Study details and key findings

For the study, researchers analyzed data from actively licensed RNs in New York and Illinois between April 13 and June 22, 2021. Overall, there were 7,887 nurses who recently ended their healthcare careers between 2018 and 2021. The respondents had an average of 30.8 years of experience.

The mean age of the respondents was 60.1 years, 93% were women, and 78% were white. Among the respondents, 694 were employed outside of healthcare, 2,287 were not currently employed, and 4,906 were retired.

Overall, 39% of respondents said their decision to leave healthcare was due to a planned retirement. However, 26% of respondents cited burnout or emotional exhaustion, and 21% cited insufficient staffing. Other reasons for leaving included family obligations, COVID-19 concerns, and unsafe working conditions.

Among nurses who were already retired, 41% said they left healthcare for reasons other than planned retirement, including burnout or emotional exhaustion (22%) and insufficient staffing (18%).

Nurses' reasons for leaving also varied by age, with those ages 61 and older being the most likely to cite planned retirement. Among nurses aged 30 and younger, 43% said they left due to burnout or emotional exhaustion, and 40% said they left due to insufficient staffing.

"I think there's a narrative that nurses no longer want to work in certain settings because of the pandemic," said Jane Muir, the study's lead author from the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing. "Our research really debunks this."

Commentary

According to Muir, many nurses said they would have stayed in healthcare if their jobs had provided safer staffing levels.

"Nurse staffing is a modifiable feature ... it's something that hospitals can choose to invest in, and they must invest in it, if they want to have better outcomes for patients and reduce some of the high turnover and departures that they're seeing in their institutions," she said.

Some nurses also said that flexible scheduling would have helped previous employers retain them. Similarly, older nurses said that while they could no longer handle the "physical toll" of the job, they would have stayed if they had been offered an educator role.

"I think this speaks to the lack of creativity and the need to modernize healthcare working conditions," Muir said.

In an accompanying editorial, Olga Yakusheva from the University of Michigan and Katie Boston-Leary from the American Nurses Association said hospitals have largely focused on increasing the supply of new nursing graduates and immigrant nurses rather than investing in safer staffing, supportive work environments, or competitive wages.

"A consistent influx of new nurses is undoubtedly needed to grow the nursing workforce, yet without correcting the issues nurses face at the bedside and improving retention, it may not provide a long-term solution," Yakusheva and Boston-Leary wrote.

Advisory Board's workforce resources

To increase recruitment and retention of your nursing workforce, check out these Advisory Board resources:

This expert insight outlines the top causes of nurse recruitment and retention challenges and provides actionable ways healthcare leaders can address these issues.

For nurses early in their career, this toolkit explains how to retain first year nurses, and this research explains four strategies leaders can use to retain newer nurses while also fast-tracking their professional growth.

We also offer specific recommendations on how to stabilize the RN workforce. These recommendations will help you balance the needs and expectations of your RN workforce with both organizational and market realities. Similarly, this cheat sheet outlines how to build a flexible nursing workforce with the help of nontraditional work options and cross-specialization.

For a broader look, the Radio Advisory podcast team has compiled five episodes that dive into short- and long-term challenges of the ongoing workforce crisis, while also offering leaders strategies to combat them. (Firth, MedPage Today, 4/9; Muir et al., JAMA Network Open, 4/9)