How did Covid-19 impact nurse turnover—and what steps should executives take to stabilize the workforce in the long-term? We know that nursing shortages are top of mind right now for health system executives, and while definitive projections of national nursing supply are still yet to come, there is one variable that leaders can use right now to gauge the stability of their frontline workforce: turnover.
With an uptick in travel nursing demand, early retirements, high sign-on bonuses, and bedside RN burnout, 2020 had no shortage of workforce challenges. And according to the Advisory Board’s annual survey of over 200 health systems, average bedside RN turnover in 2020 rose to an all-time high of 18.6%. This jump, up nearly 2% from 2019, also represented the largest annual increase in seven years.
While RN turnover rose across the board, certain segments of the workforce were hit harder than others.
While alarming, this spike in turnover belies an even more insidious problem: rising instability in the nursing workforce over the past decade. Turnover rose for six years preceding the pandemic, from 13.5% in 2013 to 16.7% in 2019. So even as the pandemic wanes, leaders should expect even more acceleration in turnover for two reasons:
A 2021 survey of nurses indicates that 22% of nurses intend to leave their jobs within the next year. The top reasons nurses cited for their intention to leave were related to long-term challenges within the work environment, including the following:
With the highest Covid-19 peaks behind most United States communities, frontline nurses now have the breathing room to reevaluate their employment and seek new jobs. Combined with a tighter labor market, skyrocketing sign-on bonuses, and fierce recruitment tactics, nurses that are feeling disengaged or ambivalent in their current roles now have powerful motivation to leave.
Employers looking to stabilize their workforce—both in the short-term and long-term—will need to move beyond sign-on bonuses to addressing those structural issues, including the following:
Here’s the bottom line: Covid-19 exacerbated the workforce crisis, but historical turnover indicates that there were pre-pandemic underlying issues that contributed to the decade-long trend of rising RN turnover. This instability will not improve unless health systems address the structural challenges at the heart of RN disengagement.
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