Why 33% of New Nurses Leave Their First Job — and How to Make Sure You’re Not One of Them
The Reality No One Tells You About Your First Nursing Job
If you’re a new nurse who’s ever thought, “I can’t do this anymore,” you’re not alone.
According to the American Nurses Association, 33.7% of new graduate nurses leave their first job within the first year and nearly one in five leave nursing altogether.
Let that sink in.
These are nurses who spent years working toward their dream, only to feel disillusioned and exhausted within months of starting their career.
As a nurse of more than a decade and a clinical instructor who now coaches new grads, I see this every single day. Nurses enter the profession full of compassion and motivation, only to be met with unsafe staffing, burnout, and unrealistic expectations. So today, let’s talk about why this is happening and, more importantly, what you can do to protect your career, your mindset, and your passion for nursing.
The Numbers Don’t Lie
Let’s start with the data.
In addition to the ANA’s findings, the 2022 NSI National Health Care Retention Report reported a 31.7% turnover rate among novice RNs, and a 2023 study from the American Nurses Foundation and McKinsey found that nearly 4 in 10 nurses planned to leave their role within six months.
Some of these nurses simply transfer to other units, but many leave the bedside entirely or the profession altogether.
So what’s going wrong in a field that’s supposed to be built on compassion, service, and teamwork?
Nursing School vs. Real Life: A Harsh Reality Check
As a clinical instructor, I see firsthand how different nursing school is from actual bedside practice. In lab, we teach skills with care and repetition but then we have to say things like, “In the real world, you’ll have five patients, not one.”
Hospitals have also become more restrictive about what nursing students can do in clinicals because of liability.
The result?
Many new grads graduate having learned the theory, but without the hands-on experience. When they start their first jobs, they’re suddenly performing complex procedures for the first time on real patients, under real pressure.
No wonder so many feel unprepared and overwhelmed.
The 2 Main Causes of New Nurse Turnover
There are two categories of reasons behind high turnover: systemic factors and emotional factors.
Systemic Factors
Unsafe staffing ratios
Short or inconsistent orientation periods
Preceptors who are burned out
Unrealistic productivity expectations
2. Emotional Factors
Compassion fatigue
Feeling undervalued or unsupported
Constant short staffing
Lack of work-life balance
In that same McKinsey survey, nurses said their top reasons for leaving were:
“Not feeling valued by my organization,” “Insufficient staffing,” and “Inadequate compensation.”
But underneath all that is something deeper… disconnection.
Many new nurses tell me, “I thought this would feel different.” They envisioned mentorship, teamwork, and meaningful patient connections. Instead, they find exhaustion and isolation.
Let me be clear: You are not the problem. The system is.
The Hidden Cost of Unsafe Ratios
When I started as a new grad on a med-surg unit 13 years ago, I typically had four to five patients during the day. It was busy but manageable I could learn, grow, and still deliver safe care.
Then my hospital brought in a financial consulting firm to “improve efficiency.” Suddenly, staffing grids changed, and my patient load jumped to five or six.
On paper, it didn’t seem like a big difference. In reality? It changed everything.
Those “breather” days when the unit was fully staffed disappeared. Every shift became a race against the clock, and the human connection that makes nursing meaningful began to fade.
I’ve asked countless nurses what they’d change about their jobs, and the answer is almost always the same:
“It’s not the pay - it’s the ratios.”
When the workload becomes unsustainable, even the most passionate nurse eventually runs out of energy to give.
The Ripple Effect of Nurse Turnover
High turnover doesn’t just affect the nurses who leave, it impacts everyone.
Replacing one bedside nurse costs hospitals $50,000 to $80,000. That’s not just a financial burden, it’s a ripple effect that stretches remaining staff thin, damages morale, and puts patient safety at risk.
Seasoned nurses feel this strain the most. They’re juggling full patient assignments and precepting new staff, often without any added compensation. It’s no wonder burnout spreads.
This environment breeds resentment not because nurses don’t care, but because they’re exhausted. I’ve heard experienced nurses say, “New grads always leave after a year.” But the truth is, no one wants to stay in a system that sets them up to fail.
