Nursing graduates’ perceived future career pathway and career shift tendency in Egypt: a cross sectional study

The career trajectories of nursing graduates and their propensity for career shifts are critical considerations in understanding the dynamics of the nursing workforce and ensuring the provision of high-quality healthcare services [1, 2]. Nursing, as a profession, offers diverse career pathways ranging from traditional clinical roles to non-traditional positions in education, management, research, and advanced practice nursing. However, recent years have witnessed changes in the aspirations and career preferences of nursing graduates, reflecting broader shifts in the healthcare landscape [3].

Therefore, newly graduate nurses encounter numerous career options, spanning hospital environments and community-cantered primary healthcare services like general practice with various scopes. A key approach to workforce development involves maintaining a steady influx of recent nursing graduates entering employment in diverse clinical settings, especially in regions where shortages are anticipated or prevalent. To support and reinforce the pool of graduate nurse professionals, it becomes imperative to grasp the factors that shape the career decisions of undergraduate students [4].

Career pathway planning is an ongoing process through which an individual sets career goals and identifies the means to achieve them [5]. It is a process of systematically matching career goals and individual capabilities with opportunities for their fulfilment [6]. It’s not a one-time event but is rather a process that becomes part of the repertoire of skills and experiences that enables graduate nursing students to develop as professionals [7].

According to statistics from the American Association of Colleges of Nursing (AACN), the demand for nursing professionals continues to rise, driven by factors such as population aging, increasing chronic disease burden, and healthcare reform initiatives. AACN’s report highlights that nursing schools across the United States are struggling to expand enrolment capacity to meet the growing demand for nurses, resulting in a projected shortage of registered nurses by the year 2030 [1]. This projected shortage underscores the importance of understanding nursing graduates’ career pathways and their potential for career shifts, as these factors can significantly impact the supply of nursing professionals in the workforce. Which could potentially mitigate workforce gaps, particularly by retaining more nurses within the profession. Similar concerns about workforce sustainability are evident globally, including in Egypt, where nursing graduates face significant challenges such as low salaries, poor working conditions, and limited professional development opportunities.

Moreover, studies have indicated a growing trend among nursing graduates to explore alternative career pathways beyond traditional clinical roles. In the United Kingdom many nursing graduates are considering diverse career options, including shifting to other fields such as business and industry [3]. Similarly, in Australia indicated a significant proportion of nursing graduates expressing interest in non-nursing roles or pursuing further education in another specialization [8].

Despite the extensive research on nursing career pathways and job satisfaction globally, there remains a substantial gap in understanding the specific career shift tendencies of nursing graduates, particularly in developing countries like Egypt. While studies have explored nursing workforce trends in Western countries, the Egyptian nursing context—with its unique socio-economic and healthcare challenges—has been largely overlooked. A study by Cottle examines factors influencing early career employment outcomes for nurses, particularly in Western settings. However, her research primarily focuses on nurses’ career settings and intentions to remain in the workforce, which differs from the context of nursing career shifts.

Specifically, there is limited research exploring the specific career shift tendencies and retention challenges faced by nursing graduates in Egypt. The socio-economic, cultural, and healthcare system dynamics in Egypt present unique challenges that are underrepresented in existing studies. For instance, Egyptian nursing graduates often confront a combination of low salaries, limited career progression, and a shortage of qualified mentors, which drive many to seek opportunities abroad or in alternative professions, which may influence career decisions in a very different way. This highlights the need for research that delves into local factors that affect nursing graduates’ career pathways and shifts in regions like Egypt [9].

Similarly, Laschinger et al. study the transition of new graduate nurses into practice, emphasizing their early career satisfaction and adjustment to clinical settings. While this provides valuable insight into the initial career stages, it overlooks how long-term career satisfaction and external factors—such as healthcare system limitations or economic challenges—may influence whether nurses stay within the profession or shift careers. These studies underscore the need for research that looks at career shifts not only during the early transition but throughout a nurse’s entire career pathway [10].

