Hindawi Publishing Corporation
ISRN Nursing
Volume 2013, Article ID 916061, 12 pages
http://dx.doi.org/10.1155/2013/916061
Research Article
Young Registered Nurses’ Intention to Leave the Profession and
Professional Turnover in Early Career: A Qualitative Case Study
Mervi Flinkman,
1
Ulpukka Isopahkala-Bouret,
2
and Sanna Salanterä
1,3
1
Department of Nursing Science, University of Turku, 20014 Turku, Finland
2
Faculty of Behavioural Sciences, University of Helsinki, P.O. Box 9, 00014 Helsinki, Finland
3
Hospital District of Southwest Finland, Bureau of Administration, Turku University Hospital, P.O. Box 52, 20521 Turku, Finland
Correspondence should be addressed to Mervi Flinkman; mervi.linkman@utu.i
Received 8 June 2013; Accepted 9 July 2013
Academic Editors: S. Keeney and J. Scholes
Copyright © 2013 Mervi Flinkman et al. his is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
In a time of global nursing shortages an alarming number of young registered nurses have expressed a willingness to leave the
profession. In this qualitative case study we investigate in depth why young nurses leave nursing profession and reeducate themselves
for a new career. he study is based on longitudinal interviews of three young registered nurses in Finland. hese nurses were irst
interviewed between December 2006 and May 2007, when they were 29–32 years old and having an intention to leave the profession.
he second interview took place four years later, from January 2011 to March 2011 when all of them had made the transition to a
new career. Data were analyzed in two stages. In the irst stage, comprehensive career story narratives were formed on the basis of
the interviews. In the second stage, emerging themes in these stories were compared, contrasted, and interpreted in the context of
the overall career histories. Nursing as a second career choice and demanding work content as well as poor practice environment
and the inability to identify with the stereotypical images of nurses were main themes that emerged from these career stories. he
results of this interpretative qualitative study relect a shit toward insights into understanding professional turnover as a complex
and long-lasting process.
1. Introduction
Nurses are the largest group of professionals within the
global health care system, with a total of 19.3 million nursing
and midwifery personnel in the world [1]. he current and
growing shortage of registered nurses (RNs) in health care
systems is thus a global concern [2, 3]. In fact, the European
Commission has estimated that there will be a shortage of
590,000 nurses by the year 2020 [4]. In the United States,
employment of RNs is expected to grow faster than the
expected average for all occupations [5]. Most countries
within the Organization for Economic Cooperation and
Development (OECD) have reported a nursing shortage [6],
which is predicted to get worse because the current nursing
population is aging [7]. his shortage of RNs inluences
the delivery of health care and negatively afects patient
outcomes; an insuicient nurse staing level is associated
with negative patient outcomes [8, 9] and decreased nurse job
satisfaction [10].
At the same time of this global nursing shortage, many
nurses are considering leaving their job, profession or are
out of the nursing workforce. According to Flinkman et al.
[11] literature review, nurses’ intention to leave the profession
varied from 4% up to 54% across the studies internationally.
In a NEXT (nurses early exit) study, conducted in ten
European countries ( = 30,330), 13% of nurses had thought
about leaving the profession frequently [12]. According to an
RN4CAST (nurse forecasting in Europe) study ( = 33,659
nurses/Europe; 27,509 nurses/United States), the proportion
of nurses planning to leave their current job ranged from 49%
(Finland, Greece) to 14% (United States) [13]. In European
sample of this study, every tenth (9%) of nurses was having
intention to leave the profession [14]. Furthermore, in Salmi-
nen [15] study, nearly half (37%, = 343) of young RNs
(under 35 years) working in hospitals have reported frequent
intention to leave the profession in Finland. In Sweden, 10–
20% of new graduates have considered leaving the profession
[16]. In the United States, it was reported that the percentage