Career choices in health care: Is nursing a special case? A content analysis of survey data

BackgroundAs demand for nurses and other health professionals continues to outstrip supply it is important to understand what motivates individuals to join a non-medical health profession.ObjectivesThe objectives of this study were to investigate students’ reasons for choosing a particular nursing specialism, midwifery or other non-medical health profession, and to compare motivation factors across professions, gender, age, level of award, prior qualifications, prior experience and over time.DesignA prospective follow-up study collected survey responses at the beginning and end of pre-qualifying professional programmes.SettingThe study took place in one large United Kingdom faculty.ParticipantsThe study participants were 775 first-year students undertaking non-medical health professional programmes and 393 qualifying students.MethodsAn open-ended question was included in a self-completed questionnaire administered at entry and at qualification. Content analysis identified themes.ResultsAltruism was the most frequently cited reason for wishing to join a non-medical health profession, followed by personal interest/abilities, professional values/rewards, and prior experience of the area. Students entering nursing were less likely to cite an altruistic motivation than those entering other non-medical health professions (χ2=21.61χ2=21.61, df=1, p<0.001p<0.001). On entry, adult nursing, children's nursing and radiotherapy students were least likely to cite professional values/rewards (χ2=20.38χ2=20.38, df=8, p=0.009p=0.009). Students on degree level programmes were more likely to report altruism than those on diploma level courses (χ2=17.37χ2=17.37, df=1, p<0.001p<0.001). Differences were also identified between the two data collection points. The number of students identifying altruism (χ2=3.97χ2=3.97, p=0.046p=0.046) and professional values/rewards (χ2=6.67χ2=6.67, p=0.010p=0.010) decreased over time.ConclusionFindings suggest that although a service orientation remains a key factor in choosing nursing, students also look for a career which matches their interests and attributes, as well as offering professional values and rewards. Nursing may be in danger of losing service orientated recruits to other non-medical health professions.