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ORIGINAL RESEARCH Novice nurse practitioner workforce transition and turnover intention in primary care Asefeh Faraz, PhD, APRN, FNP-BC Yale University School of Nursing, West Haven, Connecticut Keywords Novice; nurse practitioner; workforce transition; turnover intention; primary care; autonomy. Correspondence Asefeh Faraz, PhD, APRN, FNP-BC, Yale University School of Nursing, P.O. Box 27399, West Haven, CT 06516. Tel: 206-724-7795; E-mail: [email protected] Received: 12 November 2015; accepted: 5 April 2016 doi: 10.1002/2327-6924.12381 Abstract Purpose: Little is known about the workforce transition and turnover intention of novice nurse practitioners (NPs) in primary care (PC). This research aimed to describe the individual characteristics, role acquisition and job satisfaction of novice NPs, and identify factors associated with their successful transition and turnover intention in the first year of PC practice. Data sources: A descriptive, cross-sectional study was conducted via online survey administered to a national sample of 177 NPs who graduated from an accredited NP program and were practicing in a PC setting for 3–12 months. Conclusions: This study demonstrated that greater professional autonomy in the workplace is a critical factor in turnover intention in novice NPs in the PC setting. Implications for practice: Further research is needed regarding the novice NP workforce transition to provide adequate professional autonomy and support during this critical period. Introduction The United States is facing a large and growing shortage of primary care providers (PCPs). There is projected to be a deficit of 20,400 primary care (PC) physicians by 2020, while the demand for PC services is expected to grow by 81% because of population growth and aging (U.S. De- partment of Health and Human Services [HHS] Health Re- source and Services Administration [HRSA], 2013). Ensur- ing adequate access to health care is a major concern, as the demand for PCPs is expected to intensify. The projected PC physician shortage can be reduced to 6400 with effec- tive integration of nurse practitioners (NPs) and physician assistants (PAs; U.S. Department of HHS HRSA, 2013). NPs have demonstrated the ability to deliver high-quality, cost-effective health care with concomitant high patient satisfaction (Cassidy, 2013; Fairman, Rowe, Hassmiller, & Shalala, 2011; Newhouse et al., 2011). Furthermore, PC NPs are more likely to practice in underserved set- tings, caring for vulnerable populations and those insured under the Affordable Care Act (Buerhaus, DesRoches, Dittus, & Donelan, 2015). It is well recognized that NPs can play a vital role in meeting the increasing demand for quality PCPs, but what remains vastly unknown is what increases retention of NPs as direct care providers in PC settings. The transitional period between the educational and work environments seems to be particularly important to the retention of NPs (Bahouth & Esposito-Herr, 2009; Sar- gent & Olmedo, 2013; Sullivan-Bentz et al., 2010). Ac- cording to Flinter (2012), the discrepancy during the first year between PC physicians who have undergone a res-
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