The healthcare industry has not been immune to the Great Resignation. In fact, very few industries have been hit harder by such high employee attrition. According to several studies, the industry has lost an estimated 20% of its workforce, including 30% of its nurses. Another national report on nurse retention indicates that this nurse labor shortage will only intensify over the next several months.
This nursing shortage is nothing new to healthcare, but it has been accelerated by the pandemic. Over the past two years, McKinsey has found that nurses consistently, and increasingly, report planning to leave the workforce at higher rates compared with the past decade. By 2025, they project that the United States may have a gap of between 200,000 to 450,000 nurses available for direct patient care.
Along with high turnover, we’ve seen countless strikes and tense negotiations from nurses across the country. According to the BLS, nurses led a quarter of the top 20 major work stoppages in 2022. In January 2023, more than 7,000 union nurses went on strike in New York City over concerns about understaffing and patient care at several of the city’s major hospitals—issues that can also be seen on a national level.
“Since the pandemic, mounting pressure has led millions of nurses to reevaluate their careers and their expectations of their employers,” says Katie Niekrash, Senior Vice President of Tandym Health. “Many of the workplace challenges nurses are experiencing pre-date COVID-19, but the crisis has pushed them to the brink. They are saying ‘enough is enough’ and want to see meaningful change.”
Why are nurses quitting in droves?
The factors behind healthcare’s Great Resignation and challenges with nurse retention are not a secret. In surveys and reports from healthcare employees and healthcare leaders, many common trends come up:
- Staffing shortages
- Inability to provide safe patient care
- Anxiety or depression caused by COVID-19 trauma
As the ramifications of these systemic issues come to a head, many hospitals and health systems have found themselves paying top dollar in an effort to attract and retain clinicians. According to Kauffman Hall, labor expenses at American hospitals and health systems rose 37% per patient between 2019 and March 2022.
Combatting the issue + improving nurse retention
While fair and competitive compensation is a critical part of any talent strategy, it isn’t the only factor that matters for nurse retention.
“While it’s very important to pay your staff an equitable and fair salary, it’s not necessarily a catch-all solution for nurse retention. It’s just important to focus on providing a positive workplace experience. Nurses are quitting and striking because they do not feel valued or heard. If you look at the top drivers of nurse attrition, many of them are related to their workplace environment. Ask yourself. Are there any steps your organization can take to help make improvements?”
While hospitals and healthcare facilities face many systemic challenges that make driving change feel nearly impossible, we’ve reached a critical point where current nursing shortages threaten care quality, patient outcomes, and our healthcare system as a whole. Now is the time to start considering what steps—even if they are small—we can start taking to fill staffing gaps and better support clinicians.
Depending on what is feasible for your facility, here are some strategies you may want to consider to help combat the shortage and improve nurse retention.
Recruit with intention
Whether you are looking for a direct hire or a contract nurse, you should approach the recruiting process with intention. “While it’s important to act fast if you see a great candidate, you also need to do your due diligence to ensure they are the right fit for the role and they feel set up for success from the get-go,” advises Amanda Cruse, Senior Managing Director of Tandym Health. “Nurse retention starts on day one. The less surprises there are on the job, the better.”
To recruit with intention, make sure you:
- Screen for essential traits (active listening, critical thinking, time management, etc.)
- Show them the work environment
- Be upfront about the job requirements and expectations
Be open to (and nurture) less experienced nurses
This may not be feasible for every role, but try to be more flexible with experience requirements when you can. For example, being open to a candidate with one year of experience vs. two, can open up a larger candidate pool. Hiring newer nurses while you have more experienced nurses on staff can also help you with succession planning.
“Some organizations are taking this a step further by establishing nurse residency programs,” says Katie. “If you have the proper resources and support structure, these programs can be a great way to meet the needs of the organization and improve nurse retention, while providing invaluable training and experience to newer nursing grads.”
Allow scheduling flexibility
With burnout being a top concern for nurses, many of them are looking for opportunities to improve their work-life balance. As a result, finding a more flexible setting or leaving direct patient care altogether is a common job search goal. Hospitals and other major healthcare systems can help offset this trend and improve nurse retention by allowing for more scheduling flexibility.
“The norm is typically 3-12s in hospitals, but we’re seeing many nurses push back and hold out for opportunities that allow them to work less than that or to have more flexibility in their schedules,” says Katie. “While it may be challenging to balance different scheduling options, including part-time shifts and per diem coverage, doing so can give you access to a larger talent pool and improve nurse retention. It can also go a long way in attracting and retaining more experienced nurses who are considering retirement.”
Assess your tech stack
To keep the ship afloat, nurses must navigate many administrative processes or monotonous tasks that can often feel burdensome. To help them practice at the top of their license and keep their focus on patient care, consider your current tech stack and where there is room for further investment. Some examples include:
- Point-of-care technology
- Smart phones
- Electric lift systems and smart beds
- Portable diagnostics
- Scheduling applications + software
Promote career + salary growth
Ensure your nurses can see a clear path to advancement, and are rewarded for their value. As a start (if you haven’t already), outline a career ladder for your nurses (i.e. Level 1, Level 2, Level 3, etc.)—and make the expectations and requirements for each level clear. Additionally, regular raises to recognize hard work and reflect market value are key to nurse retention.
Additional incentives you can offer to foster career growth include:
- Tuition assistance or reimbursement
- Sending nurses to conferences + industry events
- Offering continuing education
- Providing internal training
Re-activate retirees with flexible jobs
Creating flexible jobs is an out-of-the-box, but effective way to improve nurse retention. “Many nurses are retiring due to burnout, but would be willing to return to work on their own terms,” says Katie. “Think about your staffing gaps across all nurse levels, and where it would make sense to create some new part-time or flexible positions.” Some examples include:
- Nurse educators / preceptors
- Floating patient safety nurses
- Specialist or mentorship roles
Utilize a healthcare recruiting partner
Whether you have a hard-to-fill opening, a highly specialized need, or a large volume project, collaborating with a healthcare recruiting partner can be a strategic move. With access to a pipeline of qualified candidates, unique market insight, and other hiring resources, they can efficiently connect you with the right talent.
At the same time, you may also want to consider contract hiring strategy. As you struggle with nurse retention and staff burnout, hiring a contractor or locums tenens practitioner can help you mitigate staff burden and provide continuity of care.