A January 2023 nurse survey fueled fears of an exodus, as 85% of those in hospital roles said they planned to quit within the next 12 months.
Those 12 months have come and gone. In fact, about 14 months have passed since AMN Healthcare polled more than 18,000 registered nurses — finding double-digit decreases across satisfaction scores, and double-digit increases in emotional drain.
Yet, hospital nurses do not appear to have reached that ultimate boiling point, Christin Stanford, AMN's vice president of client solutions, told Becker's. There hasn't been a collective great resignation, and by some measures, nursing shortages have actually eased.
Health systems took the signal to double down on retention efforts, which have helped delay departures in the short term. But organizations shouldn't rest on those laurels, Ms. Stanford advised: The "startling" declines in nurse well-being are still very present.
"The pandemic was a once-in-a-lifetime type of event that brought so many of the gaps in the staffing models to light. And so a year later, what we have seen is that has certainly settled down some from a normalized work-life now, versus the COVID years," Ms. Stanford said. "But there's still a lot of way to go."
AMN Healthcare will repeat the RN survey in 2025: There's no exact data to compare last year's findings to. However, a separate survey the company published last month found that 72% of nurse leaders are burnt out, prompting 31% to consider leaving their hospital jobs. That's not "crazy COVID" data, Ms. Stanford pointed out — those nurse leaders are reacting to current practices.
"The thought that we would just get back to business as usual, whether as a nurse or as a nurse employer … there's no back to business as usual," Ms. Stanford said. "The call to action was really for every client or healthcare system that utilizes nurses: What are you going to do differently?"
Many organizations answered the call this year by leaning into flexible work offerings. By offering gig shifts and hours that support nurses' schedules, they have been able to retain clinicians who may have otherwise resigned or retired. This is especially vital in today's multigenerational workforce, according to Ms. Stanford. Newer nurses are more likely to experience emotional distress and question their career choice early on. More experienced nurses can help ease their worries, offering mentorship and guidance — but sometimes doing so from a virtual setting, which is less physically taxing as they age.
Others are upping their continuous development and education offerings, offering financial support and scheduling adjustments to encourage nurses to upskill. There has also been a notable increase in sign-on and retention bonuses for nurses. In March, one California system began offering $100,000 sign-on bonuses to new nurses and $100,000 retention bonuses to current staff nurses over a three-year period, and as a result, has been able to fully staff its emergency department with minimal contract labor.
But here, the results get murky, Ms. Stanford said. At the end of those three years, when nurses have cashed their checks, will they stay?
The 85% of hospital nurses planning exits last year were well aware of their options. Some planned to return to school; some said they'd seek travel, part-time or per diem nursing roles. Other nurses shared plans to leave the profession entirely.
"There's lots of opportunities that we can see on the internet, remote positions that 10, 15, 20 years ago, we didn't really have to that degree," Ms. Stanford said.
Nurses have also grown more empowered through union activity and are increasingly advocating for change, from staffing ratios to improved care quality. They're willing (and able) to take control of their own destinies. It's going to take more than free lunches and "we love our nurses" cheers to become the employer of choice, according to Ms. Stanford. Those that rise to the top will prioritize the daily lives of their nurses, allowing them to spend as much time as possible where they want to be: at the bedside, caring for patients.
As for staffing practices as a whole, they're poised to grow more thoughtful and less urgent, Ms. Stanford said — less like a fire hose, "a little bit more like a peanut butter spread."