Turnover of New Graduate Nurses in Their First Job Using Survival Analysis

By Cho, Sung-Hyun; Lee, Ji Yun et al. | Journal of Nursing Scholarship, March 2012 | Go to article overview

Turnover of New Graduate Nurses in Their First Job Using Survival Analysis


Cho, Sung-Hyun, Lee, Ji Yun, Mark, Barbara A., Yun, Sung-Cheol, Journal of Nursing Scholarship


Abstract

Purpose: To examine factors related to turnover of new graduate nurses in their first job.

Design: Data were obtained from a 3-year panel survey (2006-2008) of the Graduates Occupational Mobility Survey that followed-up college graduates in South Korea. The sample consisted of 351 new graduates whose first job was as a full-time registered nurse in a hospital.

Methods: Survival analysis was conducted to estimate survival curves and related factors, including individual and family, nursing education, hospital, and job dissatisfaction (overall and 10 specific job aspects).

Findings: The estimated probabilities of staying in their first job for 1, 2, and 3 years were 0.823, 0.666, and 0.537, respectively. Nurses reporting overall job dissatisfaction had significantly lower survival probabilities than those who reported themselves to be either neutral or satisfied. Nurses were more likely to leave if they were married or worked in small (vs. large), nonmetropolitan, and nonunionized hospitals. Dissatisfaction with interpersonal relationships, work content, and physical work environment was associated with a significant increase in the hazards of leaving the first job.

Conclusions: Hospital characteristics as well as job satisfaction were significantly associated with new graduates' turnover.

Clinical Relevance: The high turnover of new graduates could be reduced by improving their job satisfaction, especially with interpersonal relationships, work content, and the physical work environment.

Key words

New graduate, registered nurse, survival analysis, turnover

New graduate nurses are the major source of the supply of nurses to meet patient needs. However, new graduates have been reported to experience intense stress and challenges when they transition from school to their first work setting (Duchscher, 2009; Pellico, Brewer, fr Kovner, 2009). A recent report released by the Institute of Medicine (2011) addressed difficulties of new graduates' transition to practice and the need for managing the transition to reduce their high turnover rates. Kovner and Brewer (2010) reported that 18.1% of newly licensed nurses left their first employer within a year of starting a job, and 26.2% did so within 2 years. To support a successful transition and reduce turnover rates among new graduates, it is necessary to better understand factors affecting their turnover (Kovner et al., 2007).

Previous studies on nurse turnover provide evidence of factors related to nurse turnover intention and actual turnover: job satisfaction and intent to leave, plus organizational, economic, and individual characteristics (Coomber & Barriball, 2007; Hayes et al., 2006). Studies examining new graduates' turnover have demonstrated that higher job satisfaction, organizational commitment, empowerment, support, and pay have all been associated with lower turnover or intent to leave (Beecroft, Dorey, & Wenten, 2008; Kovner, Brewer, Greene, & Fairchild, 2009; Roche, Lamoureux, & Teehan, 2004). New nurses' participation in nurse residency and internship programs also was reported to decrease new graduates' turnover (Newhouse, Hoffman, Suflita, & Hairston, 2007; Ulrich et al., 2010). For example, in their 10-year longitudinal study of new graduate nurses, Ulrich et al. (2010) reported a decrease in turnover after implementing such a residency program for registered nurses (RNs).

Although those studies have contributed evidence on nurse turnover, new methodological approaches are still required to advance nurse turnover research. First, longitudinal research designs have been suggested to be stronger than other designs because longitudinal studies could increase the ability to predict turnover when compared with cross-sectional studies (Hayes et al., 2006). Longitudinal designs are necessary when researchers want to follow up on actual turnover after assessing turnover intention, considering that turnover intention alone accounts for only a portion of actual turnover (Hayes et al. …

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