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Developing expert clinical nurses: grow them, hold them and let them walk away.

AIM: The aim of the present study was to describe three case studies that exemplify decision making by a nursing leader related to retention of expert clinical nurses in the Emergency Department.

BACKGROUND: Further understanding of decision-making processes that help nursing leaders to retain (or let go of) expert clinical nurses is needed so that sufficient numbers of expert nurses are available in the workforce to provide high-quality and safe patient care.

EVALUATION: Decision processes related to retention of expert clinical nurses are exemplified in three case studies.

KEY ISSUES: Orienting nurses to specialty areas is costly and retention of nurses is an important international issue.

CONCLUSIONS: Expert clinical nurses across the skill continuum need guidance from nursing leaders related to their work behaviours and best choice for employment.

IMPLICATIONS FOR NURSING MANAGEMENT: Nursing leaders who are well acquainted with the skills and motivations of their employees are in the best position to promote the health of individual nurses and of specialty nursing units.

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