Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 6, 150-165 2025 Publisher: Learning Gate DOI: 10.55214/25768484.v9i6.7761 © 2025 by the authors; licensee Learning Gate © 2025 by the authors; licensee Learning Gate History: Received: 13 March 2025; Revised: 6 May 2025; Accepted: 9 May 2025; Published: 2 June 2025 * Correspondence: khalidmoubtahij@gmail.com Impact of working conditions on healthcare professionals' intentions to change careers in Morocco: An empirical study Khalid Moubtahij1*, Imad-dine Bazine2, Sanae Mehdi3, Najoua El abbas El ghaleb4, Ikram El Hachimi5 1Higher Institute of Nursing Professions and Health Techniques, Fez, Morocco; khalidmoubtahij@gmail.com (K.M.) 2,3,5National School of Business and Management of Tangier, Abdelmalek Essaadi University, Morocco; bazine.imad@gmail.com (I.D.B.) sanaemehdi73@gmail.com (S.M.) ikramelhachimi06@gmail.com (N.E.E.G.). 4Faculty of Legal, Economic and Social Sciences, Tangier, Abdelmalek Essaâdi University, Morocco; elabbasnajoua@uae.ac.ma (I.E.H.). Abstract: The loss of skilled workers in the healthcare sector is a global phenomenon that places increasing pressure on health systems, and Morocco is no exception. In a national context marked by the overhaul of the healthcare system, where human capital remains a central pillar, this issue takes on particular significance. This study aims to identify the key factors that drive nurses to consider a career change. To this end, we examined organizational, professional, and personal aspects through a quantitative survey conducted with this category of healthcare professionals. Among a sample of 157 nurses and healthcare technicians, 66% expressed a desire to change their current careers. This intention is either manifested by seeking opportunities in other sectors or by changing professions while remaining within the healthcare field. Participants made clear recommendations to encourage their retention in the profession, including salary increases, improvements in working conditions, enhanced organizational and social recognition, and a more suitable regulatory framework. The findings of this study provide policymakers with a detailed understanding of the factors fueling this phenomenon, thus enabling them to better shape public policies aimed at retaining healthcare professionals and ensuring the sustainability of the healthcare system in Morocco. Keywords: Career change, Determining factors, Nurses, Organizational recognition, Turnover intention. 1. Introduction Over the past decade, the shortage of nursing staff and voluntary departures have remained major challenges affecting the quality of healthcare worldwide. In 2020, the World Health Organization (WHO) estimated a global deficit of 5.9 million nurses globally. This figure, far from stabilizing, could worsen in the coming years, with a risk of reaching up to 9 million if departures continue to increase. More recently, WHO’s estimates revised the global shortage to approximately14.7 million in 2023, with a projected 11 million vacant positions by 2030. The majority of these shortages concentrated in the regions of Africa and the Eastern Mediterranean [1]. Alongside the human resources crisis in the healthcare sector, there is a growing trend toward career changes to other professional or academic fields, offering professionals new skills and career opportunities. Insufficient continuous training in their field encourages these professionals to take advantage of available training opportunities. To progress professionally, some opt for a career change or move into other sectors, sometimes staying within the healthcare environment. This evolution leads to a loss of essential skills for the healthcare system, which becomes increasingly reliant on less experienced staff, particularly in hospitals and healthcare districts [2]. https://orcid.org/0009-0003-8484-789X https://orcid.org/0009-0006-6241-0090 https://orcid.org/0009-0003-0489-8532 https://orcid.org/0000-0003-3463-1882 https://orcid.org/0000-0002-8769-4724 151 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 6: 150-165, 2025 DOI: 10.55214/25768484.v9i6.7761 © 2025 by the authors; licensee Learning Gate One of the key strategies to address the nursing staff shortage is to reduce the voluntary turnover rate among nurses [3, 4]. In this regard, Tourangeau and Cranley [4] developed a model entitled Determinants of Nurses’ Intention to Remain Employed, which highlights four main variables influencing this intention: (1) job satisfaction, (2) nurses’ personal characteristics, (3) team cohesion and collaboration, and (4) organizational commitment. Their analysis shows that managing and improving these four factors has a direct impact on nurses’ willingness to stay in their positions, and conversely, on their intention to leave. To strengthen retention, it is therefore essential to act on these levers by creating a positive work environment, fostering interpersonal relationships, supporting professional development, and reinforcing the sense of belonging to the organization. These aspects are supported by recent studies that emphasize the importance of management policies focused on well-being, recognition, and the active participation of nursing staff in decision-making processes [5, 6]. 