title: Developing expert clinical nurses: grow them, hold them and let them walk away.
abstract: OBJECTIVE
  The aim of the present study was to describe three case studies that exemplify decision making by a nursing leader related to retention of expert clinical nurses in the Emergency Department.
  
  
  BACKGROUND
  Further understanding of decision-making processes that help nursing leaders to retain (or let go of) expert clinical nurses is needed so that sufficient numbers of expert nurses are available in the workforce to provide high-quality and safe patient care.
  
  
  RESULTS
  Decision processes related to retention of expert clinical nurses are exemplified in three case studies.
  
  
  RESULTS
  Orienting nurses to specialty areas is costly and retention of nurses is an important international issue.
  
  
  CONCLUSIONS
  Expert clinical nurses across the skill continuum need guidance from nursing leaders related to their work behaviours and best choice for employment.
  
  
  CONCLUSIONS
  Nursing leaders who are well acquainted with the skills and motivations of their employees are in the best position to promote the health of individual nurses and of specialty nursing units.
authors.affiliation: Emergency/Trauma Services Associate Chief of Nursing-Research, University of Louisville Hospital, University of Louisville, Louisville, KY, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Spivak
authors.forename: Anna
authors.initials: A
authors.lastname: Smith
authors.forename: M Cynthia
authors.initials: MC
authors.lastname: Logsdon
mesh_terms: D001291:Attitude of Health Personnel; D002322:Career Mobility; D002983:Clinical Competence; D003142:Communication; D003659:Decision Making, Organizational; D004509:Education, Nursing, Continuing / Q000458:organization & administration; D016529:Emergency Nursing / Q000193:education / Q000458:organization & administration; D006801:Humans; D007400:Interprofessional Relations; D007857:Leadership; D016294:Models, Nursing; D017008:Negotiating / Q000379:methods / Q000523:psychology; D009718:Nurse Administrators / Q000458:organization & administration / Q000523:psychology; D024802:Nurse's Role / Q000523:psychology; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology; D009745:Nursing, Supervisory; D010560:Personnel Selection / Q000458:organization & administration*; D010563:Personnel Turnover; D012944:Social Support; D013192:Staff Development / Q000458:organization & administration*