Where are all the graduates? A systematic scoping review findings

Introduction/Purpose: The turnover rate of newcomers to nursing and midwifery is higher than in later years of practice, contributing to the worldwide nurse and midwife shortages. Individual and environmental factors, often in combination, contribute to attrition. Studies demonstrate the associations of factors with turnover or intention to stay. However, the scope of these factors has not been explored. The purpose of this literature review was to identify and map the individual and environmental factors that influence nurses and midwives to stay in or leave their respective disciplines within the first three years of graduate practice. 

Methods: The JBI method for scoping reviews was followed. A search strategy was developed, and peer reviewed by the PRESS Forum before being adapted and translated across databases on various platforms. 

Quantitative and qualitative studies, systematic reviews, text and opinion pieces that explored individual or environmental factors that influence the decisions to leave or remain in nursing and midwifery were considered. Articles must have been peer-reviewed and/or written by a person of standing in the field since 1974 and published in English. Titles and abstracts were independently screened by two reviewers, with potentially relevant papers retrieved for detailed assessment. The results of the search will be presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram. 

Results: Fourteen articles were included in the review. Extracted data has been synthesized, and we will present a mind map demonstrating the individual and environmental factors that influence the longevity of newcomers to nursing and midwifery. Our findings are informing a future study to understand the characteristics of newcomers who stay in nursing and midwifery, natural and induced attrition during the first three years of practice, and any differences within and between nurses and midwives, to identify vulnerable groups and context specific factors.