Nursing Research  July/August 2012  Vol 61, No 4, 300–308 Effective Retention Strategies for Midcareer Critical Care Nurses A Q-Method Study Vanessa M. Lobo 4 Anita Fisher 4 Andrea Baumann 4 Noori Akhtar-Danesh b Background: Midcareer nurses continue to be overlooked in the current nursing shortage that is amplified in intensive care units (ICUs) requiring greater numbers of specialized nurses. b Objectives: The aim of this study was to discover what mid- career critical care nurses perceive would be effective re- tention strategies. b Methods: As a combination of both qualitative and quantita- tive approaches, Q methodology was used to allow for the development of innovative strategies as well as to provide an understanding of a population of viewpoints and pref- erences that can guide retention efforts. Forty ICU nurses between the ages of 25 and 44 years from within a Canadian academic health science corporation completed a 45-item Q sort representing their ideas for increasing staff retention. Data were analyzed using centroid factor extraction and varimax rotation in PQMethod version 2.11. b Results: Four viewpoints emerged: The Healthy Workplace and Respect Seeker, The Flexibility and Reward Seeker, The Professional Development and Teamwork Seeker, and The Lifestyle Seeker. Correlations between the factors were appropriately weak, with seemingly distinct demographics characterizing each. b Discussion: These findings suggest a possible association between perceptions and both years of nursing experience as well as age. Implications from the study include the need to involve frontline nurses in developing strategies that will retain them. Following further investigation of the nurses’ preferred strategies, it may be necessary for organizations to develop an array of retention strategies rather than im- plementing a single solution. In future research, generational preferences and the possible dissonance between nurse man- agers and frontline nurses’ perceptions should be explored. b Key Words: critical care & midcareer & Q methodology & retention & turnover N urses are essential to the delivery of healthcare in any nation. In Canada, they make up over one third of all healthcare professionals in the country (Advisory Committee on Health Human Resources, 2002). Despite their pivotal role at all levels in the healthcare system, the Canadian Nurses Association is predicting a shortfall of 60,000 nurses by 2022 (Canadian Nurses Association, 2009). This shortage is exacerbated in intensive care units (ICUs) where elevated nurseYpatient ratios and the use of advanced technologies require greater numbers of highly educated, specialized nurses (Fisher, Baumann, Hunsberger, Blythe, & Fitzpatrick, 2008). Under the pressure of tightening budgets, an aging workforce, and the imminent exodus of the baby boomer generation, retention of these nurses is paramount (Canadian Institute for Health Information, 2004). Nurse re- tention is particularly important as the contemporary cohort of midcareer nurses (ages 25Y44 years) in Ontario are con- fronted with newly graduated and retiring nurses benefitting from current government initiatives. Nurses in this intermedi- ate cohort have ‘‘the professional memory that employers count on, the expertise that patientsIrequire, and theIwisdom that new nurses depend on for coaching, mentoring and support’’ (Donner & Wheeler, 2001, p. 27). This career stage tends to be characterized by attempts to stabilize, increase productivity, and prepare for advancement (Blythe et al., 2008; Jepsen & Dickson, 2003). Consequently, concerted efforts may be neces- sary to retain the current critical care nursing workforce with increased focus on the midcareer critical care nurse. The pur- pose of this study was to identify the viewpoints of midcareer critical care nurses regarding effective retention strategies. Background Critical care units are reporting frontline personnel shortages and high rates of nursing staff turnover- up to 26% (Strachota, Normandin, O’Brien, Clary, & Krukow, 2003). In this 300 Nursing Research July/August 2012 Vol 61, No 4 Vanessa M. Lobo, MSc, RN, is PhD Student, McMaster University, Hamilton, Ontario, Canada. Anita Fisher, PhD, RN, is Associate Professor, School of Nursing, and Senior Research Associate at Nursing Health Services Research Unit, McMaster University, Hamilton, Ontario, Canada. Andrea Baumann, PhD, RN, is Associate Vice-President, Faculty of Health Sciences (International Health), and Scientific Director, at Nursing Health Services Research Unit, McMaster University, Hamilton, Ontario, Canada. Noori Akhtar-Danesh, PhD, is Associate Professor of Biostatistics, School of Nursing, McMaster University, Hamilton, Ontario, Canada. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.nursingresearchonline.com). DOI: 10.1097/NNR.0b013e31825b69b1 Copyright @ 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.