Why New Nurses Decide to Leave: Qualitative Study Traces Gradual Exit

Newly graduated nurses who walked away from their first clinical jobs did not usually arrive at that decision overnight. According to a qualitative study published in BMC Nursing, the intention to resign appeared to build up slowly, within a wider process of disrupted professional adaptation, rather than in reaction to one dramatic event. The open-access article, published on 24 October 2026, offers a retrospective account of how early-career nurses moved from trying to fit in toward seeing fewer and fewer reasons to stay.

The study team, led by Zhaoning Xu and colleagues, recruited fifteen former newly graduated nurses using purposive sampling. Each participant had resigned from their initial clinical nursing position, and each was interviewed individually using a semi-structured format. The researchers then applied Braun and Clarke's thematic analysis, a qualitative method in which interview transcripts are coded and grouped into recurring themes.

Because the design was qualitative and descriptive, the findings describe patterns in these fifteen accounts rather than measuring how common any given experience is across the wider nursing workforce. A central pattern in the interviews was that turnover intention was not clearly formed when participants first entered clinical practice. Instead, their accounts reflected a gradual shift in orientation: from actively trying to adapt toward perceiving fewer reasons to remain.

The authors frame this as a cumulative process, one in which difficulties accumulated over time until leaving shifted from an occasional thought to a persistent consideration and, for some participants, an eventual decision. Participants generally entered the workplace expecting to be supported, guided, and gradually prepared for independent clinical practice. The reality they described diverged from that expectation in several specific ways.

Demanding workloads exposed the physical realities of the job. Assignment to clinical departments they had not preferred removed another layer of control over their early careers. Participants also reported difficulties translating theoretical knowledge into clinical action, a gap between classroom learning and bedside performance that their training had not fully prepared them to bridge.

The accounts point to the quality of early workplace support as a central contextual element in this process. When preceptorship support was difficult to access, participants described being left to navigate complex clinical situations alone. When asking questions felt unsafe, participants described holding back a basic learning behavior at exactly the stage when they needed guidance most.

When a sense of team belonging was lacking, the social environment that might have sustained them through a difficult transition was absent. Under these conditions, participants described increasing feelings of isolation and self-doubt alongside continuing difficulties in adaptation. In their accounts, the struggle to adapt made support needs more urgent, while the inaccessibility of support left those struggles unresolved.

As this continued, participants reported a diminishing sense of professional value and accumulating physical and emotional exhaustion, the experiences that most closely preceded the shift toward persistent thoughts of leaving. One of the more striking observations in the findings concerns what happened before resignation. For some participants, occasional thoughts of leaving became more persistent and were accompanied by psychological withdrawal before the eventual decision to leave.

In other words, the visible resignation may be the final step in a longer internal process that had already unfolded well before any formal notice was given. The authors conclude that, in this sample, turnover intention emerged cumulatively within the context of disrupted professional adaptation rather than in response to any single adverse experience. The study's scope and limitations matter for interpreting these conclusions.

The sample consisted of fifteen nurses who had already resigned, recruited purposively and interviewed retrospectively, so the accounts capture remembered experience rather than real-time observation, and recall may shape how participants reconstruct the sequence of events. As a qualitative descriptive study, it does not estimate turnover rates, test interventions, or establish causal effects between specific workplace conditions and resignation. Earlier research summarized in the article's background has largely explained turnover intention through factors such as work-related stress, burnout, the practice environment, and social support; this study adds a process-oriented perspective on how the intention forms over time from the vantage point of those who left.

Within those boundaries, the findings suggest that the early months of a nursing career are not merely a vulnerable period but an active formation stage, in which the accessibility and continuity of support may shape whether a new nurse stays long enough to become an independent professional.

Subject of Research: Turnover intention formation among newly graduated nurses who resigned from their initial clinical nursing positions

Article Title: Turnover intention formation among newly graduated nurses: a qualitative study from the retrospective perspectives of nurses who resigned from their initial clinical nursing positions

Article References: Xu, Z., Ni, Y., Song, D., & Wang, P. (2026). Turnover intention formation among newly graduated nurses: a qualitative study from the retrospective perspectives of nurses who resigned from their initial clinical nursing positions. BMC Nursing. https://doi.org/10.1186/s12912-026-05578-9

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05578-9

Keywords: newly graduated nurses, turnover intention, qualitative study, preceptorship, professional adaptation, nurse resignation, workplace support, semi-structured interviews, thematic analysis, nursing workforce, early-career nurses, BMC Nursing