2. Literature Review Job satisfaction is widely recognized in the literature as the most consistent predictor of nurses’ intention to leave, accounting for a significant proportion of the variance in this intention Sourdif [3] and Tourangeau and Cranley [4]. Shields and Ward [7] demonstrated that nurses who reported being generally dissatisfied with their jobs were 65% more likely to consider leaving their position compared to those who were satisfied. Consistently, several studies have highlighted a positive correlation between job satisfaction and nurses’ intention to leave the organization [8]. Specific dimensions of job satisfaction, such as remuneration and benefits, working hours, autonomy and responsibility, career advancement opportunities, support received, and interpersonal relationships at work, have also been associated with turnover intention [9-11]. Other individual characteristics, such as age, seniority, and education level, also influence nurses’ intention to leave. Older, more experienced nurses tend to be more likely to stay in their positions, whereas younger and more highly educated nurses report greater job dissatisfaction and a higher intention to leave [12, 13]. However, some researchers argue that these patterns are more closely related to generational differences or cohort-specific characteristics than to age per se [14]. Studies conducted in the African context show that difficult working and living conditions, as well as low wages, are major factors explaining the intention of healthcare workers to leave their profession. Between 1980 and 2007, Willis-Shattuck, et al. [15] highlighted low motivation among healthcare providers in Africa, emphasizing salary as the main factor for motivation and retention in developing countries [16]. Moreover, contextual factors play an important role: healthcare workers are attracted by better working conditions offered in Northern countries, while the high unemployment rate in developing countries also serves as an incentive for emigration [17]. This dynamic contributes to a massive exodus of African healthcare professionals, particularly nurses, who leave their countries in search of better salary opportunities, more specialized training, and better working conditions abroad. This phenomenon exacerbates the shortage of qualified personnel in African healthcare systems, further weakening these already pressured structures. In summary, studies present varying results regarding the link between the individual characteristics of nurses (age, education level, work experience), organizational environmental factors (types of services, hierarchical levels), as well as perceived job satisfaction on one hand, and their intention to leave on the other. The healthcare sector in Morocco is not exempt from this phenomenon, particularly in the post- pandemic context. Knowledge about the factors influencing Moroccan nurses' intention to stay in or leave their profession remains limited. In fact, most research conducted in Morocco has primarily focused on the determinants of nurse migration abroad. These studies suggest that the current framework and conditions of the healthcare system are not adequately suited to retain these 152 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 6: 150-165, 2025 DOI: 10.55214/25768484.v9i6.7761 © 2025 by the authors; licensee Learning Gate professionals [18]. The lack of career advancement prospects, challenging working conditions, and stress related to responsibilities are often cited as major factors motivating career change. These challenges, exacerbated by the specificities of the hospital environment, intensify the difficulties faced. However, the specific elements influencing the intention to change careers among nurses and healthcare technicians remain insufficiently studied. This research aims to identify the key determinants of career transition in this particular context, in order to better meet the expectations of healthcare staff and minimize the loss of skills within hospital establishments. 3. Hypotheses and Research Model Based on the research works mentioned in the literature review, we have formulated the following hypotheses and developed a research model that explores the various factors influencing the professional career change intention of hospital nurses. 3.1. Main Hypothesis The intention of hospital nurses to change their professional career is influenced by a combination of organizational, professional, personal, psychosocial, and contextual factors. 3.2. Secondary Hypotheses Hypothesis 1: Organizational and professional factors promote the career change intention. H1.1: Working conditions are a major determinant of this intention. H1.2: The level of motivation and organizational support also influence this willingness to change. Hypothesis 2: Personal factors contribute to nurses' intention to change careers. H2.1: An imbalance between work and personal life, particularly related to inadequate working hours, increases this intention. H2.2: The social perception of the profession significantly impacts the decision to change careers. Hypothesis 3: Psychosocial factors, such as stress, burnout, as well as conflicts and violence at work, reinforce the intention to leave the profession Hypothesis 4: The absence of a clear and structured regulatory framework for the nursing profession (lack of specific legislative texts and a professional order) strongly encourages considering a career change. Hypothesis 5: Hospital nurses are primarily motivated to stay in their profession by factors related to their working conditions, professional development, and recognition. Figure 1. Conceptuel Model. 153 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 6: 150-165, 2025 DOI: 10.55214/25768484.v9i6.7761 © 2025 by the authors; licensee Learning Gate 4. Methodology In this study, we have chosen to focus on hospital nurses, a key professional group for analyzing the organizational, professional, personal, psychosocial, and contextual factors influencing the career change intention of nurses and healthcare technicians. The central question of our research is as follows: What are the determining factors behind hospital nurses’ intention to leave the profession? To answer this question, we will conduct a survey among a sample of nurses to precisely identify the factors associated with their professional environment. To this end, a quantitative approach has been favored. This is a descriptive study with a quantitative purpose, whose primary objective is to identify the factors influencing the career change intention of hospital nurses at the Hassan II University Hospital Center in Fez, in order to formulate recommendations aimed at improving working conditions and reducing the intention to change careers. 