Careers in nursing: longitudinal study of healthcare assistants and registered nurses after entry into working life

The predicted shortage of skilled health professionals threatens the future provision of health and nursing care in Switzerland. In order to develop and implement effective measures against the shortage of personnel, knowledge about careers in nursing is also necessary.

Nursing professional at work
ZHAW School of Health Professions/John Canciani

Since 2010, the Zurich University of Applied Sciences (ZHAW) and the Swiss Federal University for Vocational Education and Training (SFUVET) have been studying the career plans and professional and educational trajectories of healthcare assistants and registered nurses. Based on this data, factors influencing career paths and decisions to remain in the profession were investigated. The data are now being analysed comparatively in order to identify typical career patterns in nursing.

This project is part of a joint effort by Swiss higher institutions specialised in healthcare to develop the competence network health workforce (CNHW). Various local projects are pursued to gahter basic knowledge and identify possible measures. The ZHAW School of Health Professions is currently conducting a six-part study entitled ‘Occupational Careers and Job Retention of Health Professionals (BB-GES)’, which is intended to improve the data basis and identify measures aimed at retaining health professionals.


The aim is to develop a database on the various professional activities in health care. This database can then be used for research and planning in the health care sector and as a basis for comparative findings on career entry and subsequent retention of healthcare assistants and registered nurses.

The following activities will be carried out in pursuit of this aim:

Conclusions on possible measures that can be taken to encourage people to remain in the profession may be derived from analysis of the various factors influencing professional careers.


The comparative analysis of the career paths of registered nurses and healthcare assistants examin mobility between fields of work (e.g. between hospitals and nursing homes) and levels of training as well as the role of previous experience as a healthcare assistant at career entry as a registered nurse. Certain patterns are apparent: Overall more qualified staff move to the acute care sector than to other sectors during the first few years after obtaining their initial qualifications, while the long-term care sector loses qualified staff during the first few years after training. Mobility between the sectors differs between healthcare assistants and registered nurses. While registered nurses and healthcare assistants completing nursing studies predominantly move from the long-term or home care sectors to acute care, healthcare assistants who have remained in the profession are increasingly moving to the home care sector. Based on these findings, enhancing the status and attractiveness of the long-term care sector as a place of learning and working for nurses by adopting suitable measures is recommended. One approach would be to offer functions with extended tasks and good conditions for further education and training. This takes account of the fact that nursing professionals often seek new challenges in the early years of their careers and wish to develop their knowledge and skills.

Another approach to improve the retention of registered nurses in the profession is providing targeted support for nurses with little previous experience during the career entry phase. Results from the combined data set indicate that registered nurses with previous experience from training as healthcare assistants suffer less stress in their day-to-day work and have a clearer understanding of their role than nurses who come directly from baccalaureate or specialised schools. Support during the career entry phase can be provided through mentoring programmes, for example.

The detailed report on the overall project which explores the pros and cons of remaining in the care sector can be found here. Many of the reasons indicated also apply to healthcare assistants as highlighted by the trend report "Healthcare assistant – a dream job or a stopover?" (Link to report).