Job demands, resources, mental health, and intention to leave among early-career nurses: A cross-sectional study

The COVID-19 pandemic has intensified global nursing shortages, increasing the importance of retaining early career nurses (those with <5 years since initial licensure) in the profession. Understanding the mechanisms by which job demands and resources influence nurses' mental health and career intentions is critical to improving retention. As such, McGonagle's model of perceived work ability guided the design of this study.

This study aimed to examine the effects of job demands and resources, mental health, and perceived work ability on the career intentions of early career hospital-based registered nurses in the U.S. and to identify differences between nurses with 0-2 years and 3-5 years of professional experience.

Cross-sectional survey study. A total of 772 early career registered nurses employed in direct care hospital positions across four U.S. states completed an online survey via Qualtrics.

Data were collected on demographics, job characteristics, mental health (burnout, psychological distress, well-being), perceived work ability, job demands and resources, and career intentions. T-tests and multivariable linear regression analyses were conducted to compare predictors of mental health, perceived work ability, and intent to leave the hospital setting and nursing profession between the two subgroups.

Participants reported high psychological and emotional job demands, with 69% reporting moderate to high burnout and 43% at risk for a moderate or severe mental disorder. Burnout and lower perceived work ability were the strongest predictors of intent to leave the hospital and the profession in early career nurses. Emotional and psychological demands were the primary predictors of burnout and psychological distress. Colleague support was protective for mental health and work ability. For nurses within their first two years of practice, supervisor support and workplace safety climate were particularly salient, while for those in years 3-5, exposure to bullying and working in a Magnet hospital influenced career intentions.

The findings support a conceptual model wherein high job demands and insufficient resources negatively affect mental health, which in turn reduces perceived work ability and increases intent to leave the hospital or profession. Tailored strategies are needed to mitigate emotional and psychological demands and to bolster workplace support and safety during the first five years of nursing practice.