4.1. Study Population The target population for this study consists of the 1,036 hospital nurses working at the University Hospital Center (CHU) of fez. The inclusion criteria specify that only nurses with more than one year of experience at the CHU are eligible to participate in the study. No specific exclusion criteria are applied, although nurses with less than one year of experience are not eligible to take part. As for the sampling method, it will be conducted using a stratified random approach. This method will take into account the different hospitals and specialties to ensure a balanced representation of the various CHU facilities and the professional categories of nurses. The use of this approach ensures the representativeness of the sample, reflecting the diversity of services and specialties, while minimizing the biases that could arise from simple sampling. Finally, the sample size has been calculated using the classical formula for finite populations, considering various parameters, in order to ensure reliable and representative results for the target population. Where: N = 1,036 (population size) Z = 1.96 (Z-score for a 95% confidence level) p = 0.5 (estimated proportion in the absence of specific data) e = 0.05 (margin of error of 5%) This formula results in a sample size of 281 participants, ensuring adequate statistical precision for the planned analyses. This formulation incorporates the key aspects of the sampling methodology, highlighting the rationale for the choice of method and sample size, in accordance with the standards of quantitative research. 4.2. Ethical and Administrative Considerations Prior to initiating the study, official authorization was obtained from the administration of the University Hospital Center (CHU). In accordance with ethical principles, informed consent was collected from each participant. This process ensured the confidentiality and anonymity of the data, thereby protecting participants’ privacy and rights throughout the research. 4.3. Data Collection Tools 154 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 6: 150-165, 2025 DOI: 10.55214/25768484.v9i6.7761 © 2025 by the authors; licensee Learning Gate The main data collection instrument used in this study was a self-administered questionnaire specifically designed for research purposes. It comprised 33 questions divided into several sections: • General information: age, gender, years of service, assigned department, specialty, and education level; • Career change intention: a direct question regarding the participant’s intention to change professions and possible underlying reasons; • Factors influencing the intention to change careers: items covering organizational, personal, psychosocial, and contextual dimensions such as working conditions, remuneration, interpersonal relationships, stress, etc.; • Suggestions for improvement: participants’ recommendations aimed at enhancing job satisfaction. To maximize participation, the questionnaire was distributed both in paper format and online. This dual approach allowed for broader reach while maintaining anonymity and confidentiality of responses. 4.4. Statistical Analysis Data were processed using SPSS software, following a rigorous statistical approach. First, descriptive analyses were conducted to calculate frequencies, percentages, means, and standard deviations. A five-point Likert scale was used to assess participants’ responses in a nuanced manner. Subsequently, mean scores and standard deviations were calculated for each dimension studied, enabling a comparative ranking of the factors influencing career change intention. 4.5. Methodological Validity The development of a robust theoretical framework, clear definition of variables, and structured research protocol contributed to the coherence and validity of the study’s findings. Furthermore, adherence to ethical standards and the use of a carefully defined sampling method reinforced the scientific rigor of the research. In conclusion, this methodology provides a solid foundation for achieving the study’s objectives and contributes to a deeper understanding of the professional dynamics shaping the hospital environment. 5. Results 5.1. Response Rate The study collected responses from 283 hospital nurses out of an initial sample of 500 individuals, resulting in a response rate of 57%. Among the responses received, 49 were submitted online, while the remaining ones were completed in paper format, reflecting the effectiveness of using multiple distribution methods to optimize participation. 5.2. Sample Characteristics The following descriptive results provide an overview of the sociodemographic characteristics of the 283 participants who took part in the study. To begin with, regarding gender, 66% of respondents were women, while 34% were men, reflecting a predominance of female professionals in the sample. This distribution is consistent with trends typically observed in the healthcare sector. Concerning age, nearly half of the participants were between 31 and 40 years old, indicating that the sample was largely composed of mid-career professionals. As for educational level, the vast majority of respondents (257 individuals) reported holding a bachelor's degree. In addition, 18 participants indicated having a master’s degree, 5 held a doctoral degree, and 3 reported possessing another type of qualification. This suggests a workforce with a predominantly undergraduate academic background, but also a presence of highly qualified 155 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 