The nursing shortage raises an important question long before a graduate begins their first shift: how effectively does nursing education connect with the support provided in clinical settings? The National Council of State Boards of Nursing reported in 2025 that 39.9% of U.S. registered nurses surveyed intended to leave the profession within five years of practice. Improving the transition from nursing student to practicing professional should therefore be part of the broader effort to retain staff.
This figure reflects intentions across the nursing workforce, including both recent graduates and experienced professionals. However, the pressures behind those decisions are also relevant to the workplaces new graduates are entering. Among nurses considering leaving for reasons other than retirement, stress, burnout, workload and understaffing were identified as key factors. These findings indicate that recruitment alone is not enough to address the conditions that influence whether nurses remain in the profession.
Research into the early stages of nursing practice also highlights the importance of connection and support. A 2025 systematic review examining peer support for newly qualified nurses considered nine studies and found benefits linked to shared experiences, emotional connection and collaborative learning. The authors concluded that introducing structured peer support into graduate transition programs may help strengthen emotional resilience and improve retention.
Similarly, a 2026 review in BMC Nursing, which examined 31 studies across 10 countries, identified potential advantages associated with structured clinical education and support. However, it also highlighted a significant challenge: staffing pressures can leave limited time for graduates to participate in educational activities. Effective support therefore requires more than a well-designed orientation program. It also depends on manageable workloads and protected time for learning.
For Jennifer Johnson, an emergency nurse and founder of NurseAssure, an initiative dedicated to supporting early-career nurses, these issues reflect a challenging transition between education and employment. She believes nursing schools work hard to establish the clinical foundations students need, but employers also have a responsibility to help graduates build confidence in applying those skills. Her concern lies in the gap between these two stages, where newly licensed nurses can find themselves feeling overwhelmed.
Johnson draws on her own experience to illustrate the importance of continued learning after graduation. “When I graduated, my employer provided training in inserting intravenous lines,” she says. “That experience showed me the value of supervised practice in building skills after graduation.”
However, the transition involves much more than developing technical abilities. In Johnson’s experience, emergency nursing requires professionals to care for frightened patients, communicate with distressed family members and respond to situations involving grief. Developing the confidence and communication skills needed to handle these moments takes time. “There’s a finesse to nursing that takes time to teach and to learn,” she says. “I believe preparation should give these interpersonal demands more attention.”
Her suggested approach includes extending orientation periods when necessary, providing practical crisis-intervention training and offering greater support to experienced nurses responsible for mentoring new colleagues. Johnson believes mentoring requires considerable time and commitment. When these responsibilities are added to an already demanding workload, providing graduates with consistent guidance can become difficult for both the mentor and the new nurse.
Johnson also says she is undertaking an international study to gain a better understanding of why newly qualified nurses leave the profession. The ongoing research examines graduates’ workplace experiences, expectations and access to support, with the intention of identifying the challenges that have the greatest influence on their decisions to leave nursing.
Her book, Nursing Intuition, also draws on reflection, including her experiences of working during the pandemic. Johnson believes nurses should be encouraged to recognize their development, including achievements that are not always easy to quantify. Offering comfort to a family or gaining the confidence to raise a concern can be meaningful milestones in a nurse’s professional growth.
Through her journal and NurseAssure program, Johnson aims to extend this approach by encouraging reflection and providing access to mentoring. She emphasizes the importance of creating opportunities for nurses to discuss difficult shifts, acknowledge uncertainty and speak openly about their experiences. These conversations can also help educators recognize where additional training may be needed, allowing individual concerns to inform practical improvements in workplace support.
For Johnson, support should not stop once a nurse completes their initial orientation. It should be available from the moment they enter the profession and continue throughout their careers. Nurses who care for patients and support families also need opportunities to process the emotional demands of their work.
“Nurses need to know their well-being matters and that they can speak openly about the challenges they face,” she says. “That support should be part of their working lives from the beginning.”