My Story: When “Success” Felt Like a Prison
A few years ago, I was managing one of the busiest units in my hospital. On paper, it looked perfect: I had earned my MSN in Nursing Leadership and Management, had weekends off with my kids, and made the best salary of my career.
But inside, I felt trapped. My days were spent behind a desk doing administrative work instead of mentoring my team. I was being called nights and weekends over staffing issues. I was constantly running from meetings to daycare to appointments and my stress levels were sky-high.
I wasn’t the nurse, leader, or mom I wanted to be.
When I finally resigned, it broke my heart. My staff understood, but their comments stuck with me:
“Don’t feel bad, everyone leaves this role.”
That sentence said everything. The system wasn’t designed to support sustainable leadership or sustainable nursing.
Leaving that role was one of the hardest decisions of my life, but it was also the healthiest. It’s what ultimately led me to create The New Nurse Society, so I could help other nurses find joy and alignment in their careers.
What Hospitals Should Be Doing
High new nurse turnover isn’t inevitable. Hospitals can fix this… but it requires commitment, investment, and a culture shift.
Here’s where change needs to start:
✅ Structured Nurse Residency Programs that go beyond clinical skills and build emotional resilience.
✅ Preceptor Training that focuses on mentorship, not just oversight.
✅ Safe Staffing Ratios that protect both patients and nurses.
✅ Access to Mental Health Support and peer mentoring programs.
Until hospitals make these changes, the responsibility falls on individual nurses to protect their own well-being and growth which brings me to my next point.
What You Can Do to Protect Your Nursing Career
I tell every new nurse I mentor: your goal in that first year is simple make it to one year.
One full year of bedside experience is a game-changer. After that, you’ll have options. But during that year, you need strategies to protect your peace and your passion.
Here are my top tips for surviving (and thriving) in your first year as a nurse:
1. Find Your People
Surround yourself with supportive nurses. If you can’t find that on your unit, join communities like The New Nurse Society, where new grads connect and grow together.
2. Set Boundaries Early
Don’t pick up every extra shift. Don’t answer work calls on your days off. You can’t pour from an empty cup.
3. Advocate for Yourself
If your assignment is unsafe, speak up. You deserve a safe work environment — and your patients do too.
4. Prioritize Your Well-Being
Make time for rest, movement, and hobbies. Your mental health is just as important as your license.
5. Invest in Your Growth
Review clinical skills, take workshops, or work with a nurse coach. The faster you build competence, the more confident and empowered you’ll feel.
6. Work on Your Mindset
Try Mel Robbins’ “Let Them” theory, a reminder that other people’s behavior isn’t your responsibility. Let them gossip. Let them complain. You stay focused on your growth.
A Message to Every New Nurse Thinking About Leaving
If you’ve been questioning whether you belong in nursing hear me when I say this:
You are not broken.
You are not a failure.
You are human.
Sometimes the healthiest decision is to walk away from an environment that’s breaking you. But before you do, make sure you’ve explored every way to make it work because once you hit that one-year mark, a whole new world of opportunities opens up.
Your nursing license should be a key to opportunity, not a source of burnout.
The Future of Nursing Belongs to You
My dream is that nurses continue to walk away from toxic workplaces not from the profession itself. Because the more we advocate for ourselves, the more pressure hospitals will feel to change.
Change is coming… slowly, but surely and I believe the next generation of nurses will lead the way.
So if you’re struggling right now, I want you to know: you’re not alone. You’re part of a growing movement of nurses demanding better.
And in the meantime, I’m here to support you.
Join us inside The New Nurse Society, where we’re having real conversations about burnout, mindset, and career growth.
Because you deserve a nursing career that lights you up, not one that drains you.
Final Thoughts
If this resonated with you, share it with a fellow nurse who needs to hear it. And remember:
You can leave toxic environments.
You can rebuild your confidence.
And you can create a nursing career that actually fits your life.
If this resonated with you, take a second to check out the full podcast episode.
And - as always, I’ve got one hand for me… and the other for you.
Until next time,
Caroline
PS. Want more on this topic? Listen to Life After Nursing School Episode 38