Turnover intention and retention of newly licensed nurses in their first job: A longitudinal study

Abstract

Aim: To examine newly licensed nurses' retention in their first job and factors related to their turnover.

Background: Newly licensed nurses have a high turnover rate within three years of entering their first job.

Introduction: The factors affecting newly licensed nurses' turnover should be identified and prevented.

Methods: This longitudinal study tracked newly licensed nurses for three years. Data were collected online, and nurses could participate four times in the survey. The Kaplan-Meier method was used to estimate survival curves and to present nurses' retention. Cox proportional hazards regression model was used to analyze factors related to turnover.

Results: The estimated survival probabilities in nurses' first job at one, two, and three years were 0.927, 0.778, and 0.686, respectively. Nurses who reported turnover intention within one year in the first survey had significantly lower survival probabilities than those who did not have turnover intention. Turnover was more likely among male nurses. Turnover intention was associated with a significant increased likelihood of nurses leaving their first job.

Discussion: More than one third of newly licensed nurses left their first job within three years of employment. To reduce nurses' turnover, it is necessary to understand and manage turnover intention in advance. Specific steps should be taken to address male nurses' turnover.

Conclusions: Turnover intention was the most powerful predictor of turnover. Further research should investigate reasons for turnover intention at the beginning of employment, and strategies to prevent turnover should be developed before nurses enter the workforce.

Implications for nursing and health policy: Newly licensed nurses with turnover intention at the beginning of their career should receive particular attention, and wellness programs should be prepared to promote retention.

Keywords: hospital type; longitudinal study; newly licensed nurse; retention; survival analysis; turnover intention.