Turnover prevalence and the relationship between transition shock and turnover intention among new nurses: A meta-analysis

Abstract

Background

: Higher turnover rates of new nurses is a global problem. New nurses are the workforce that retains and prevents the nursing shortage. Many new nurses often experience transition shock during their first year of practice, which correlates with a greater intention to leave the profession. However, there is no universal definition of new nurses, various studies define as nurses with one year, one to three year or up to five years of employment. The unsuccessful transition from academic into clinical practice affects the nurses’ well-being, the quality of patient care, and organizational costs.

Aims

: This review aims to examine the prevalence of turnover intention among new nurses and to identify the relationship between transition shock and turnover intention.

Methods

: A systematic review and meta-analysis were performed with nine databases searching CINAHL, ProQuest, PubMed, Scopus, Science Direct, Academic Search, etc., from inception to October 2024. The quality of studies was assessed using the JBI checklist, and a random effect model was used to estimate the pooled prevalence and effect size. Heterogeneity, publication bias, subgroup analysis and sensitivity analysis were conducted. All statistical analyses were conducted with Comprehensive Meta-Analysis, version 4 and R software version 3.5.3.

Results

: Our meta-analysis of 12 out of 15 studies found that the prevalence of turnover intention ranged from 6 %– 61 % of (8593) new nurses across eight countries. The pooled prevalence was 36 % (95 % confidence interval: 27 % to 46 %, I² - 98 %), and a significant moderate association of transition shock of new nurses was found with turnover intention (effect size 0.489, 95 % confidence interval of 0.297 to 0.644, I² - 97 %).

Conclusions

: The higher prevalence of turnover intention highlights a significant challenge for the global nursing workforce crisis. The findings revealed a need for structured transition programs to mitigate transition shock and diminish turnover intention. Nurse and hospital administrators should urgently address this by providing smoother transition and implementing early career support to stabilize nursing workforce.