6: 150-165, 2025 DOI: 10.55214/25768484.v9i6.7761 © 2025 by the authors; licensee Learning Gate professionals. When analyzing years of professional experience, 18% of respondents had less than two years of experience, 25% had between two and five years, 15% had between five and ten years, while a significant proportion (43%) had more than ten years of experience. This indicates a sample with a broad range of seniority, but with a strong representation of seasoned professionals. Regarding professional category, the sample composition closely mirrors the distribution observed in the general hospital population. Nurses, who constitute the dominant profession in the hospital sector, were the most represented group with 97 individuals. They were followed by 30 health technicians, 15 rehabilitation specialists, 11 midwives, and 4 social medical assistants. This distribution reinforces the representativeness of the sample relative to the professional landscape of the institution. Finally, concerning the workplace, the breakdown of respondents (nurses, health technicians, midwives, rehabilitation staff) reflects a similar distribution to that found in the general hospital population, thereby strengthening the generalizability of the findings to the broader healthcare context. Table 1. Distribution of Nurses by Workplace. Workplace (Department) Frequency % Addictology 08 3% Rehabilitation 08 3% Laboratory 11 4% Oncology 11 4% Pharmacy 11 4% Radiology 11 4% Resuscitation 16 5% Medical Unit 17 6% Operating Room 17 6% Pediatrics 23 8% Administration 25 9% Psychiatry Department 25 9% Emergency Department 25 9% Maternity Ward 29 10% Addictology 46 16% Total 283 5.3. Data Processing The statistical processing applied included the analysis of frequency distributions (in absolute values and percentages), the calculation of central tendency measures (mean) and dispersion measures (standard deviation), as well as the use of a measurement scale consistent with the five-point Likert model. Table 2. Rating Scale Based on a Five-Point Likert Scale. Response Weighted Mean Level Strongly Disagree From 1 to 1.80 Low Disagree From 1.81 to 2.60 Neither Agree nor Disagree From 2.61 to 3.40 Moderate Agree From 3.41 to 4.20 High Strongly Agree Above 4.20 The analysis will rely on the calculation of weighted averages of the nurses' responses to the items measured by the five-point Likert scale, with the aim of identifying the dominant trend in the respondents' opinions. 156 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 6: 150-165, 2025 DOI: 10.55214/25768484.v9i6.7761 © 2025 by the authors; licensee Learning Gate 5.4. Average Scores, Standard Deviations, and Rankings of the Dimensions Table 3. Working Conditions. Working conditions Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree Average Score Standard Deviation Compensation Frequency 14 5 28 22 34 3.55 1.36 % 8.9 3.2 17.8 14 21.7 Hospital Safety Frequency 11 17 14 21 40 3.60 1.42 % 7 10.8 14 8.3 25.5 Workload Frequency 8 13 24 16 42 3.69 1.33 % 5.1 8.3 15.3 10.2 26.8 Work Organization Frequency 10 10 16 34 33 3.68 1.40 % 6.4 6.4 10.2 21.7 21.0 Quality of Care Frequency 19 44 14 17 9 2.54 1.34 % 12.1 28.0 8.9 10.8 5.7 Work Environment (quality of facilities and equipment, cleanliness, etc.) Frequency 12 18 16 24 33 3.47 1.33 % 7.6 11.5 10.2 15.3 21.0 Item Average 3.44 Item Standard Deviation 1.33 The table above presents the descriptive data related to working conditions, categorized into organizational and professional factors. The mean scores provide a comparative basis for assessing participants’ satisfaction levels across six key dimensions: workload, work organization, hospital safety, remuneration, work environment (including facilities, equipment, and hygiene), and quality of care. The overall analysis reveals a weighted average of 3.44 (σ = 1.33) for the influence of these working conditions on nurses’ intention to consider a career change. This score, corresponding to the "agree" level on the Likert scale (range [3.41–4.20]), indicates a significant and high-level influence, according to the predefined interpretative thresholds. Table 4. Motivational and Organizational Support Factors. Motivation and Supportive Organizational Factors Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree Average Score Standard Deviation Career Development Opportunities (Career Plan) Frequency 5 5 16 32 45 4.04 1.11 % 3.2 3.2 10.2 20.4 28.7 Management Style Frequency 7 8 32 29 27 3.59 1.16 % 4.5 5.1 20.4 18.5 17.2 % 12.1 5.7 15.9 21.7 10.2 Support and Recognition Frequency 9 10 15 29 40 3.79 1.30 % 5.7 6.4 9.6 18.5 25.5 Internal Communication Frequency 17 7 18 30 31 3.50 1.41 % 10.8 4.5 11.5 19.1 19.7 Motivation Frequency 9 5 20 26 43 3.86 1.26 % 5.7 3.2 12.7 16.6 27.4 157 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 6: 150-165, 2025 DOI: 10.55214/25768484.v9i6.7761 © 2025 by the authors; licensee Learning Gate The average of the item 3.76 The standard deviation of the item 1.25 The table above summarizes the descriptive statistics related to motivational factors and organizational support. Analysis of the mean scores allows for a ranking of these dimensions based on perceived satisfaction levels: career advancement opportunities are rated highest, followed by perceived demotivation, managerial recognition, leadership style, and internal communication effectiveness. The overall weighted mean is 3.76 (σ = 1.25), indicating a notable influence of these factors on nurses’ intention to pursue a career change. This score, positioned within the [3.41–4.20] range of the Likert scale, reflects a high level of influence according to the predefined interpretative thresholds. Table 5. Descriptive Statistics on Personal Factors. Personal factors Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree Average Score Standard Deviation Work-life balance Frequency 17 9 