Career choice motivations, perceptions, and future intentions among Indian nursing students: a mixed-methods study

Background: Ensuring a sustainable nursing workforce requires both academic capacity building and a deeper understanding of the experiences that nurture students’ commitment to the profession. In India, rapid growth in nursing education has intersected with changing societal perceptions and competitive career landscapes. This study sought to explore career choice motivations, professional perceptions, and future career intentions among Indian nursing students. Methods: A sequential explanatory mixed-methods approach was gently conducted between April 2025 and June 2026. Phase I involved an online cross-sectional survey (N=1544) across multiple geographical zones. Descriptive statistics were used to summarize the data. Group comparison tests, and multiple linear regression modelling were also used. Phase II comprised semi-structured qualitative interviews (N=27) analyzed using Colaizzi’s descriptive phenomenological approach to better contextualize the statistical findings. Quantitative and qualitative strands were integrated via joint display and narrative synthesis. Results: A notable proportion of participants (69.8%) reported considering alternative career choices, most commonly medicine (37.4%) and technical fields (25.8%). Mean domain scores indicated high intrinsic motivation (19.94 ± 4.61) and economic expectations (20.00 ± 4.11), alongside academic stress (20.03 ± 3.90). Multiple regression analysis (F = 5.085, p < 0.001, R² = 0.103) showed that female gender (B = 4.717, p < 0.001) and salary expectations (B = 1.493, p = 0.002) were positively associated with perception scores, whereas career change intention (B = −4.659, p < 0.001) and higher secondary examination marks (B = −1.905, p = 0.002) were negatively associated. Qualitative findings, organized into seven themes and 27 subthemes, provided explanatory context. Students described how entrance exam setbacks, heavy assignment loads, inconsistent mentorship, and social stigma contributed to uncertainty. In contrast, rewarding patient encounters and the development of clinical confidence fostered a growing sense of professional commitment. Conclusion: Indian nursing students navigate diverse pathways into the profession, balancing altruistic goals with practical challenges and evolving career preferences. The results tentatively highlight that supportive career counseling, refined academic requirements, enhanced clinical mentorship, and clear role definitions may help strengthen students' professional identity and support long-term commitment to nursing practice.