Date of Conferral

8-26-2025

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Services

Advisor

Suzanne Richins

Abstract

This integrative review was conducted to examine how comprehensive career development initiatives influence registered nurse retention and job satisfaction in non-profit urban hospitals, which are affected by limited advancement opportunities, inadequate mentorship, and unsupportive work environments. Guided by the Johns Hopkins Evidence-Based Practice model and the Authentic Nurse Leadership framework, this review synthesizes peer-reviewed literature from 2019 to 2024 to identify evidence-based, leadership-driven strategies for improving nurse retention. Four key themes emerged: (a) career development and advancement through structured learning pathways, mentorship, and leadership training; (b) empowerment and decision-making via participative management and clinical autonomy; (c) supportive work environments that prioritize safe staffing, inclusive leadership, and diversity; and (d) professional recognition and organizational commitment through tailored retention efforts and values alignment. Findings underscore that authentic leadership fosters trust, psychological safety, and engagement, elements essential to retaining nurses in financially constrained environments. Career development strategies, when supported by transparent and ethical leadership, significantly reduce burnout and professional stagnation. Broader implications for social change include care continuity, economic mobility for historically marginalized nurses, and health equity for underserved communities. These strategies address key domains of the social determinants of health, including economic stability, access to education, and quality of healthcare. Ultimately, investing in structured, leadership-supported career development not only strengthens nurse satisfaction and retention but also contributes to more equitable and sustainable healthcare systems.

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