10 37 30 3.52 1.42 % 10.8 5.7 6.4 23.6 19.1 Working hours Frequency 8 10 19 31 35 3.73 1.25 % 5.1 6.4 12.1 19.7 22.3 Social perception of the profession Frequency 12 7 22 34 28 3.57 1.28 % 7.6 4.5 14 21.7 17.8 The average of the item 3,60 The standard deviation of the item 1,32 The table above presents the descriptive statistics related to personal factors potentially influencing nurses’ intention to change careers. The mean scores reveal a ranking of perceived satisfaction, starting with work schedule flexibility and the quality of internal communication, followed by the social image of the profession, and finally, the balance between professional and personal life. The overall weighted mean is 3.60 (σ = 1.32), indicating a high level of influence according to the normative scale ([3.40–5]). However, Table 2 classifies this same score as “neutral” within the [2.61–3.40] interval, revealing a discrepancy that suggests a need to review the applied analytical thresholds. Table 6. Descriptive Statistics on Psychosocial Factors. Psychosocial factors Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree Average Score Standard Deviation Ranking Burnout Frequency 14 5 23 35 26 3.52 1.30 3 % 8.9 3.2 14.6 22.3 16.6 Stress Frequency 6 11 13 38 35 3.83 1.18 2 % 3.8 7 8.3 24.2 22.3 Workplace conflicts and violence Frequency 15 10 11 37 30 3.55 1.38 4 % 9.6 6.4 7.0 23.6 19.1 The average of the item 3.63 The standard deviation of the item 1,29 The table above displays the descriptive data related to psychosocial factors influencing nurses' intention to change careers. The analysis of mean scores ranks these factors according to their perceived impact: stress exposure ranks first, followed by workplace relational tensions and violence, 158 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 6: 150-165, 2025 DOI: 10.55214/25768484.v9i6.7761 © 2025 by the authors; licensee Learning Gate and lastly, burnout state. This ranking highlights the dimensions considered most influential by the participants. Regarding the overall impact, the weighted mean is 3.63 (σ = 1.29), indicating a high influence on nurses’ career change intentions, according to the Likert scale ([3.41–4.20], Table 2). This score, corresponding to the “agree” option on the scale, confirms the significant role of psychosocial factors in career change decisions, categorized as “high” based on the predefined thresholds. Table 7. Descriptive Statistics on the Regulatory Framework of the Nursing Profession. The regulatory framework of the ITS profession Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree Average Score Standard Deviation The absence of legal text governing the nursing profession Frequency 10 8 11 18 56 3.99 1.36 % 6.4 5.1 7 11.5 35.7 The absence of a nursing regulatory board Frequency 9 9 10 23 52 3.97 1.32 % 5.7 5.7 6.4 14.6 33.1 The average of the item 3.98 The standard deviation of the item 1.34 The table above presents the descriptive statistics regarding the regulatory framework of the nursing profession. The analysis of mean scores allows for a comparison of respondents’ satisfaction across the different dimensions measured. These dimensions are ranked in descending order of mean score, highlighting two main issues: the lack of legal regulations governing the nursing profession and the absence of a nurses’ council. The weighted mean obtained is 3.98 (σ = 1.34), placing the influence of the regulatory framework in the “agree” category according to the standard Likert scale ([3.41–4.20], Table 2). This score also reaches the high level ([3.40–5]) defined in the study, emphasizing the significant role this factor plays in nurses' intentions to change careers. Table 8. Descriptive Statistics on the COVID-19 Pandemic. Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree Average Score Standard Deviation The COVID-19 pandemic Frequency 39 5 24 13 22 3.57 1.28 % 24.8 3.2 15.3 8.3 14 With a score of 3.57, the impact of the COVID-19 pandemic on nurses’ career change intentions is classified as “high”, exceeding the established threshold of 3.40 for this classification. This result reflects the significant influence of the pandemic on nurses' career decisions. This high impact underscores the importance of the health crisis in prompting nurses to reconsider their professional paths, potentially leading them to explore career changes to other sectors or professions. 5.5. Areas of Focus The analysis of the participants' responses reveals three major career change orientations. The first orientation is a transition to another sector, chosen by 48% of the respondents. The second significant trend is a shift towards administrative roles in healthcare, preferred by 32% of the participants. Finally, 20% of the nurses are considering professional expatriation as a potential 159 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 6: 150-165, 2025 DOI: 10.55214/25768484.v9i6.7761 © 2025 by the authors; licensee Learning Gate solution to their career concerns. These findings highlight the diversity of professional paths considered by nurses, reflecting not only a desire to change sectors but also an interest in administrative and international opportunities. 