In Egypt, Abd-elmonem et al. explored entrepreneurial tendencies among new graduate nurses and how these relate to their professional development and career aspirations. However, while their study touches upon career aspirations, it does not directly investigate the specific motivations behind career shifts or how graduates perceive their long-term career pathways. This creates a significant gap in understanding the broader picture of how Egyptian nursing graduates view their professional futures and the factors influencing these decisions to leave clinical roles or transition into non-clinical careers [11].

The career aspirations and trajectories of nursing graduates are pivotal considerations in the landscape of healthcare delivery, not only in global contexts but also within specific regions such as Egypt. The nursing profession in Egypt faces unique challenges and opportunities shaped by cultural, economic, and healthcare system factors. Understanding the career pathways and tendencies of nursing graduates in Egypt is crucial for addressing workforce needs, ensuring quality patient care, and advancing the nursing profession in the country [9].

According to Central Agency for Public Mobilization and Statistics [12] total nursing staff who actually work reached 227 thousand nurses in 2020 compared to 229 thousand nurses in 2019, an increase, while the Initial indicators in last 3 years indicates a sharp decrease in healthcare providers specially nurses numbers as result of migration and career shift.

Research specific to Egypt’s nursing workforce landscape is limited but emerging. Studies have shown that Egyptian nursing graduates often encounter challenges in securing employment opportunities that align with their career aspirations [2]. Factors such as limited job prospects, inadequate professional development opportunities, and disparities in salary and benefits influence nurses’ decisions regarding their career pathways and potential shifts within or outside the nursing profession. Despite the increasing demand for nurses in Egypt, few studies have explored the career aspirations and shift tendencies of newly graduated nurses in the region. Understanding the factors influencing these decisions is critical for addressing workforce instability and improving nurse retention, particularly in light of Egypt’s unique healthcare and economic challenges. Moreover, cultural norms and societal perceptions of nursing as a profession may impact nursing graduates’ career choices in Egypt. While nursing is a respected profession, misconceptions about the role and scope of nursing practice persist, affecting career advancement opportunities and job satisfaction among nursing professionals [13].

The migration of nursing graduates from Egypt has been a growing concern in recent years, driven by several key factors. Financial instability, including low wages within the public healthcare sector, plays a central role in this migration trend. Despite the essential role nurses play in healthcare, many nursing graduates find it difficult to sustain themselves and their families due to low salaries and limited opportunities for career advancement in Egypt’s healthcare system. Additionally, the perception of better job prospects and higher salaries abroad, particularly in countries like the Gulf States, the United States, and Canada, motivates many Egyptian nurses to seek employment opportunities overseas. The global demand for healthcare professionals, especially in developed countries, further amplifies this trend. Furthermore, the lack of adequate resources, training opportunities, and career development programs in the domestic healthcare system also contributes to the desire to migrate, as many nurses seek better work environments, job security, and career growth opportunities abroad [14].

While the nursing profession offers a wealth of opportunities for career advancement and professional growth, various factors influence nursing graduates’ career decisions and propensity for career shifts [9]. These factors may include job satisfaction, work-life balance, opportunities for advancement, salary considerations, workplace culture, and external factors such as changes in healthcare policies and technological advancements [15].

Furthermore, the COVID-19 pandemic has brought attention to the resilience and adaptability of nursing professionals. Studies examining the pandemic’s impact on nursing graduates’ career aspirations and shift tendencies can provide valuable insights into how global health crises shape healthcare workforce dynamics [16].

The current study addresses this critical gap by exploring how nursing graduates perceive their career pathways, their tendencies toward career shifts, and the factors influencing these decisions. By doing so, it offers a unique contribution to the literature, providing much-needed insights into the career trajectories of Egyptian nurses. Understanding these factors is crucial for informing policies aimed at improving nurse retention and addressing workforce shortages in Egypt’s healthcare sector. Understanding such issues in Egypt requires nuanced exploration of the factors influencing their career decisions and aspirations. By addressing the barriers to career advancement and providing tailored support and opportunities for professional growth, also ensure a resilient and skilled nursing workforce capable of meeting the evolving healthcare needs of its population.

