Why Nurses Resign: A Qualitative Study Across Life Stages and Implications for Workforce Management.

BACKGROUND: Voluntary resignation among nurses poses a growing challenge for healthcare organisations, with implications for workforce stability and quality of care. While intention to leave has been widely examined, little is known about the experiences of nurses who have already enacted their decision to resign, particularly across different life stages. AIM: To explore the reasons underlying voluntary resignation among nurses and examine how these reasons vary across generational cohorts, with the goal of informing life-stage-sensitive workforce retention strategies. METHODS: A qualitative descriptive study was conducted in a large Italian university hospital. Nurses who voluntarily resigned between March and November 2025 participated in semistructured exit interviews. Data were collected through detailed field notes and analysed inductively using thematic analysis. RESULTS: Sixty-six nurses participated. Resignation emerged as a multifactorial process shaped by the interaction between organisational conditions and evolving life-stage priorities. Generation Z participants reported insufficient onboarding, unmet expectations and difficulties balancing work with academic or personal commitments. Generation Y emphasised workload pressures, limited recognition, poor organisational climate and restricted career development. Generation X highlighted physical strain, scheduling needs and logistical barriers such as commuting and parking difficulties. Across all groups, chronic understaffing, limited flexibility and insufficient managerial support were consistently identified as key contributors. CONCLUSIONS: Voluntary resignation reflects a complex interplay between organisational factors and life-stage-specific needs rather than isolated dissatisfaction. The findings highlight under-recognised determinants-such as micrologistical stressors and personal development aspirations-that influence enacted turnover. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should adopt life-stage-sensitive retention strategies, including structured onboarding, supportive leadership, flexible scheduling, recognition of competencies and attention to logistical and quality-of-life factors. Addressing both organisational and relational dimensions may enhance staff retention and contribute to a more sustainable workforce.