Thoughts on and Motives for Leaving the First-Line Manager Position: A Qualitative Study.

The aim of this study was to describe first-line managers' thoughts on and motives for leaving their position. The turnover rate of first-line managers impacts healthcare organizations' overall performance. Burnout, dissatisfaction, and desired career advancement contribute to the intention to leave. High turnover negatively impacts patient care and has financial consequences. Involving managers in decision-making, providing support, and addressing workload and resource challenges are known to be crucial factors in retaining managers. Sixteen semistructured interviews were conducted with first-line managers. Qualitative content analysis was used to analyze the data. Our study showed that some first-line managers experience difficulties at work, leading them to reach a breaking point and leave. These difficulties stem from a lack of influence, feeling unheard, and having inadequate support. Some first-line managers reach a point where they feel the need to move on, often due to personal reasons or a lack of motivation. Upon deciding to leave, managers commonly have a plan to ensure a smooth transition for their successor, aiming to help both the new manager and the unit's staff. First-line managers can perceive their work situation as challenging and frustrating when they lack authority and support. This can lead to them leaving their role for reasons such as retirement, seeking more time for family, or seeking new work challenges. It is important for healthcare management to empower and support first-line managers. Smooth transitions for successors and staff are crucial, regardless of why a manager leaves.