New Zealand has been facing an alarming shortage amongst the nursing profession whilst having difficulty in attracting and retaining nurses (North et al., 2006; Bedford, 2003). The shortage in this profession has been an ongoing issue not only in New Zealand but worldwide. Investigating the many different reasons for a poor retention record in the New Zealand public health sector, various concerns have been identified. An integrative literature review has been conducted to be able to understand the causes of a poor retention record in New Zealand. This has ensured that multiple different sources have been analysed to gain a broad understanding as to what has been happening over a period of time. By using an integrative literature review as the key research methodology, this has established similarities and differences from different authors and articles. Additionally, it has heled understanding the different patterns that may have caused a poor retention record in New Zealand, such as different extrinsic and intrinsic factors.

Over time, there have been various internal issues evident amongst nursing staff which has been identified through seven different themes in the discussion section of the dissertation. In the past, the main issues were intrinsic issues such as long working hours, shift work, and a lack of recognition and support within the workplace. In contrast, extrinsic issues consisting of low pay and pay parity amongst the nursing workforce appear to play a greater role during the Covid-19 pandemic. Thus, both intrinsic and extrinsic issues play a role towards low retention in the nursing workforce today. Due to the pandemic, low pay and pay parity have become identified as contributing towards poor retention amongst nurses is low pay.

While the overall research question was “Are we able to retain nurses in New Zealand in the public health sector?”, there have also been many different sub-questions. The sub-questions are based around unsuccessful versus successful organisational practices that influence positive or negative retention levels. This includes intrinsic factors and organisational strategies that can contain employee turnover, as well as the major influence of the pandemic and the negative impact it brings along towards a low retention record amongst nurses in the public health sector. The research identified seven retention themes: intrinsic rewards, cost of turnover, recognition of nurses, employer branding, systems approach, pay issues, positive and negative impacts of the Covid-19 pandemic. In particular, recent research highlighted the last theme about the effect of the pandemic and how having higher pay remains a current priority amongst nurses.

When discussing pay-related issues during the Covid-19 pandemic, the included research and comments are nearly based on recent media reports. Due to the pandemic being a recent crisis, there has been limited empirical academic research available so far. On the other side, a vast range of empirical academic research can be found regarding the nursing workforce prior to the pandemic. This range of academic research has allowed a comprehensive overview of issues and trends but has also raised several questions, as explored in the seven retention themes mentioned above. Furthermore, when acknowledging the short-term effects of the pandemic, most reports suggest that Covid-19 has increased negative implications for the nursing workforce. However, this dissertation also opens for an opposing view to this perspective. Amongst the limited media reports available, some have suggested that the pandemic may open for radical, beneficial remedies, especially in terms of pay and pay parity. This comparison between positive and negative effects due to the pandemic can be viewed in the discussion chapter of the dissertation. At the moment, when comparing the overall negative and positive impacts of the pandemic, the dissertation concludes that it is highly evident that the negative impacts outweigh the positive impacts.

Generally, this research project has been an interesting journey investigating issues behind a poor retention record amongst the nursing workforce in New Zealand over time. It has been fascinating learning about various issues that have become embedded in this profession, despite various initiatives to deal with these issues. It highlights how the New Zealand public health sector has struggled to retain nurses over time and how staff shortages amongst the nursing workforce have increased due to the impact of the pandemic.