Understanding inpatient nurse turnover among new graduates: A scoping review of factors impacting the first 2 years of practice

BACKGROUND: Turnover among new graduate nurses (NGNs) during the first 2 years of practice threatens workforce stability, patient safety, and organizational sustainability. Despite extensive research, early-career attrition remains high, with studies often examining contributing factors in isolation rather than as interconnected system-level influences. PURPOSE: This scoping review synthesized international literature on inpatient NGN turnover within the first 2 years of practice to identify overarching system-level patterns shaping early attrition. METHODS: Guided by Arksey and O'Malley's framework and Braun and Clarke's thematic analysis, a systematic search of four databases identified peer-reviewed studies published within the past 10 years. Sixty-five studies met inclusion criteria and were synthesized using an iterative analytic process. RESULTS: Sixty-five studies were included. Findings were grouped into five domains: Transition, Readiness, Identity, Development, and Environment. Across studies, turnover was associated with factors related to role transition, preparedness for practice, professional identity, psychological functioning and competence, and work environment conditions. Environmental factors were most frequently represented in the literature. DISCUSSION: These findings suggest that NGN turnover reflects disruptions across multiple domains rather than isolated factors. The STRIDE framework organizes these domains into a systems-level structure for understanding early-career turnover. CONCLUSIONS: This review advances the literature by reframing NGN turnover as a systems-level phenomenon rather than a collection of isolated contributors. The STRIDE framework provides an integrative structure for understanding how structural, organizational, and educational conditions interact to shape early-career retention. Addressing NGN turnover requires coordinated, multi-domain strategies that strengthen systemic support across transition, readiness, identity, development, and environment. STRIDE establishes a foundation for future research to examine pillar interactions, relative salience, and leverage points for workforce retention.