Strategies for Retaining Top Nursing Talent

Addressing the nursing shortage before it’s too late: recruitment and retention strategies.

Written by: Dr. Dawna L. Cato, PhD., RN, NPD-BC


Over 3 million registered nurses (RNs) work in healthcare in the U.S., and according to the Bureau of Labor Statistics, that number is expected to grow approximately 6% per year through 2031. This equates to over 200,000 open nurse positions needing to be filled each year. 

Meeting this demand is going to be challenging given the current healthcare environment, which faces an aging population, higher acuity levels, burnout, insufficient enrollment in nursing schools and other complex issues. Healthcare organizations will need to take meaningful steps to address these issues in order to effectively recruit and retain nursing talent. 

Causes of the current nursing shortage

The healthcare industry has been discussing the topic of nursing shortage for the last decade, well before the pandemic occurred in early 2020. Throughout the pandemic, nurses became heroes – providing fast-paced, demanding care under new protocols, while also dealing with the pandemic in their personal lives. However, this took a toll, and a significant number of nurses left the healthcare industry, exacerbating the issue of a nursing shortage. A recent Health Affairs study found that the total supply of RNs decreased by more than 100,000 from 2020 to 2021 – the largest drop than ever observed over the past four decades.

Several factors that attribute to the current nursing shortage, including: 

  • An aging population: As the global population continues to age, the demand for healthcare services increases. Older adults typically require more medical attention and care, which places a greater strain on the healthcare system and the nursing workforce. The U.S. Census Bureau reported that by 2034, there will be 77 million people age 65 years and older, compared to 55 million in 2021. With larger numbers of older adults, there will be an increased need for geriatric care, including care for individuals with chronic diseases and comorbidities.
  • Increased healthcare needs and acuity of care: Advancements in medical technology and treatments have led to an expansion of healthcare services. This increased demand for healthcare, combined with the growing prevalence of chronic diseases, has created a greater need for nurses to provide care to patients.
  • Nursing workforce demographics: The average age for an RN is 52 years old, which may signal a large wave of experienced nurses leaving the workforce over the next 15 years as they hit retirement age. Additionally, fewer young people are entering the nursing profession, resulting in a shortage of new nurses to replace the retiring ones.
  • Burnout and workload: Nursing is a demanding profession that often involves long hours, high stress levels and heavy workloads. These factors contribute to burnout and can lead to nurses leaving the profession or reducing their hours, further exacerbating the shortage.
  • Lack of resources and support: Nurses may face inadequate resources, such as staffing, equipment and infrastructure.  In addition, environmental stressors such as incivility, bullying, and physical and mental assault from the patient population contributes to their ability to provide safe quality care and effectively manage and treat patients within the interdisciplinary team. This often leads to job dissatisfaction and nurses seeking better working conditions elsewhere. A recent survey cited by the Advisory Board suggests that 50% of nurses have a side job, and many plan on leaving the profession to focus on the side job full-time.
  • Insufficient nursing school enrollment: One of the biggest factors restricting nursing school enrollment is lack of faculty. Additional factors include lack of clinical sites, classroom space, and clinical preceptors, as well as budget constraints. The demand for a nursing degree is high based on how many people are applying for nursing school; however, the absence of educational capacity restricts the number of new nurses entering the workforce each year.

5 ways to retain top nursing talent

Among nurses who are considering leaving the profession, higher pay was the most influential motivation to stay, followed by better support for work-life balance and more reasonable workload, according to the 2022 Nurse Salary Research Report

Retention of nurses is a critical concern in the healthcare industry. Here are five strategies that can help improve nurse job satisfaction and reduce turnover:

  1. Competitive compensation and benefits: A competitive salary and benefits package is crucial to attract and retain nurses. Ensuring that nurses receive fair compensation for their skills and expertise can improve job satisfaction and reduce the temptation to seek higher-paying opportunities elsewhere.
  2. Supportive work environment: By creating a positive and supportive work environment, organizations will help to ensure higher nurse retention. This can be done in a variety of ways, including fostering open communication, having adequate staffing ratios, encouraging teamwork, addressing concerns promptly, providing transition to practice and mentoring programs, as well as professional  growth opportunities and promoting work-life balance. 
  3. Flexible schedules: Providing nurses with flexible work schedules can enhance job satisfaction. Offering options like part-time, job sharing, or self-scheduling can help accommodate their personal needs and responsibilities outside of work. Flexibility allows nurses to maintain a healthy work-life balance, which is crucial for long-term job satisfaction.
  4. Career development opportunities: Investing in ongoing professional development for nurses demonstrates a commitment to their growth and advancement. Providing access to training programs, conferences, workshops and specialized certifications not only enhances their skills but also promotes engagement and job satisfaction. Offering career progression opportunities within the organization can further motivate nurses to stay in their current role.
  5. Engagement and recognition: Actively involving nurses in decision-making processes and seeking their input on issues that affect their work can foster a sense of ownership and engagement. Recognizing and appreciating their contributions through rewards, incentives and acknowledgment programs can boost morale and job satisfaction. 

Implementing these strategies can contribute to creating a supportive and fulfilling work environment for nurses, ultimately reducing turnover and retaining valuable healthcare professionals.

The power of a “Stay Interview”

Whether you have annual performance reviews, or build them into more frequent manager meetings, it is important to take the time to ask each of your high-performing nurses about what it would take to make them stay with their current organization. This helps nurse managers understand why their staff stays and what might cause them to leave. Stay Interviews should only be conducted with your most tenured, high-performing employees.

Here are a few questions you could ask during a Stay Interview: 

  • What do you look forward to when you come to work each day?
  • What do you like most or least about working here?
  • What keeps you working here?
  • If you could change something about your job, what would that be?
  • What would make your job more satisfying?
  • How do you like to be recognized?
  • What talents are not being used in your current role?
  • What can I do to best support you?
  • What can I do more of or less of as your manager?
  • What might tempt you to leave?

In summary, while nurses represent the largest group of healthcare professionals in the country, there is a shortage that must be addressed today. Healthcare organizations must tackle fundamental issues, such as work environment, work-life balance, career growth opportunities, compensation, and policies that support quality of care. 

These investments will tremendously support recruitment and retention efforts to have the best talent available and develop a strong foundation for other healthcare provider organizational goals.