Factors Associated With Intent to Leave the Nursing Profession in the United States: An Integrative Review.
Kathryn Leep-Lazar, Chenjuan Ma, Amy Witkoski Stimpfel
PMID 40223789WHAT IT FOUND
High workload, bullying, and lack of resources were consistently linked to nurses' intent to leave the profession.
Demographics, wages, and certification showed inconsistent or no relationship. Staffing levels and supportive environments were the strongest predictors of retention.
Key findings
01High workload, job demands, and inability to cope with them were consistently associated with greater intent to leave the nursing profession.
02Access to resources, including sufficient staffing, and positive work environments were associated with decreased intent to leave.
03Demographic factors such as age, gender, and nursing tenure, as well as wages and certification, were largely unrelated or inconsistently associated with intent to leave.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The review included studies with methodological weaknesses, such as inadequate control for confounders and poor handling of missing data, which limits the strength of the conclusions. Only one author screened articles, which introduces potential bias in study selection. The review was limited to U.S. studies, so findings may not apply to other healthcare systems. Most included studies were cross-sectional, so they cannot prove that these factors cause nurses to leave, only that they are associated with intent to leave. Few studies examined physical health or early-to-mid career nurses, leaving gaps in understanding these aspects of retention.
Declared interests
The authors have no conflicts of interest to report, and no relevant financial or non-financial interests to disclose.
The easy way to misread this
Do not interpret this as evidence that specific interventions will reduce turnover. The review reports associations from cross-sectional studies, not causation. Furthermore, it is a study of nurses' career intentions, not of patient care outcomes, so it does not directly inform clinical practice guidelines for treating patients.