Relationship between transition shock, resilience, career calling, and retention intention among new nurses: a moderated mediation model

Abstract

BACKGROUND: Nurse shortage has become an ongoing and urgent problem worldwide. The high turnover rate of new nurses, who are the primary backup personnel for the nursing force, exacerbates the possibility of this situation. Transition shock has been demonstrated to be critical in influencing new nurses' retention intention. However, the mechanisms underlying this impact remain unclear. OBJECTIVES: This study aims to explore transition shock's effect mechanism on retention intention among new nurses, and to clarify the career calling's mediating role and the resilience's moderating role in this relationship. METHODS: This is a multicenter cross-sectional study. From January 28 to February 20, 2024, an online questionnaire survey was administered among 739 new nurses from 11 hospitals in Shanxi Province, China, using convenience sampling. The survey included a demographic information questionnaire, the Transition Shock of Newly Graduated Nurses Scale, the Medical Staff Resilience Scale, the Career Calling Scale, and the Nurses' Intention to Stay Scale. The data were analyzed using descriptive analysis, Pearson correlation analysis, and the PROCESS Macro Model 4 and 7 for the regression. RESULTS: Transition shock was significantly negatively correlated with retention intention (p < 0.001). Career calling played a partial mediating role between transition shock and retention intention, accounting for 63.53% of the total effect. Further, resilience moderated transition shock's effect on career calling; thereby, a moderated mediation model was developed. CONCLUSIONS: Transition shock reduces retention intention by decreasing new nurses' levels of career calling, while resilience moderates this mechanism. Nursing managers can adopt measures to increase retention intention among new nurses by reducing their transition shock and enhancing their career calling education and resilience training. TRIAL AND PROTOCOL REGISTRATION: This study was registered with the Chinese Clinical Trial Registry ( http://www.chictr.org/cn/ ) under the following ID: ChiCTR2400080373.