Hospitals' average turnover and vacancy rates for registered nurses nearly returned to their 2019 levels in 2023 after peaking in the middle of that timeframe.
In 2023, the national average turnover rate for hospitals' staff RNs was 18.4% compared to the 15.9% average in 2019. Meanwhile, the RN vacancy rate last year stood at 9.9% nationwide.
The figures, from the 2024 NSI National Health Care Retention & RN Staffing Report based on 400 hospitals in 36 states, mark significant improvement from the nurse staffing challenges experienced by hospitals and health systems throughout the COVID-19 pandemic. RN turnover jumped to 27.1% in 2021, leading to a high vacancy rate of 17% in 2022.
In addition to hospitals' employment, research published in JAMA found that the U.S. RN workforce has seen greater stabilization as a whole, with projections for 4.56 million RNs in the U.S. in 2035 — similar to pre-pandemic forecasts. "In this study, the rebound in the total size of the US RN workforce during 2022 and 2023 indicates that the earlier drop in RN employment during the first 2 years of the COVID-19 pandemic was likely transitory," authors of the study, based on census data, noted.
Greater stability in nurse retention has come at a cost for hospitals and health systems. According to data from the Bureau of Labor Statistics, hospital-employed RNs experienced an almost 22% increase in their annual mean wage between 2019 and 2023.
Wages are one aspect of the issue. Retention requires ongoing efforts, rather than being a matter of one-time contract negotiations or signing bonuses, as executives understand. This has prompted a heightened focus on implementing flexible work arrangements, refining scheduling practices, optimizing workflows, providing continuous development and education opportunities, and prioritizing nurse wellness.
After years where nurses commanded the labor spotlight among hospitals and health systems, health system CEOs are redirecting their attention to other critical roles within their organizations that face significant demand. Technicians, most recently, lead the pack. At the start of the year, technician shortages slightly surpassed RN shortages as CEOs' greatest workforce concern for 2024.