Navigating Professional Aspirations: The Role of Work-Family Conflict, Job Demand and Control, and Social Support in Shaping Nursing Students' Career Intentions.

Background: Nurses are the backbone of healthcare and vital to patient outcomes. Newly qualified nurses face significant challenges, with many leaving the profession within 2 years, worsening the nursing shortage. Methods: This study aimed to examine how work-to-family conflict, job demands, job control, and social support influence the career intentions of nursing students in the Czech Republic. A nationwide cross-sectional survey was conducted between August and December 2023 using a self-administered online questionnaire. The instrument was adapted from the Nurses Early Exit Study and included validated measures related to psychosocial working conditions and work-to-family balance. Data were analyzed using IBM SPSS Statistics to explore associations between these factors, health-related characteristics, and students' intentions to remain in or leave the nursing profession. Results: Among 559 respondents, WAI scores were significantly associated with gender, self-perceived health (ρ = 0.531), and exhaustion (ρ = -0.542). Social support improved training expectations alignment (AOR = 1.021, p < 0.001) and increased likelihood of pursuing nursing qualifications (AOR = 1.308, p=0.004). Conversely, exhaustion negatively influenced endurance (AOR = -0.247, p=0.030) and increased the likelihood of switching careers (AOR = 1.145, p=0.019). Work ability positively predicted endurance (AOR = 0.309, p < 0.001) and reduced career-shift intentions (AOR = 0.891, p=0.003). Despite strong training endurance, 55.6% considered leaving nursing, citing exhaustion and work-family conflict as key factors. Conclusion: Social support emerged as a protective factor, aligning training expectations with clinical experiences and encouraging further nursing qualifications. Work ability promoted endurance in training and reduced career shift. In contrast, exhaustion, work-family conflict, poor health, and negative clinical experiences-including bullying-undermined retention. Nursing education administrators and healthcare managers should prioritize supportive environments, strengthen mentorship and peer support, and implement interventions to reduce stress and improve clinical placements to enhance retention and workforce sustainability.