, practical work experiences, encounters with environments that are either conducive to learning or not, the satisfaction of different needs (e.g., autonomy, competence, belonging, sense of meaningfulness), as well as the associated feelings of well-being affect how vocational aspirations develop over the first year of training. In addition, the study identifies four different patterns of how trainees typically oscillate between thoughts of staying in nursing and leaving the profession in the short or long run: (a) arriving and wanting to stay, (b) staying as a transitional passage, (c) seeking to stay, and (d) exiting as a knee-jerk reaction. The patterns present evidence of a variety of approaches regarding how trainees deal with certain experiences during their training and how the combination of experiences might affect young professionals’ subsequent career choices.