Stress, Transition-to-Practice, Burnout, and Turnover Intention in Early-Career Nursing (1981-2025): A Bibliometric...

Stress during training, transition-to-practice strain, burnout, and turnover intention are recurring early-career nursing concerns and can be viewed in occupational safety and health terms as work-related psychosocial hazards.

Web of Science records (1970-31 Aug 2025) were screened, yielding 664 eligible articles (earliest eligible year: 1981). Using VOSviewer (version 1.6.20; Centre for Science and Technology Studies [CWTS], Leiden University, Leiden, the Netherlands) and Biblioshiny (version 5.0; web interface of bibliometrix, developed by Massimo Aria and Corrado Cuccurullo, University of Naples Federico II, Naples, Italy), we mapped the intellectual base via cocitation (minimum cocitation = 12), themes via coword analysis (minimum occurrence = 15; thesaurus-cleaned keywords), and change over time via thematic evolution (1981-1999, 2000-2009, 2010-2019, and 2020-2025).

Five cocitation clusters centered on transition theory, stress/coping, burnout measurement, resilience, and organizational determinants of retention. Coword mapping yielded four thematic clusters spanning transition supports, student stress/mental health, early-career burnout/turnover intention, and well-being/self-efficacy interventions. The literature frequently links stress, transition-to-practice strain, burnout, and turnover intention; when these constructs are framed in a sequential narrative, we interpret this as thematic convergence rather than evidence of a causal or developmental mechanism. Retention was often operationalized via intention rather than observed turnover.

The mapped literature depicts an interconnected psychosocial hazard domain linking education and early practice to retention-risk signals with implications for staffing stability, patient safety, and safety culture. We propose a three-pillar heuristic synthesis: structured residency/preceptorship with protected preceptor time, longitudinal screening using validated stress/burnout tools, and psychologically safe leadership. This framework is an interpretive synthesis informed by mapped themes and central empirical literature, not a validated intervention model and not a direct algorithmic output of the clustering procedure.