ORIGINAL ARTICLE Is anybody listening? A qualitative study of nurses’ reflections on practice Annette Huntington, Jean Gilmour, Anthony Tuckett, Stephen Neville, Denise Wilson and Catherine Turner Aim and objectives. To explore nurses’ perceptions of the reality of practice based on data from the Nurses and Midwives e-cohort Study which examined the workforce characteristics, work–life balance and health of nurses. Background. Recruitment and retention of the nursing workforce is of international concern as demands increase due to demographic changes, political pressure and community expectations, in a climate of economic constraint. Design. Qualitative analysis of data from a cohort of Australian, New Zealand and UK nurses. Method. Of the 7604 participants in the electronic cohort, 1909 provided qualitative comments of which 162 related to nursing practice; thematic analysis resulted in four high order themes. The analytical discussion is structured around ‘care’ as the organising construct. Results. Four themes emerged: ‘embodied care’ which discusses the impact of work on the nurse’s physical and emotional health; ‘quantity/quality care’ which addresses increasing pressures of work and ability to provide quality care; ‘organisational (non)care’ raising the seeming lack of support from management; and ‘(un)collegial/self care’ where bullying and professional relationships were raised. Conclusions. Issues raised by participants have been discussed in the nursing literature for several years yet nurses still expe- rience these negative aspects of nursing. It appears there is a significant gap between what is known about the practice environment, recommendations for change and change occurring: the management equivalent of the theory–practice gap, resulting in nurses intending to leave the profession. Relevance to clinical practice. Research demonstrates that a well-qualified, stable nursing workforce improves quality of health care and health outcomes. Changing the work environment and fostering a positive workplace culture seems fundamental to supporting the retention of nurses, that this is not occurring in some areas in the current climate is a concern for the profession and those responsible for the provision of care. Key words: bullying, nursing workforce, organisational management, shift work, stress, workplace injuries Accepted for publication: 21 August 2010 Introduction Focus on nursing and midwifery workforce issues has inten- sified as awareness of the impact of current and future nursing shortages has grown and the multi-factorial and complex nature of the problem identified (International Council of Nurses [ICN] 2006, Rafferty 2009). The significant issues of attrition, the ageing profile of the nursing workforce and Authors: Annette Huntington, RN, PhD, Associate Professor, Massey University; Jean Gilmour, RN, PhD, Senior Lecturer, Massey University, Wellington, New Zealand; Anthony Tuckett, RN, MA, PhD, Senior Lecturer, School of Nursing and Midwifery, The University of Queensland, Qld, Australia; Stephen Neville, RN, PhD, Senior Lecturer, Massey University; Denise Wilson, RN, PhD, Senior Lecturer, Massey University, Auckland, New Zealand; Catherine Turner, PhD, RN, Professor, School of Nursing and Midwifery, The University of Queensland, Qld, Australia Correspondence: Annette Huntington, Associate Professor, Massey University, PO Box 756, Wellington 6021, New Zealand. Telephone: 0064 4 8015799. E-mail: a.d.huntington@massey.ac.nz Ó 2011 Blackwell Publishing Ltd, Journal of Clinical Nursing 1 doi: 10.1111/j.1365-2702.2010.03602.x