title: Understanding student nurse attrition: learning from the literature.
abstract: Student attrition in nursing causes concern, but is not a new phenomenon. Challenges in defining and understanding attrition, changes in the commissioning of nurse education and developments within the United Kingdom National Health Service (UKNHS) and the profession contribute more generally to making this a complex topic for managers and for research. In this paper we discuss findings from an integrative review of the UK literature and discuss three levels of possible contributory factors identified from the literature (micro/individual; meso/institutional; and macro/political and professional). In conclusion, we argue that a concern with attrition is legitimate and that strategies should be put in place to respond to each level of contributory factors. Factors contributing to attrition are complex and interact. We argue that some degree of attrition is inevitable if we are to maintain standards within the profession. There is, therefore, an ethical and professional imperative for attrition in some circumstances. We suggest that Tinto's model relating to social integration might inform further research.
authors.affiliation: Faculty of Health and Social Care Sciences, Kingston University and St. George's University of London, Kingston Hill, Kingston upon Thames KT2 7LB, United Kingdom.
authors.forename: Sharon
authors.initials: S
authors.lastname: Urwin
authors.forename: Robert
authors.initials: R
authors.lastname: Stanley
authors.forename: Malcolm
authors.initials: M
authors.lastname: Jones
authors.forename: Ann
authors.initials: A
authors.lastname: Gallagher
authors.forename: Paul
authors.initials: P
authors.lastname: Wainwright
authors.forename: Andrew
authors.initials: A
authors.lastname: Perkins
mesh_terms: D000223:Adaptation, Psychological; D002321:Career Choice; D003657:Decision Making; D004506:Education, Nursing; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007398:Interpersonal Relations; D007858:Learning; D017145:Models, Educational; D010563:Personnel Turnover; D013338:Students, Nursing