Table 6 sociodemographic characteristics illustrates the relationship between nurses’ profiles, future career pathway perceptions, and career shift tendencies among studied nurses. Gender differences are apparent, with male nurses showing a lower mean perception of future career pathways (25.27 ± 5.19) compared to female counterparts (32.79 ± 7.80), and these differences are statistically significant (p = 0.001). Age categories also play a role, influencing both future career pathway perception and career shift tendencies. The highest nursing degree earned is associated with variations in perceptions, notably with nurses holding a Bachelor of Science in Nursing (BSN) degree showing higher means for both future career pathways (31.04 ± 10.92) and career shift tendency (15.00 ± 8.92). Additionally, years since graduation reveal nuanced patterns, demonstrating significant variations in both career pathway perception and career shift tendency among nurses with different levels of experience. Furthermore, the current employment status and work setting significantly impact nurses’ career perceptions and shift tendencies.

Table 7 demonstrated Future Career Pathway Perception Notably, 49.3% stated that they wanted to pursue advanced nursing education, while 29.2% aim for advancement in their current nursing roles, showcasing a commitment to professional development. Passion for the field is a significant motivator, with 34.0% citing it as a driving factor, and financial prospects (46.5%) emerge as a key motivator as well. Challenges such as a lack of financial resources (60.9%) and job market competitiveness (31.4%) are acknowledged, emphasizing the importance of addressing these barriers. In terms of long-term goals, academic roles (39.7%) and nursing leadership/management roles (18.6%) are prominent, reflecting a desire for academic and managerial responsibilities. However, it is notable that certain roles, such as nursing informatics, nurse researcher, and advanced practice nursing, currently have zero representation among respondents. The overall mean future career pathway perception is 58.03 ± 13.11, indicating a positive and diverse range of career aspirations and challenges within the nursing profession (Fig. 1).

The Table 8 presents insightful information on career shift tendencies among 1000 respondents, revealing that 25.9% are actively considering a change. As regards factors influencing this consideration include a strong desire for change (56.0%), better career opportunities (30.1%), and a focus on work-life balance (74.0%) and financial growth (80.4%). Respondents anticipate challenges, particularly related to financial resources and time constraints for additional education. Notably, fields such as software development (21.0%) and freelancing (27.9%) are prominent considerations for a career shift. The mean values for certain aspects, such as the age-related value for those considering a career shift (12.25 ± 5.12), may warrant further clarification. Overall, the data highlights the dynamic factors influencing career decisions and sheds light on the diverse fields attracting career-shift considerations (Fig. 2).

Table 9 demonstrates a statistically significant positive correlation between future career pathway perception and career shift tendency.

Table 10 shows Pearson’s correlation analysis examining the associations among career pathway perception and career shift tendency are presented in Table 9. The variables accounted for 20.88% of the variance in career shift tendency. It was observed that career pathway perception demonstrates a positive correlation with career shift tendency.

The present study aims to explore nursing graduates perceived future Career pathway and their Career shift tendency. Understanding graduates’ perception toward their career pathway is essential as it influences their decisions regarding further education, specialization, and employment opportunities. Additionally, insights into their career shift tendencies provide valuable information for educational institutions, healthcare organizations, and policymakers to tailor support systems and resources to meet evolving workforce needs.

By comprehensively examining these aspects, stakeholders can foster an environment that facilitates career progression, professional satisfaction, and ultimately, enhances the quality of patient care. As nursing manpower has a considerable shortage, it is necessary for undergraduate nursing students to develop positive attitudes based on logical knowledge about nursing profession. Therefore, the present study explored issues concerning factors affecting how nursing graduates perceive and engage with the profession, aiming to identify key factors that influence their attitudes and decision-making processes.

