New nurse workplace adaptation: a Walker and Avant concept analysis

Abstract

Introduction: High turnover among new nurses critically threatens the stability of the global healthcare workforce. While existing theories explain why new nurses struggle, they fail to clarify how new nurses successfully adapt. This gap shifts the focus to the individual-driven process of workplace adaptation, a key factor in retention. However, the core concept of workplace adaptation itself remains ambiguous and is often conflated with top-down organizational socialization. Without a clear and consistent definition, progress in understanding and facilitating this critical process is severely limited. Accordingly, this study aims to systematically clarify the concept of new nurse workplace adaptation. Methods: Concept analysis was conducted using Walker and Avant’s eight-step method. A systematic search of CNKI, Wanfang Data, CQVIP, CBM, CiNii, PubMed, Web of Science, CINAHL, Embase, and PsycINFO was conducted from their inception to June 1, 2025. Results: The attributes of new nurse workplace adaptation were identified as continuous dynamic adjustment, achievement of internal–external equilibrium, and integration into team collaboration. Antecedents include sociodemographic factors, individual intrinsic adaptation capital, and organizational socialization strategies. Consequences encompass promotion of personal career development, optimization of nursing service quality, and stabilization of team organizational structure. Discussion: This concept analysis clarifies new nurse workplace adaptation as an integrated, individual-driven process, distinct from top-down organizational socialization. This distinction is critical as it reveals the overlooked phenomenon of “sacrificial adaptation”—a state where a nurse compromises internal well-being for superficial integration. The identification of this phenomenon exposes a fundamental flaw in management strategies that prioritize behavioral compliance over authentic well-being. This ultimately points to the necessity of a paradigm shift: from enforcing conformity to cultivating supportive environments where genuine adaptation can thrive.