This study, published in the European Journal of Public Health, concludes that career opportunities significantly influence the decision to remain in the National Health Service (SNS) more than salary does.
“Retention does not depend solely on salary but rather on how they work and how they see their future within the institution,” states Tiago Correia, co-author of the study, in a press release.
About 1,500 nurses working in the SNS, either in primary care (health centers) or hospitals, were surveyed for this study.
The findings also reveal that almost one in three professionals with fixed schedules express a greater intention to stay in the SNS compared to those working in rotating shifts.
The results highlight the importance of implementing integrated retention strategies that combine “organizational improvements, career progression plans, and work-life balance policies.”
The researchers from the Institute of Hygiene and Tropical Medicine emphasize that the results differ from those observed among doctors in parallel studies, confirming the need for profession-specific retention strategies.
“Retention is now one of the biggest determinants of the sustainability of health systems,” notes the coordinator of the WHO Collaborating Centre for Health Workforce Policy and Planning and professor at IHMT.
The authors also stress the importance of considering the perspectives of nurses who have already left the SNS—who were not part of this study—highlighting that this measure is vital to “capture the full range of motivations, barriers, and experiences that influence retention decisions.”
Based on their findings, researchers Mónica Morgado, André Beja, Rita Morais, and Tiago Correia suggest extending the adoption of predictable work schedule models, particularly in hospital settings, to mitigate the negative impact of rotating shifts on nurse retention.
They also advocate for the establishment of “structured and transparent career progression paths” to enhance professional recognition and retain younger nurses, and the implementation of retention strategies in national health human resource planning cycles, ensuring they are part of “broader sustainability efforts” rather than isolated interventions.
This research comes at a time when Portugal faces an aging workforce in the health sector, with strong competition from the private sector and the international labor market, factors that complicate the stability of SNS teams.
Data from the Ordem dos Enfermeiros indicated that in July and August of this year, the organization awarded 3,000 titles to newly-graduated nurses, and 50% requested certification to emigrate.
As of December 2023, Ministry of Health data showed a shortfall of 14,000 nurses in the SNS.
OECD figures released in November indicate that Portugal is among the countries that “export” the most nurses.
In 2020, there were 15,418 Portuguese nurses working in OECD countries, a 568% increase from 2000 (when there were just 2,310).
The OECD report published in November notes that the healthcare workforce shortage has become a critical challenge in member countries, driven by an aging population, increased care needs, and growing demand for medical services.