By understanding these factors, educators and stakeholders can develop targeted interventions and educational strategies to foster positive attitudes toward the nursing profession among undergraduate students. This, in turn, can help mitigate the shortage of nursing manpower by attracting and retaining more individuals in the field, ultimately contributing to the stability and sustainability of the healthcare workforce. The information obtained through this part of the study showed whether there was a need for nursing graduates to be oriented to their career pathway.

This study examined the perceived future career pathway and career shift tendency among nursing graduates. They reported how satisfied they were with their career indicating a positive and diverse range of career aspirations and challenges within the nursing profession. Many graduates in this study reported that they were having proper, positive perception regarding their career pathway; however, a considerable percentage of them reported tendency for career shift. In addition, we found that graduates’ perception of career pathway had a significant effect on their career shift tendency in future.

In the present study, nearly half of the nursing graduates expressed a desire to pursue advanced nursing education as an immediate career goal. This preference is likely driven by the belief that further education can improve job satisfaction and financial rewards. Acquiring specialized knowledge and skills may open up more career opportunities, including higher-paying positions with greater job security. The desire for advanced education reflects a commitment to lifelong learning and a dedication to advancing both individual careers and the nursing profession as a whole.

This finding is consistent with another study [9], which found that most students considered further education as a key goal. Similarly, a previous study [12] reported that 70% of Norwegian nursing students intended to pursue additional education, seeing it as a professional step that would enhance their economic and career prospects. The motivation for advanced education may also stem from the recognition that healthcare is constantly evolving. Continuous learning is essential to provide high-quality care, adapt to new technologies and evidence-based practices, and address emerging health challenges. By investing in further education, nursing graduates may feel more prepared to navigate these changes effectively.

The present study revealed that nearly a half of study subjects reported financial prospects as a motivator to explore pathways. Moreover, as regards challenges or obstacles anticipated in pursuing chosen career pathway, nearly two thirds of nursing graduates highlighted Lack of financial resources as the main obstacle. These results are consistent with previous research [20] who have highlighted the significant influence of financial factors on nursing career decisions, they examined the factors influencing nurse labor market outcomes in the United States and found that salary considerations were among the key determinants affecting nurses’ job choices and career trajectories. Similarly, [21] explored the factors influencing nurses’ intention to leave their current positions in Taiwan and identified salary as one of the main predictors of turnover intention.

In Egypt, as in many other countries, nurses often face challenges such as low salaries, limited opportunities for career advancement, and a lack of adequate resources in healthcare settings. These difficulties can significantly affect their career decisions, with financial considerations playing a central role. Nurses may view pursuing specific career pathways or further education as ways to enhance their financial stability and improve their quality of life. The rising cost of living, inflation, and other economic pressures in Egypt can further heighten the importance of financial security when nursing professionals are making career choices. In this socio-economic environment, many nurses prioritize career paths that not only provide personal satisfaction but also offer financial security and opportunities for upward mobility.

Nurses in Egypt face considerable financial challenges due to relatively low wages in the public healthcare sector, especially in comparison to the private sector or alternative career paths. Economic pressures such as inflation and low salaries significantly affect nurses’ job satisfaction and their long-term commitment to the profession. Financial instability within the healthcare system, combined with limited career progression opportunities in public institutions, often leads nurses to seek better-paying roles either in the private sector or abroad. This trend is further intensified by the mismatch between the qualifications of nurses and the available roles within the healthcare system, creating frustration and prompting many to consider career shifts or migration for improved financial prospects [14].

The socio-economic context and healthcare system dynamics in Egypt significantly influence the career decisions of nursing professionals. Nurses in Egypt face low wages, particularly in the public healthcare sector, which often fails to meet the increasing cost of living. For example, the average salary for nurses in Egypt remains below the national median income, with many nurses earning around 5,500 EGP per month, far from sufficient to cover the rising costs of daily living, such as transportation, housing, and healthcare [22]. As a result, financial pressures have become a key driver of career shifts. Nurses often seek higher-paying opportunities either in the private healthcare sector, where salaries are relatively higher, or in non-medical fields like administration or business [23].

