Understanding New Registered Nurses’ Intent to Stay at Their Jobs

Christine T. Kovner, PhD, RN, FAAN; Carol S. Brewer, PhD, RN; William Greene, PhD; Susan Fairchild, MPH


Nurs Econ. 2009;27(2):81-98. 

In This Article


Newly licensed registered nurses (NLRNs) are critical members of the health care and hospital workforce. Most hospitals hired at least one new graduate in 2000 (Group, 2002). The National League for Nursing (2006) estimates that there were about 84,878 new graduates in 2005, most of whom will pass the licensure examination to become NLRNs. It is thought that many of these new RNs leave hospital positions within 1 year of starting work (Squires, 2002), which is sooner than RNs with more experience. The number of people choosing nursing in their late 20s and 30s has increased in the last several years, moderating the widespread shortage of nurses that was predicted, but the shortage still will be sizable by 2020 (Auerbach, Buerhaus, & Staiger, 2007; U.S. Department of Health and Human Services, 2002).

Nursing turnover is costly for health care organizations. When an employee leaves, organizations incur hiring, orientation, and decreased productivity costs as well as temporary replacement costs. Estimates of these substantial costs are 1.2 to 1.3 times the 1-year salary of a registered nurse (RN) (Jones, 2004; Jones, 2005) to replace a single RN, or up to 5% of a hospital's budget for yearly turnover costs (Waldman, Kelly, Arora, & Smith, 2004). These costs often are paid by the government as a major payer of health care costs in the United States.

While employee turnover is costly, it may also benefit employers and employees. A new employee brings experience and education to employers that may benefit the employer. When RNs switch jobs they often increase their salaries. Job switching may also improve an employee's working conditions, commute time, benefits, or intangibles of value to the employee. However, we could not locate any studies that examine the net societal costs and benefits of RN turnover.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.