5.6. Suggestions for Measures Encouraging Nurse Stability Table 9. Suggestions from Nurses on Measures to Encourage Their Stability in the Profession. Improvement Suggestions: Frequency % % of observations Improvement of working conditions 152 16.3% 96.8% Salary increase 145 15.5% 92.4% Enhancement of training and development opportunities 139 14.9% 88.5% Improvement of work-life quality 136 14.5% 86.6% Establishment of a professional order for nurses and health technicians 132 14.1% 84.1% Better professional recognition 125 13.4% 79.6% Implementation of participatory management 106 11.3% 67.5% Other 29 3.0% 18.5% Total 935 100.0% 595.5% Participants' suggestions for measures to encourage the stability of nurses highlight several key areas of concern. The main expectations include ergonomic and safe working conditions (96.8%), salary revaluation (92.4%), and a professional development pathway (88.5%). Other notable expectations include work-life balance (86.6%), ordinal structuring of the profession (84.1%), and skills recognition (79.6%). Additionally, collaborative governance was emphasized by 67.5% of respondents. Emerging proposals aimed at improving the situation include management of organizational transitions, rationalization of work processes, and adjustment of nurse-to-patient ratios. Other suggestions involve fostering a secure professional environment, implementing a continuing education and intrinsic motivation policy, and reforming the supplementary compensation system. Finally, participants recommended improving career and retirement prospects as well as providing institutionalized psychological support. 6. Discussions In this section, we will analyze and interpret the results of the study, following this structure: first, we will address the research questions formulated at the beginning of the study. Next, we will summarize the scientific and practical contributions of this work, highlighting the implications and key findings. We will also examine the methodological limitations encountered during the research, providing a nuanced view of our conclusions. Finally, we will suggest potential avenues for future research, focusing particularly on the exploration of complementary methodologies that could further enrich the knowledge in this field. Regarding the methodology, it is important to recall that the five- point Likert scale used in this study allows for a clear interpretation of the obtained scores. A score close to 1 indicates a low level of agreement, while a score below 3 reflects a general disagreement among respondents. Conversely, a score above 3 suggests agreement, ranging from "agree" to "strongly agree." 6.1. Response Rate and Sample Characteristics Response Rate: A response rate of 57% was achieved, which is considered an average standard for surveys conducted in hospital settings. Previous studies (e.g., Baruch and Holtom [19]) confirm that a response rate above 50% is deemed sufficiently representative for healthcare professionals, with similar surveys often reaching response rates of 60 to 70%. Respondent Profile: In terms of gender distribution, a predominant female representation (66%) is observed, reflecting the traditional gender composition of the nursing profession. Regarding age, the 160 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 6: 150-165, 2025 DOI: 10.55214/25768484.v9i6.7761 © 2025 by the authors; licensee Learning Gate majority of respondents fall within the 31-40 age range, indicating a well-experienced population that remains professionally active. 6.2. Professional Career Change Intentions Our study reveals that 66% of nurses at the university hospital are considering a career change, a trend consistent with global observations. For instance, in France, 64% of nurses express job dissatisfaction (IFOP), 42% of healthcare workers plan to leave the healthcare sector [20] and 40% are considering abandoning their profession (National Order of Nurses). In Macao, 39% of nurses intend to leave their position [21]. Comparative Analysis: According to the results found, a transnational crisis of vocation within healthcare professions, with Moroccan nurses showing a stronger desire for career change (66%) compared to their French (40-64%) and Asian (39%) counterparts. 6.3. Factors Influencing Career Change The analysis of the determinants of nursing profession abandonment reveals a strong convergence with the scientific literature. Respondents confirm that previously identified factors play a significant role in their career change intentions. 6.3.1. Working Conditions The main factors identified by respondents are workload, work organization, hospital safety, remuneration, and work environment. These elements are considered crucial in the decision to change careers, as evidenced by 68.8% of nurses highlighting their importance. These results align with Herzberg [22] theory, which associates job dissatisfaction with unfavorable working conditions. Furthermore, studies by IEDM and FIQ confirm that workload overload and insufficient salaries are major causes of premature departure in the nursing profession. However, contrary to Aiken, et al. [23] respondents did not consider the quality of care as a factor influencing their decision to change careers, likely due to their strong professional consciousness. 6.3.2. Motivation and Organizational Support Factors The high score of 3.76 indicates that factors such as career advancement opportunities, work motivation, support, recognition, management style, and internal communication are crucial in the decision to change careers, as confirmed by 75.2% of respondents. These results corroborate [22, 24] theories, which link recognition and professional development to employee engagement and satisfaction. Ferramosca, et al. [25] and Kox, et al. [26] reinforce this perspective, emphasizing the importance of managerial support and professional involvement in decision-making to improve job satisfaction. Additionally, participatory management practices, reflected by a mean score of 3.59, show a strong demand for organizational support. 6.3.3. Personal Factors Personal factors scored a mean of 3.60, indicating their major role in career change intentions. Work-life balance and working hours were identified as primary concerns. These results confirm [26] which emphasizes that inadequate hours negatively affect quality of life and increase turnover. Furthermore, the social perception of the nursing profession also serves as a factor encouraging career change, as the profession is often undervalued. 