Job satisfaction, burnout, and intent to stay in neonatal nursing in England and Wales: A cross-sectional survey study

Objective: To explore job satisfaction, burnout and intent to stay in neonatal nurses in England and Wales. Methods: A cross-sectional online survey study using the McCloskey Mueller Satisfaction Scale (MMSS) to explore job satisfaction, the Copenhagen Burnout Inventory (CBI) to explore burnout and the Nurse Retention Index (NRI) to measure intent to stay. All neonatal nurses working in England and Wales were eligible to take part. Data were collected between February and September 2024. Results: A total of 1590 neonatal nurses completed the survey. Job satisfaction was neutral. Moderate work burnout was reported, with statistically significant differences in mean score when comparing groups within ethnicity (p < 0.001), age (p < 0.001), marital status (p < 0.001), level of education (p < 0.001), level of NNU (p < 0.001), and hours worked per week (p = 0.002). Intent to stay in neonatal nursing was reported by 868 (54%) respondents. Job satisfaction was positively predictive of intent to stay (p = 0.001), and burnout was negatively predictive of intent to stay (p < 0.001). Strategies most likely to improve retention included enhanced pay, emotional support, communication workshops, and employee recognition. Conclusion: Higher job satisfaction and lower burnout were associated with an increased intent to stay. Policymakers and managers need to be aware of the level of job satisfaction and burnout experienced by the current workforce and the subsequent risk of not retaining nurses. Retention strategies must prioritise improving job satisfaction and reducing burnout to ensure babies and families on neonatal units are receiving safe and effective standards of care. This may also make neonatal nursing a more attractive option for future recruitment. Implications for clinical practice: Neonatal nurse shortages are a significant concern in the UK, compromising the ability to meet recommended nurse to patient ratios in many neonatal units. Additional nurses intending to leave would intensify the shortfall, and increase the risk to patient safety.