Leaving the Hospital: Generational Drivers of Voluntary Resignation Among Healthcare Workers

Abstract

Introduction. Voluntary resignation among healthcare workers (HCWs) is an increasing challenge for healthcare systems, affecting workforce stability, quality of care, and organisational sustainability. Although the intention to leave has been widely studied, fewer studies have explored the perspectives of HCWs who actually resign. This study aimed to explore the reasons for voluntary resignation among HCWs in an Italian university hospital, examine how these reasons vary across generational cohorts and life stages, and identify organisational strategies to support retention.

Methods. A qualitative descriptive design was adopted. All HCWs who formally submitted voluntary resignation between March and November 2025 were invited to participate in a semi-structured exit interview. Physicians were excluded due to differences in career structures and potential confounding factors. Data were analysed inductively using Braun and Clarke’s thematic analysis.

Results. Eighty-eight HCWs participated: Generation Z (n=22), Generation Y (n=46), and Generation X (n=20). Six themes emerged across cohorts. Generation Z reported distance from family, inadequate onboarding, and difficulties balancing work with personal or academic commitments. Generation Y highlighted workload, limited career development, lack of recognition, and challenging organisational climates. Generation X emphasised physical strain, commuting difficulties, and the need for more predictable schedules to support family responsibilities. Across groups, resignation reflected a misalignment between organisational demands and evolving personal priorities. Participants suggested staffing adequacy, structured onboarding, supportive leadership, flexible scheduling, and improved logistical resources as key retention strategies.

Discussion. Voluntary resignation appears to reflect the interaction between organisational conditions and life-stage transitions rather than isolated dissatisfaction. Retention strategies should therefore adopt flexible approaches that recognise diverse career stages and personal priorities.