6.3.4. Psychosocial Factors Psychosocial factors such as stress, burnout, and workplace conflicts have a significant impact on career change intentions, as indicated by an average score of 3.63. Stress, with a score of 3.83, is the predominant factor, followed by workplace conflicts (3.55) and burnout (3.52). These results align with Maslach and Leiter [27] findings, which associate emotional exhaustion with decreased 161 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 6: 150-165, 2025 DOI: 10.55214/25768484.v9i6.7761 © 2025 by the authors; licensee Learning Gate professional engagement. Studies by AbuAlRub, et al. [28] and Cortina, et al. [29] confirm that stress and workplace conflicts increase the likelihood of nurses considering leaving their profession. 6.3.5. Regulatory Framework The absence of a structured regulatory framework significantly influences career change intentions, with a high average score of 3.98. Nearly 80% of nurses agree on the need for institutional recognition and enhanced governance. This aligns with the World Health Organization (WHO) [30] recommendations, which stress the importance of strong governance for the safety of healthcare professionals. The establishment of an order council is seen as a priority by respondents, to ensure their recognition and legal protection. 6.3.6. COVID-19 Pandemic Our results confirm previous studies, such as those by Buchan, et al. [31] highlighting the role of the COVID-19 pandemic in the decision of many nurses to consider career change. Indeed, 71.4% of respondents agreed with this statement. 6.3.7. Areas of Career Orientation The study results show that 48% of nurses are considering a career change to a completely different sector, 32% wish to remain within the healthcare field by opting for an administrative role, while 20% are considering working abroad. These trends reflect a desire for change, while maintaining, for the majority, an indirect connection to their initial vocation. These career orientations align with trends observed in the literature. For instance, an analysis by Berwouts and Durand [32] reveals that between 2009 and 2018, approximately 6% of healthcare professionals leave the care sector each year to pursue other fields. However, the majority of these departures still maintain a connection to the profession, particularly through teaching activities, which account for 45% of cases. Regarding suggestions for improvement, nurses highlight priorities such as salary increases, better working conditions, and professional recognition. These proposals are in line with findings from existing literature, underlining essential measures to be implemented to foster their retention. 6.3.8. Working Conditions and Recognition The results indicate that improving working conditions (96.8%), increasing salaries (92.4%), and enhancing professional recognition (79.6%) are seen as essential measures. These observations are consistent with the work of [33] who define job satisfaction as a combination of emotional feelings and behavioral expressions related to employment. Job satisfaction is influenced by various factors, such as salary, benefits, recognition, working conditions, and relationships with colleagues and supervisors. Additionally, the literature review by Buqaj and Piccand [34] confirms that effective HR policies, particularly in healthcare settings, play a key role in nurse retention. 6.3.9. Professional Development The expectations expressed by 88.5% of nurses regarding opportunities for continuous education, as well as by 86.6% in favor of better work-life quality, reflect a significant need for professional growth and personal balance. These results confirm the findings of Guardini, et al. [35] who demonstrate that nurse retention is fostered by strong team support, flexible schedules, increased autonomy, regular training, constructive feedback, teaching opportunities, and a reduction in workload. Continuous education plays a critical role in enabling healthcare professionals to develop their skills, improve time management, and enhance communication capabilities, thereby contributing to a better quality of life at work. Moreover, it fosters a healthier work environment and stronger engagement, which are essential for reducing turnover and supporting nurses' motivation. 162 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 6: 150-165, 2025 DOI: 10.55214/25768484.v9i6.7761 © 2025 by the authors; licensee Learning Gate 6.3.10. Institutional Strengthening The creation of a professional order, supported by 84.1% of respondents, is seen as a priority measure to strengthen the legitimacy and recognition of healthcare technicians (ITS). This strong support highlights the need to promote the establishment of such an organization, which could improve governance, structure the profession, and align local practices with international standards. Such an initiative would also help reinforce professionals' trust in their profession, while addressing growing demands for institutional recognition and legal protection. Furthermore, the results reveal that nurses and healthcare technicians have significant expectations regarding salary, improvements in working conditions, and professional recognition. These three areas are considered critical priorities for enhancing staff retention. Additionally, factors such as work-life quality, opportunities for continuous education, and the establishment of a professional order are also viewed as essential to ensuring the retention of professionals in the field. The table below summarizes the hypotheses explored in this study, the results obtained, the main conclusions, and their alignment with existing literature. Table 10. Synthesis of Hypotheses: Results, Conclusions, and Alignment with the Literature. Hypothesis Result Conclusion Alignment with the Literature Hypothesis 1: Organizational/pr ofessional factors promote the intention to pursue a career change. H 1.1: Working conditions are a key factor in the intention to pursue a career change. The working conditions have a weighted average of 3.44. 