Background Professional, financial and ethical reasons require nursing to gain an increased understanding of student nurse attrition.¹ Attrition has been previously identified as multifactorial.² Further work is required to understand its complexities. Few previous studies have specifically focussed on children’s nursing or been conducted following introducing degree based courses to England.

Aim To explore causes of attrition from pre-registration children’s nursing courses across four London universities

Methods Following University research ethics approval, an exploratory mixed methods study was conducted. To understand attrition rates and yearly variation, three years’ data were obtained from a centrally collated portal. Attrition causes were explored through 1:1 semi-structured interviews with participants who had faced challenges and either ‘left’ or ‘stayed’ on their programme. Interview questions were based on a literature review, previous exit data and expert opinion. Interviews were recorded, transcribed and subjected to thematic analysis.

Results Attrition varied according to University and year. Overall, most attrition occurred in the first year of programmes and was primarily due to academic failure or personal circumstances. Between July and September 2015, 18 (5 ‘left’, 13 ‘stayed’) participants were interviewed. Reasons for actual or potential attrition were connected to academic, placement and/or personal issues. Emerging themes were ‘Expectations of pre-registration children’s nursing’, ‘Realities of a pre-registration children’s nursing course’, ‘Decision to stay or leave course’, ‘Factors that influence students leaving or staying on the course’, and ‘Advice for future nurses’. Many participants were reluctant to disclose issues on the course. Key academic, placement and services were identified however large variations existed in delivery. Support to continue on the programme was often obtained away from universities and students often relied on self-determination.

Conclusions This study has implications for future pre-registration children’s nurse provision. This includes targeted areas of intervention that focus on a student’s first year and reducing variation in provided services. With improved understanding of attrition from children’s nursing courses, targeted interventions can be developed. Through this study it is envisaged that strategies can be introduced and evaluated.

References

1. Urwin S, Stanley R, Jones M, et al. Understanding student nurse attrition: learning from the literature. Nurse education today 2010;30(2):202–07

2. Orton S. Re-thinking attrition in student nurses. Journal of Health and Social Care Improvement 2011;(1): 1–7