Early-career registered nurses’ work experience and nurse outcomes in South African hospitals: a cross-sectional survey

BMC Nurs. 2025 May 13;24(1):523. doi: 10.1186/s12912-025-03188-5.

ABSTRACT

BACKGROUND: Early-career registered nurses within their first five years of practice, experience the highest turnover rates in the nursing profession, with 20 to 40% leaving their jobs within the first two years. These high turnover rates are due to poor nurse outcomes. Despite growing global research on ECRNs, limited evidence exists within the South African context. This study aimed to examine the nurse outcomes of ECRNs in both private and public hospitals of South Africa and to explore the association between their work experience and these outcomes.

METHODS: Total population sampling was used to recruit ECRNs in private and public hospitals of South Africa. The cross-sectional survey instrument measured job and career satisfaction, workplace violence, emotional exhaustion (burnout), and intent to leave job and career. Descriptive statistics and ANOVA-type hierarchical linear modelling were used to present the differences in ECRNs’ work experience and their nurse outcomes.

RESULTS: Dissatisfaction rates among ECRNs were notable, with 34.9% dissatisfied with their jobs and 23.1% dissatisfied with their career choice. Workplace violence, including personal (M = 1.60; SD = 0.78) and physical (M = 1.44; SD 0.73) violence, was reported, primarily from managers and supervisors. Emotional exhaustion was prevalent (M = 30.85; SD = 14.62), with 38.9% of the respondents intending to leave their job and 14.5% considering leaving the profession. NGs experienced more workplace violence and were least satisfied with professional status and advancement opportunities, although most satisfied with their co-workers. First-year ECRNs were most satisfied with independence and recognition, while fifth-year ECRNs were least dissatisfied with educational opportunities. Private sector ECRNs reported higher job satisfaction, work-life balance, salary, recognition, educational opportunities, work schedule, and advancement prospects than those in the public sector.

CONCLUSION: The study highlighted poor nurse outcomes among ECRNs, especially regarding emotional exhaustion, job satisfaction, and intent to leave. NGs face significant workplace violence and dissatisfaction with advancement opportunities. Urgent interventions are needed, such as transition-to-practice programmes with mentors, fostering positive work environments, and supportive leadership, to enhance ECRNs’ quality of work life and reduce attrition rates in South Africa’s health sector.

PMID:40361103 | DOI:10.1186/s12912-025-03188-5