School of Nursing


Doctor of Nursing Practice (DNP)


Cindy Goodrich


turnover, first-year nurses, new graduate nurses, retention, intent to leave




The purpose of this integrative review was to identify themes within the literature related to the first-year turnover of new graduate nurses within the hospital setting and what nursing leaders can do or have done to increase retention. This review was not intended to evaluate specific interventions implemented in response to turnover, such as nurse residencies, transition to practice, and mentorship programs. This review’s overall purpose was to better understand why new nurses leave their jobs within the first 12 to 24 months, the best practices to reduce first-year turnover, and how nursing leaders best support new graduates. According to the 2022 National Health Care Retention & Staffing Report, significant increases in nursing turnover. High vacancy rates due to turnover are causing health systems to implement costly staffing strategies such as the use of agency nurses and forced overtime. These interventions are not sustainable, and leaders must focus on targeting who is leaving the bedside and why. Nursing Solutions, Inc., reports that nurses leaving within the first year of practice are the most significant group of concern. Fifteen studies were evaluated that provided factors contributing to first-year nurse turnover. Three themes emerged from the literature regarding why nurses leave within their first year: work environment, transition shock, and unsupportive relationships. Work environments that were complex, understaffed, and where bullying occurred were shown to decrease professional commitment and increase intent to leave. Difficulty transitioning from student to professional and lacking peer and managerial support also increased first-year turnover. Understanding the underlying factors of first-year turnover can help nursing leaders develop appropriate retention strategies.

Available for download on Saturday, October 12, 2024

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