Moreover, systemic challenges in the healthcare sector, such as severe staffing shortages, inadequate resources, and high nurse-to-patient ratios, exacerbate these financial and emotional pressures. A report from the Egyptian Ministry of Health (2021) [24], highlighted that there is a chronic shortage of nursing staff, with a ratio of just 1 nurse for every 10 patients in certain public hospitals, leading to burnout and job dissatisfaction. These factors, combined with limited career advancement opportunities, often push nurses to consider alternative career paths, including migration abroad for better pay and working conditions [25].

The poor working conditions within the Egyptian healthcare system are another key factor influencing career shifts. Chronic staffing shortages, inadequate resources, and high patient-to-nurse ratios contribute to nurse burnout and stress. These systemic challenges not only affect job satisfaction but also increase the likelihood of nurses seeking alternative career paths. Faced with these pressures, nurses may consider shifting within the healthcare sector, such as transitioning from clinical roles to educational or managerial positions, or even leaving the healthcare field entirely for less demanding careers in administration or other industries.

Social factors also have a significant influence on career decisions. In Egypt, cultural expectations related to work-life balance and family responsibilities can be powerful motivators for career shifts, particularly among women. Traditional gender roles often place added pressure on female nurses to prioritize family obligations over professional development, which may lead them to seek more flexible or stable career opportunities. As a result, some may move towards roles within healthcare that offer better work-life balance, or they may consider completely changing careers to find positions outside the healthcare sector [11].

Educational and professional development opportunities play a crucial role in shaping career pathways for nurses in Egypt. While there is a strong emphasis on education in the country, financial constraints and institutional limitations often hinder nurses’ ability to pursue further education or specialization. This lack of professional advancement opportunities drives many nurses to explore alternative career paths or even consider migrating to countries with more accessible and lucrative career options. This barrier to further education and specialization often leads nurses to reevaluate their career goals and seek opportunities where they can achieve personal and professional growth [26].

In addition to local factors, the global demand for healthcare professionals, including nurses, significantly influences career decisions. Many nurses in Egypt view opportunities to work abroad or in international organizations as an attractive option due to the promise of significantly higher salaries and better benefits. This global trend prompts Egyptian nurses to explore career pathways that could lead to international opportunities, where they can enhance their financial stability and career prospects. This external demand for healthcare workers also reinforces the perception that pursuing a career abroad is a viable and rewarding path for many nurses [27].

The role of financial motivations in nursing career decisions in Egypt can be attributed to a combination of economic realities, socio-cultural pressures, and global trends shaping the profession. Nurses are not only dealing with local financial challenges but are also responding to the global mobility of healthcare professionals, which further drives their career choices. The interplay of these factors highlights the complex decision-making process nurses face when choosing career pathways, with financial security often being a significant driver.

In relation to long-term career goals, many nursing graduates expressed interest in academic roles. This inclination may stem from the demanding nature of clinical practice, where nurses often experience challenging work conditions and less favourable work environments. Academic roles are seen as offering more stability, flexibility, and opportunities for intellectual growth. This finding aligns with previous studies that found a significant percentage of nursing students aspiring to become academics, citing the desire for a less stressful and more rewarding career path [6, 28]. Additionally, studies conducted in other countries, such as Turkey, also revealed that a notable proportion of nursing students aim to pursue academic careers, suggesting that this aspiration is shared across different cultural contexts [29].

The desire for academic roles may also be driven by the growing recognition of the need for well-educated nurse leaders who can contribute to the advancement of nursing practice and healthcare education. Nurses pursuing academic careers are in a unique position to influence the future of nursing by engaging in teaching, research, and policy development. This reflects a broader global trend in nursing, where higher education and academic positions are increasingly valued as essential for professional advancement and improving healthcare outcomes.

