Hospital, Registered Nurse Turnover Rates Remained High in 2022

While healthcare employment is slowly bouncing back from the COVID-19 pandemic, the registered nurse (RN) turnover rate in 2022 was 22.5 percent, resulting in hospitals losing millions of dollars, according to a report from NSI Nursing Solutions, Inc.

The 2023 NSI National Health Care Retention & RN Staffing Report reflects survey responses from 273 hospitals across 35 states, representing more than 730,000 healthcare workers and over 200,000 RNs. The hospitals reported data from January through December 2022.

In 2022, hospitals regained 5.65 percent of the workforce that was lost during the “Great Resignation,” which translated to 975,000 employees.

The number of workers leaving their jobs declined in the later part of 2022, leading to reduced hospital turnover. The hospital turnover rate decreased by 3.2 percent from 2021 but was still 22.7 percent in 2022. Labor competition, provider burnout, and retirement are still causing retention challenges.

The mean hospital turnover rate was 23 percent, ranging from 7.3 percent to 40.5 percent due to varying hospital sizes.

Resignations accounted for 94.7 percent of hospital exits, with personal reasons, career advancement, and relocation as the most common reasons workers resigned. Workers also reported leaving their job due to salary, retirement, and scheduling reasons.

The RN workforce gained 142,000 workers back in 2022, for a 4.17 percent add rate. RN turnover increased by 8.4 percent in 2021 but fell by 4.6 percent to 22.5 percent in 2022. The median turnover rate was 21.7 percent, ranging from 6.5 percent to 64.5 percent.

The average cost of a turnover for a staff RN is $52,350 and ranges from $40,200 to $64,500, according to the report. With the 22.5 percent turnover rate, the average hospital lost $8.55 million in 2022, ranging from $6.57 million to $10.53 million.

Each percent change in RN turnover will either cost or save the average hospital $380,600 annually.

Similar to hospital staff, most RNs left their jobs due to personal reasons, career advancement, and relocation.

To manage these staffing challenges, hospitals asked RNs to volunteer for overtime, authorized critical staffing pay, relied on travel nurses, and increased the RN salary scale. Respondents noted that the compensation programs relative to critical staffing were the most successful strategies.

Within the RN workforce, telemetry (27.1 percent), step down (23.7 percent), and medical/surgical (23.1 percent) RN turnover were the highest and exceeded the national average. Step down, telemetry, behavioral health, and emergency services departments will likely turn over their entire RN staff in less than five years, the report said.

The current RN vacancy rate is 15.7 percent, while the RN Recruitment Difficulty Index ranges from 61 to 120 days. These figures indicate that hospitals will continue to face labor shortages.

Despite these indications, hospitals have hopeful plans for the future. Sixty-two percent of hospitals expect to increase their labor force and 69 percent expect to increase their RN complement. Additionally, 37 percent of hospitals anticipate an increase in the recruitment budget, while 20 percent plan to boost their recruitment staff.