ORIGINAL RESEARCH Predictors of actual turnover in a national sample of newly licensed registered nurses employed in hospitals Carol S. Brewer, Christine T. Kovner, William Greene, Magdalene Tukov-Shuser & Maja Djukic Accepted for publication 26 April 2011 Correspondence to C.S. Brewer: e-mail: csbrewer@buffalo.edu Carol S. Brewer PhD RN FAAN Professor School of Nursing, University at Buffalo, New York, USA Christine T. Kovner PhD RN FAAN Professor College of Nursing, New York University, USA William Greene PhD Professor Henry Kaufman Management Center, Department of Economics, New York University, USA Magdalene Tukov-Shuser RN MSN MPH School of Nursing, University at Buffalo, New York, USA Maja Djukic PhD RN Assistant Professor College of Nursing, New York University, USA BREWER C.S., KOVNER C.T., GREENE W., TUKOV-SHUSER M. & DJUKIC M. BREWER C.S., KOVNER C.T., GREENE W., TUKOV-SHUSER M. & DJUKIC M. (2011) (2011) Predictors of actual turnover in a national sample of newly licensed reg- istered nurses employed in hospitals. Journal of Advanced Nursing 00(0), 000–000. doi: 10.1111/j.1365-2648.2011.05753.x Abstract Aim. This paper is a report of a study of factors that affect turnover of newly licensed registered nurses in United States hospitals. Background. There is a large body of research related to nursing retention; how- ever, there is little information specific to newly licensed registered nurse turnover. Incidence rates of turnover among new nurses are unknown because most turnover data are not from nationally representative samples of nurses. Method. This study used a longitudinal panel design to obtain data from 1653 registered nurses who were recently licensed by examination for the first time. We mailed surveys to a nationally representative sample of hospital registered nurses 1 year apart. The analytic sample consisted of 1653 nurses who responded to both survey mailings in January of 2006 and 2007. Results. Full-time employment and more sprains and strains (including back injuries) result in more turnover. Higher intent to stay and hours of voluntary overtime and more than one job for pay reduces turnover. When we omitted intent to stay from the probit model, less job satisfaction and organizational commitment led to more turnover, confirming their importance to turnover. Magnet Recognition Award Ò hospitals and several other work attributes had no effect on turnover. Conclusion. Turnover problems are complex, which means that there is no one solution to decreasing turnover. Multiple points of intervention exist. One specific approach that may improve turnover rates is hospital policies that reduce strains and sprains. Keywords: hospital injury, nurses, organizational commitment, registered nurse, nursing staff turnover, working conditions Introduction Understanding registered nurse (RN) organizational turnover is important because of the high cost of replacing RNs, resultant decreased productivity and turnover’s effect on patient care (Zimmerman et al. 2002, Gardner et al. 2007). We define organizational turnover as occurring when a nurse leaves an organization rather than the nursing position, profession or career, although definitions are varied (Romano 2002). Turnover costs are up to 1Æ3 times the annual salary of a Ó 2011 The Authors Journal of Advanced Nursing Ó 2011 Blackwell Publishing Ltd 1 JAN JOURNAL OF ADVANCED NURSING