Changes in retention intention across the student-to-nurse transition: A prospective longitudinal cohort study

초록

Background: Despite integrated theoretical and clinical education, many nursing students experience transition shock upon entering the workforce, contributing to high turnover and worsening nurse shortages. Understanding retention intention and its associated factors is essential for improving workforce stability. Aim: To investigate how nursing students' characteristics and transition shock are associated with changes in retention intention among newly graduated nurses (NGNs) over time. Design: A prospective longitudinal study using secondary data analysis. Methods: Data were drawn from the New Nurse e-Cohort Study (2020-2023) in South Korea. A total of 448 participants from 51 nursing schools and affiliated hospitals completed three surveys: two months before graduation and one and two years after graduation. Participants had at least three months of clinical experience. Retention intention patterns were classified into four groups: staying-staying, staying-leaving, leaving-staying, and leaving-leaving. Multinomial logistic regression was used to identify factors associated with each group, including demographics, students' characteristics, work-related characteristics, and transition shock. Results: The largest group was "leaving-leaving" (39.2%), and the smallest was "staying-staying" (14.0%). Workplace relational support-from both coworkers and managers-was observed at higher levels in the group classified as leaving at T1 and staying at T2 (the leaving-staying pattern), whereas lower academic performance, low readiness for practice, and weaker nursing values during nursing education served as temporally antecedent baseline predictors associated with persistent leaving intention. Conclusions: Tracking nursing students through their transition into practice suggests that academic performance, nursing values, and readiness for practice may play an important role in NGNs' retention intention. These findings highlight the relational workplace climate as a potentially modifiable correlate co-occurring with reconsideration of leaving intention, alongside the more stable individual resources formed during nursing education.

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