In order to reduce costly turnover among newly-licensed nurses, hospitals should work to improve job satisfaction and organizational commitment before nurses develop the desire to leave their jobs, in addition to working to reduce workplace injuries.

Many investigators have examined nurse retention, but there has been little research into why newly-licensed nurses (NLRNs) leave their initial hospital jobs. This study is based on data from a national sample of 1,653 nurses who were employed by hospitals; were working in their first nursing jobs; and who answered a survey twice, a year apart, in January 2006 and 2007.

Key Findings:

• Fifteen percent of the sample had left their jobs between the first and second surveys. Scaled nationally, this represents roughly $728 million in annual employer turnover costs, and as much as $2.1 billion over three years.
• Most NLRNs remain in hospital nursing after a job change, suggesting they want to remain in hospitals but were not satisfied with their initial employment.
• Of the 40 percent of the sample that had suffered bodily sprains and strains by the time they initially answered the survey, 19 percent of those had left their jobs by the time they answered the second round of the survey.
• NLRNs were more likely to leave their first jobs if they were employed full-time, but less likely if they worked more hours of voluntary overtime or had more than one job for pay.
• “Intent to stay” in the current job was associated with lower turnover. Additional analysis revealed that “job satisfaction” and “organizational commitment” were underlying statistically significant variables associated with intent.
• Working at a Magnet Recognition Award hospital was not associated with reduced turnover.

The authors believe their work highlights several priorities for hospital employers, including: programs, such as “no-lift” guidelines, designed to reduce nurse injury; and efforts to improve job satisfaction and commitment before a nurse develops the intent to leave the job.