Thus, in the context of the Egyptian healthcare system, it is clear that multiple factors, including financial stability, working conditions, social expectations, and educational opportunities, play a significant role in shaping nursing graduates’ career choices. Nurses are navigating a complex landscape that involves balancing personal goals with the socio-economic realities of their profession. As the profession continues to evolve, understanding these factors is crucial for developing targeted strategies to support nurses in achieving their career aspirations and improving their job satisfaction.

Regarding nursing graduates’ tendency toward career shifts, over a quarter of them expressed consideration of such a change, indicating a significant proportion and potential signs of workforce instability and dissatisfaction within the nursing profession. This trend serves as a key indicator that systemic issues affecting job satisfaction and retention need to be addressed. High turnover rates, job dissatisfaction, and a desire to leave the profession are well-documented phenomena in recent studies [30, 31], further validating the concerns raised by the current study.

Financial growth (84.4%), work-life balance (74%), and a desire for a change (56%) were identified by nursing graduates as the leading factors influencing their consideration of career shifts. This aligns with findings from other studies, which highlight financial concerns, work-life balance, and the desire for professional change as prominent drivers for career shifts or leaving the profession [32‐34]. The financial aspect is particularly relevant given the non-competitive salaries in the healthcare sector, which do not match the rising cost of living. Work-life balance issues, including long hours, overtime, and limited time off, also contribute to nurses’ dissatisfaction. Meanwhile, the desire for a change can reflect a wish for new challenges and personal growth opportunities.

Regarding the challenges anticipated in pursuing their chosen career pathways, nursing graduates reported several obstacles. The most commonly cited challenges were lack of financial resources (60.9%), limited time for further education (53%), and job market competitiveness (31.4%). These factors, combined with financial concerns, may discourage nursing graduates from pursuing career shifts due to apprehensions about change and the uncertainty of delayed financial rewards in new fields. This suggests that despite the desire for career change, practical barriers remain a significant concern for many nursing graduates.

In terms of the fields or specializations considered for a career shift, nursing graduates expressed interest in various sectors. These included marketing management (49%), real estate development (36%), freelancing (27.9%), social media work (27.4%), and trading (26.0%). These results are in line with studies on German and European nurses, which have identified similar fields as attractive career options for those considering leaving the nursing profession [35, 36]. The appeal of these fields lies in their perceived opportunities for career growth, financial rewards, and flexibility. The rise of digital technologies and the expansion of global markets have likely increased the accessibility and attractiveness of these sectors to nurses seeking new professional challenges outside traditional nursing roles.

Several confounding variables can influence career perceptions and shift tendencies among nursing graduates, and these need to be considered when evaluating career pathway decisions. Educational qualifications are a significant factor in shaping career satisfaction and the likelihood of career shifts. Nurses with higher levels of education, such as bachelor’s or master’s degrees, generally report higher career satisfaction and greater stability, making them less likely to consider a career change [27]. This suggests that investing in education could potentially help mitigate some of the factors that contribute to career dissatisfaction and shifts.

Age and professional experience also play a role in career decisions. Older nurses and those with more years of experience tend to feel more secure in their roles and are less likely to pursue career shifts. This is supported by research indicating that experienced nurses report higher levels of job satisfaction and a stronger sense of professional identity, which reduces their likelihood of leaving the profession [37]. Conversely, younger nurses with less experience may be more open to change and explore different career paths.

This is often due to physical exhaustion, burnout, and dissatisfaction with working conditions in clinical roles. In contrast, younger nurses tend to have more flexibility in their career decisions and are more open to exploring different pathways, such as roles in healthcare administration or academia. Interventions targeted at older nurses, such as opportunities for less physically demanding roles or mentorship programs, can improve retention and job satisfaction. For younger nurses, providing clear professional development pathways and continuous education can enhance career commitment and reduce the likelihood of early career shifts [38].

