The short version: Aged care is often a graduate nurse’s first job and, too often, one of their shortest. Almost 10,000 nurses and care workers left residential aged care in a single quarter in 2023. The reasons are specific enough to act on.
Every aged care operator has a version of the same story: a promising graduate nurse starts full of energy, and within eight or nine months they have moved to a hospital, another sector entirely, or out of nursing altogether. This is not simply a perception problem. National data shows almost 10,000 nurses and care workers left residential aged care between July and September 2023 alone, and research into early career nurses consistently points to the same handful of causes.
Why the first year is different for a graduate nurse
A prospective cohort study of Australian early career registered nurses found that feelings of uncertainty and isolation are common in the first year, and that these feelings, not pay, were the strongest predictors of whether a nurse intended to stay. Aged care compounds this in a specific way: a graduate nurse is often the only registered nurse on shift far sooner than they would be in a hospital, with less senior support to lean on and less structured supervision built into the roster.
The cost of this is rarely calculated properly. Replacing a registered nurse involves recruitment fees, weeks or months of agency cover at a premium rate, and the lost productivity of a facility running short-staffed while a new hire is found and inducted. A graduate who leaves after eight months has usually cost the facility more in total than it would have cost to run a proper mentoring program for the whole first year. Framed as a retention cost rather than a training expense, the maths tends to look very different in a board or management meeting.
What predicts a graduate nurse staying
| Factor | Effect on retention |
|---|---|
| Structured mentoring in the first six months | Consistently associated with lower early attrition in the research |
| Being rostered solo as the only RN too early | Strongly linked to feelings of isolation and burnout |
| Clear escalation pathway for clinical uncertainty | Reduces the anxiety that drives early exits |
| Workload matched to experience | High workload is cited by nearly forty per cent of aged care staff as a reason nurses leave or avoid the sector |
It is also worth separating this from the broader burnout conversation that gets more attention. Burnout tends to describe experienced staff wearing down over years; the graduate retention gap is a different, earlier problem, often resolved or lost within the first twelve months, before burnout has had time to set in at all. Treating the two as the same issue leads facilities to apply burnout solutions, wellbeing days, flexible rosters, to a problem that is really about structured support and clinical confidence in the first instance.
What Tasmanian operators can change
- Build a genuine, rostered mentoring period, not a one-day induction, for the first three to six months of any graduate’s employment.
- Avoid rostering a graduate as the sole registered nurse on shift until they have had real exposure to the facility’s specific clinical escalation pathway.
- Give graduates a named senior nurse they can call, not just a generic on-call number, particularly on night shifts.
- Ask leaving graduates directly what would have kept them, and track the answers over time rather than treating each exit interview as a one-off.
A graduate who feels supported for six months will usually give you several years back. One who feels alone for six weeks rarely gives you six months.
None of this requires new funding, mostly it requires deciding that a graduate’s first year is a genuine investment period rather than a rostering problem to solve as cheaply as possible. Smaller Tasmanian facilities are often better placed to do this properly than larger providers, simply because a graduate nurse is more visible and less likely to be lost in a big roster.
The mentoring itself does not need to be elaborate. A weekly, protected half-hour check-in with a senior nurse, a clear document setting out who to call for what kind of clinical question, and an honest conversation in week one about what the role will actually involve day to day, all cost very little and address the exact isolation the research keeps flagging. The facilities getting this right tend to describe it less as a program and more as simply making sure someone new is never quietly struggling alone.
If building a stronger graduate program, or finding the right nurses to fill your roster in the first place, is something your facility is working through, Community Health Connect works with Tasmanian aged care providers on both.
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