For years, conversations about the healthcare workforce have centered on shortages –– particularly nursing shortages. Especially since the pandemic, hospitals, nursing schools and policymakers have invested heavily in expanding nursing programs, increasing enrollment and building a stronger pipeline.
A recent TIME report challenges the conventional narrative, stating healthcare leaders are asking the wrong question to solve the nursing shortage crisis. Instead, the article claims that while thousands of nurses continue to enter the profession each year, more leave bedside care due to unsustainable working conditions. The result is a shortage of licensed nurses due to a retention crisis.
Karen Lasater, PhD, RN, FAAN, a professor at the University of Pennsylvania School of Nursing who studies nurse retention, shares a perfect analogy in the TIME article, “We’re really putting a lot of money into building a pipeline for nursing, but if nurses are leaving after a year or two of getting into employment, the problem isn’t so much a pipeline problem as a leaking gas tank.”
It’s not enough to find ways to fill the pipeline if experienced nurses leave faster than they can be replaced.
Why Nurses Are Leaving Bedside Nursing Roles
Workforce numbers alone don’t necessarily reflect the number of available nurses who can provide bedside patient care.
There are many reasons nurses leave these types of positions. Many licensed registered nurses pursue advanced practice roles, transition into education, case management, IV drip therapy, aesthetics and other non-bedside careers. Others maintain active licenses after retirement or work part-time.
Nurse practitioners are the fastest-growing career in healthcare, and these clinicians are still counted among licensed nurses. They’re required to keep an active nursing license. This means that despite the number of licensed nurses reported in TIME, they’re not all actually positioned to fill vacancies.
Of course, the nuance doesn’t diminish the workforce challenge, but it does shift the conversation toward the organizational factors that healthcare leaders can influence.
Why Nurse Retention Is Critical for Healthcare Organizations
No matter how you slice the numbers, it’s still clear that improving nursing retention is imperative.
“The issue is not simply whether enough nurses are entering the profession, but whether healthcare organizations are creating environments where nurses can safely practice, grow and sustain their careers. Recruitment may fill vacancies temporarily, but without appropriate staffing, supportive leadership, manageable workloads, and meaningful investment in retention, the cycle continues. We have to move beyond asking how to hire more nurses and start asking what organizational conditions are causing experienced nurses to leave,” says Massiel Heffner, vice president of nursing at Callen-Lorde Community Health Center and founder of Savilla Healthcare Consulting.
While recruitment addresses current vacancies, retention protects the future workforce.
Why Nurse Retention Is a Patient Safety Strategy
Every experienced nurse who leaves takes years of clinical judgment, institutional knowledge, mentorship and patient-care expertise with them. Replacing those nurses is costly. More importantly, frequent turnover can strain teams, increase workloads for remaining staff and disrupt continuity of care.
“As someone who’s watched excellent nurses walk away from the profession not because they stopped caring, but because caring has become unsustainable—this is exactly the reframe our industry needs. Retention isn’t a ‘nice to have’ workforce initiative, it’s a patient safety intervention,” says Abigail Freitag Neff, MSN, RN, assistant nurse manager in the Department of Radiation Oncology at Penn Medicine.
Her perspective reflects a growing recognition among experienced nurses that organizations can’t recruit their way out of chronic turnover if the workplace itself pushes experienced clinicians away.
What Keeps Nurses at the Bedside? Top Retention Drivers
Everyone likely recalls social media posts and news stories featuring praise and pizza parties for “healthcare heroes” during the pandemic. But special lunches and kind gestures aren’t long-term drivers of retention. Instead, the following are proven ways to keep clinicians onboard.
Fair Compensation for Nurses
Competitive pay is obviously one of the clearest ways to recognize nurses’ expertise and commitment. Compensation doesn’t solve burnout, but it does help keep nurses from feeling undervalued and leaving for better-paying positions.
Safe Nurse Staffing Levels
No retention initiative can overcome chronically unsafe staffing due to budget cuts. A lack of adequate numbers of floor nurses leads to burnout and affects patient safety.
Appropriate staffing levels allow nurses to deliver quality care while reducing physical and emotional exhaustion. It also protects meal breaks and reasonable scheduling.
Communication Between Nurses and Leadership
The relationship between nurses and their leaders often determines whether someone stays or leaves. Managers who do the following foster environments where clinicians feel respected and supported:
- Communicate openly
- Advocate for their nurses
- Encourage meaningful professional development and growth opportunities
- Involve nurses in collective decision-making
Solving Nurse Retention Is Key to Nursing’s Future
The healthcare industry will always need to recruit the next generation of nurses. But recruitment alone cannot solve workforce instability if experienced clinicians continue leaving environments where the work has become unsustainable.
The most important takeaway from the current nursing staffing conversation isn’t whether there’s a shortage or a retention crisis. It’s recognizing that healthcare leaders have significant influence over creating workplaces where nurses choose to stay.
Retaining experienced nurses starts with creating workplaces where they can thrive. Explore CM&F’s resources for registered nurses to learn how proactive risk management contributes to stronger, more resilient healthcare teams.