Job satisfaction is another crucial factor influencing career decisions. Poor working conditions, including high nurse-to-patient ratios, inadequate staffing, and limited organizational support, can lead to burnout and dissatisfaction. Studies have consistently found that nurses experiencing poor job satisfaction are more likely to consider leaving their roles [39]. As such, improving workplace conditions is essential to reducing turnover intentions and preventing unnecessary career shifts.

Socioeconomic factors, such as economic pressures and the cost of living, are particularly relevant in countries like Egypt. Nurses may prioritize financial security, which can drive career shifts if they perceive limited financial rewards in their current roles. Additionally, cultural expectations, particularly concerning gender roles and family responsibilities, can influence career decisions, particularly for women who may feel societal pressure to balance work with familial duties. These cultural and socioeconomic factors highlight the complex decision-making process that nursing graduates face when considering career shifts.

In conclusion, the tendency toward career shifts among nursing graduates is driven by a combination of financial, personal, and systemic factors. Financial growth, work-life balance, and a desire for change are significant motivators, while challenges such as lack of financial resources, time constraints for further education, and market competitiveness remain obstacles. The fields considered for career shifts reflect the evolving job market and nurses’ search for opportunities that offer better financial prospects, flexibility, and growth. Addressing these issues through policy changes, improved working conditions, and better educational opportunities is essential for retaining skilled nursing professionals and ensuring the stability of the healthcare workforce.

Additionally, the global demand for healthcare professionals has created significant opportunities for nurses to migrate abroad for better-paying jobs and career advancement. This potential for migration has influenced the perceptions of nursing graduates in Egypt, with many viewing foreign job opportunities as more attractive than staying within the local healthcare system. Recent studies have highlighted the impact of global workforce mobility on nurses’ career choices. For example, research by [40] found that the perception of better opportunities abroad was a major factor in nurses’ decisions to leave their home countries. Such opportunities are often seen as offering higher salaries, better working conditions, and greater professional growth, making them appealing to nurses facing challenges within the domestic healthcare system.

When examining the impact of gender on career pathway perceptions and career shift tendencies, the current study found no statistically significant difference between male and female nurses. This suggests that gender does not play a significant role in shaping career decisions or the likelihood of career shifts among nursing graduates in Egypt. This finding contrasts with some previous studies, where gender-related factors, such as societal expectations and familial responsibilities, were found to influence career choices [35]. Regarding age, a noticeable difference emerged between younger and older nurses. Younger nurses, who are often more enthusiastic and passionate about their careers, were more likely to express a desire for professional development and workplace innovation. Older nurses, on the other hand, exhibited a greater intention to leave the profession, possibly due to burnout or dissatisfaction with career progression [36].

The current study also explored the role of educational qualifications in shaping career pathway perceptions. A statistically significant relationship was found between nurses’ degrees, their current employment status, and their career pathway intentions. Nurses with higher qualifications, such as a bachelor’s or master’s degree, were more likely to express a strong motivation toward their profession compared to those with less education [41]. Research by Watts et al. [27] further supports this, showing that certified nurses were less likely to leave the profession compared to their non-certified counterparts. This suggests that higher educational qualifications may lead to greater job satisfaction, career stability, and lower intentions to shift careers.

Furthermore, the study revealed a significant relationship between demographic factors, such as age, years since graduation, and years of experience, with career pathway perceptions and career shift tendencies. Older nurses and those with more years of experience were less likely to consider a career shift, reflecting a negative correlation with career change tendencies (p < 0.001). This finding aligns with previous research, which suggests that experienced nurses tend to experience higher job satisfaction, develop a stronger professional identity, and exhibit more career stability [35]. Older nurses are also less inclined to shift careers due to concerns about job security, retirement, and the difficulties associated with starting anew in a different field [36].