68.8% of nurses confirmed that working conditions play a crucial role in their decision to pursue a career change. Work overload, inadequate compensation, and the work environment are identified as the main causes of dissatisfaction. Validated Aiken, et al. [23] ; Ferramosca, et al. [25] and Beaudry [36] H 1.2: Motivational and organizational support factors promote the intention to pursue a career change among nurses and health technicians. The motivational and organizational support factors have a weighted average of 3.76. 75.2% of nurses confirmed that motivation and organizational support promote the intention to change careers. These include recognition, career development opportunities, and participative management. Validated Gagné and Deci [37]; Ferramosca, et al. [25]; Kox, et al. [26]; Stemmer, et al. [38] and Neves, et al. [39] Hypothesis 2: Personal factors promote the intention to pursue a career change. • H 2.1: The imbalance between professional and personal life, particularly due to perceived unsatisfactory working hours, increases the intention to pursue a career change. • Personal factors have an average of 3.60. 72% of participants identify work-life balance and working hours as a major cause. Validated Kox, et al. [26]; Beaudry [36] and Kox, et al. [26] H 2.2: The social perception of the profession significantly influences the intention to pursue a career change. The social perception of the profession is a key factor. 71.4% of respondents confirm that a negative image of the profession encourages consideration of a career change. Validated McCormack [40] and van Der Cingel and Brouwer [41] 163 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 6: 150-165, 2025 DOI: 10.55214/25768484.v9i6.7761 © 2025 by the authors; licensee Learning Gate • Hypothesis 3: Psychosocial factors, such as stress, burnout, and workplace conflicts and violence, increase the intention to pursue a career change. Psychosocial factors are rated 3.63 on a 5-point scale, as reported by 72.6% of participants. Validated AbuAlRub, et al. [28]; Maslach and Leiter [27]; Cortina, et al. [29] and Buchan, et al. [31] Hypothesis 4: The lack of a clear and structured regulatory framework for the ITS profession (absence of specific legal texts and a professional regulatory body) strongly encourages nurses to consider a career change. 80% of participants identify the absence of a regulatory framework as a major barrier. The weighted average of regulatory satisfaction is 3.98. Validated Hypothesis 5: Nurses are primarily motivated by factors related to their working conditions, professional development, and recognition to encourage them to remain in their current profession. Nurses place major importance on three key factors for their retention: improving working conditions (96.8%), increasing salaries (92.4%), and professional recognition (79.6%). Additionally, there are significant expectations regarding professional development, particularly opportunities for continuous education (88.5%) and improving quality of life at work (86.6%). Finally, 84.1% of respondents highlight the need to create a professional order to structure and strengthen their profession. Validated Buqaj and Piccand [34] ; Guardini, et al. [35] and Cowin, et al. [33] 7. Conclusion The nursing and healthcare technician profession plays a crucial role in the healthcare system but is facing a growing shortage of personnel. In 2020, the World Health Organization (WHO) estimated a global deficit of 5.9 million nurses, a number that could reach 9 million in the coming years due to factors such as an aging population and the rise of chronic diseases. This alarming situation results in an increased demand for nurses, while migration, career changes, and resignations are on the rise, making staff retention a major challenge. This study, conducted with 283 hospital nurses, adopted a quantitative approach to identify the factors influencing their intention to pursue a career change. Four main categories of factors were identified: organizational and professional, personal, psychosocial, and contextual, in line with widely used theoretical frameworks. The results reveal that the primary motivations for career changes are inadequate working conditions, a lack of support and recognition, and the absence of an appropriate regulatory framework. The participants also provided clear recommendations, including salary increases, improved working conditions, professional recognition, and stronger regulatory measures. The findings of this research offer concrete suggestions to improve nurse retention, focusing on aspects such as compensation, career development prospects, work-life balance, and the material working conditions. Despite certain limitations, this study contributes to a deeper understanding of the challenges related to retaining nursing and healthcare technician staff in Morocco and paves the way for future research aimed at developing effective strategies to enhance workplace attractiveness and satisfaction, in order to curb the loss of skilled professionals in the hospital sector. 164 Edelweiss Applied Science and Technology ISSN: 2576-8484 Vol. 9, No. 6: 150-165, 2025 DOI: 10.55214/25768484.v9i6.7761 © 2025 by the authors; licensee Learning Gate Transparency: The authors confirm that the manuscript is an honest, accurate, and transparent account of the study; that no vital features of the study have been omitted; and that any discrepancies from the study as planned have been explained. This study followed all ethical practices during writing. Copyright: © 2025 by the authors. 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