It Felt Unsafe: New Nurse Turnover Intention and Perception of Safety.

Abstract

Background: New nurse turnover remains a significant issue. Studies demonstrate that when nurses think their patients' safety is threatened, they are more likely to question their job commitment.

Objective: The objective of this study was to explore the question "How do new nurses' perceptions of safety affect their intention to leave their first job?"

Methods: We used reflexive thematic analysis, a qualitative analytic method. Participants were recruited as part of a subset of a larger nationwide survey on transition to practice of RNs who were newly licensed in 2021. Thirteen nurses from 7 states were included in the sample.

Results: Four of the 13 nurses were in their first positions at the time of the interview. When asked to describe their first year in practice, an overarching finding was "It felt unsafe." The subthemes derived from this main theme were Entering a Precarious Environment and Questioning Their Readiness for Practice. Environmental and nurse-related factors contributed to this feeling.

Conclusion: Helping new nurses feel safe requires the development of a supportive clinical culture. Improving staffing alone will not ensure that new nurses feel supported. When the nurses in this study felt that they were not alone and that they could count on other staff to be helpful, they thrived even in the face of high patient acuity and stressful situations. This support helps them to develop their nursing judgment and learn to care for themselves so they can deliver optimal patient care.