These insights underscore the importance of considering demographic factors when developing strategies to support career pathways and workforce retention in healthcare settings. Understanding the unique needs and motivations of different nurse cohorts—based on their age, qualifications, and experience—can help tailor interventions that address specific challenges and improve job satisfaction.

The findings of this study also emphasize the importance of addressing factors that contribute to career shift tendencies, such as financial pressures, work-life balance, and the desire for professional change. To mitigate these issues and enhance career satisfaction, the study suggests implementing targeted interventions that focus on improving workplace conditions, promoting work-life balance, and providing ample opportunities for career advancement and professional development. By addressing these key factors, healthcare organizations can foster a more satisfied and committed nursing workforce, ultimately contributing to the quality of patient care.

Additionally, the study recommends proactive measures to address the factors driving intentions to leave the profession, such as improving work environments, fostering intergenerational collaboration, and offering mentorship programs. These interventions can help retain nursing professionals and create a more cohesive, resilient workforce capable of meeting the challenges of modern healthcare delivery.

To enhance career retention and satisfaction among nursing graduates in Egypt, targeted interventions are needed, especially to address work-life balance and mentorship. Mentorship programs could be implemented by pairing experienced nurses with recent graduates to provide career guidance, emotional support, and professional development. These programs would help young nurses navigate the early stages of their careers, improve job satisfaction, and reduce the likelihood of career shifts. Mentorship could be particularly effective in retaining talent and fostering professional growth, especially for those feeling uncertain about their career pathways.

Work-life balance initiatives are also crucial, particularly for female nurses in Egypt who often juggle professional and familial responsibilities. Healthcare institutions could introduce flexible work schedules, shift rotations, and childcare support to alleviate the pressures on nurses. Such policies would not only improve nurses’ well-being but also enhance their job satisfaction, potentially reducing turnover and encouraging retention. These changes would help nurses manage their personal and professional responsibilities more effectively, contributing to long-term career stability in the Egyptian healthcare sector.

In conclusion, this study provides valuable insights into the career perceptions and shift tendencies of Egyptian nursing graduates. It highlights positive perceptions regarding their career pathways, over a quarter of them were contemplating career shifts, indicating potential workforce instability and dissatisfaction. The study also highlighted that financial challenges, low salaries, limited career advancement, and inadequate resources which could influence their career choices, including financial concerns, educational qualifications, and workplace conditions, as well as the role of demographic factors such as age and experience. To support the retention and career satisfaction of nursing professionals, it is essential to implement targeted strategies that address these concerns and promote professional growth. Future research with larger sample sizes would further deepen our understanding of these issues and guide the development of more effective workforce retention strategies in healthcare settings.

The present study delved into career pathway perceptions of Egyptian nursing graduates, revealing a notable tendency to consider career shifts, driven by factors such as financial growth, work-life balance, and the desire for new opportunities. The most popular career alternatives identified were in fields such as marketing management, real estate development, freelancing, social media, and trading. While the majority of nursing graduates expressed positive perceptions regarding their career pathways, over a quarter of them were contemplating career shifts, indicating potential workforce instability and dissatisfaction. The study also highlighted that financial challenges, low salaries, limited career advancement, and inadequate resources in the healthcare system were significant drivers behind these career considerations. Economic factors, such as the rising cost of living and inflation, further emphasized the role of financial security in career decision-making. Additionally, the study found that older nurses were more likely to consider leaving the profession, while there was a significant relationship between nursing graduates’ education level, current employment status, and their career perceptions. Moving forward, future research should focus on evaluating the effectiveness of interventions like mentorship programs, work-life balance initiatives, and career development opportunities in enhancing nurse retention and job satisfaction. Studies should also explore how professional development opportunities, such as continuing education and specialization, impact long-term career trajectories. Further research could examine how cultural and socio-economic factors, such as gender and age, influence career decisions, and assess the impact of international migration trends on the nursing workforce. These areas of exploration will help develop targeted strategies to support a stable and satisfied nursing workforce, ensuring both high-quality patient care and sustainable healthcare systems.