Attrition from nursing programs is common, costly and burdensome to individuals, nursing faculties and the health care system. Increasingly, nursing faculties are requested to monitor attrition rates as a measure of performance, but little is known of the influence of career choice on program completion. The aim of this study was to assess the impact of nursing as a first choice for study on attrition in a baccalaureate nursing program. A longitudinal, cohort design was used in this study, which involved undergraduate nursing students enrolled at a university in Australia. Of the 357 participants who completed a baseline survey in 2004 at entry to their Bachelor of Nursing program, 352 were followed up over a six-year period to the end of 2009. Students who selected nursing as their first choice for study were nearly twice as likely (OR: 1.99 95% CI: 1.07–3.68) to complete their nursing program compared to those who did not. These students were also more likely to be older (mean age: 26.8 vs 20.1years, P<0.001), and employed in nursing-related work (35% vs 2%, P<0.001). In addition, the study revealed that male students (OR: 1.93 95% CI: 1.07–3.46) and those who worked more than 16h per week during semester (OR: 1.80 95% CI: 1.09–2.99) were less likely to complete than their counterparts. These data assist in generating realistic projections of completion and entry to the workforce. Understanding patterns of attrition and individuals' motivations to be a nurse is important not only for supporting nursing students to help them complete their studies but also for developing more targeted strategies directed toward student recruitment and retention.