High labor costs continue to stress health system leaders.
In 2023, for example, the average turnover cost for one staff RN grew to $56,300, up from $52,350 in 2022. The financial stakes are high — with each 1% percent change in RN turnover estimated to cost or save the average hospital $262,500 per year. In response, healthcare leaders are looking at new ways to attract and retain the next generation of nurses.
Becker’s Healthcare and Works recently conducted a brief survey of chief nursing officers to learn more about the qualities, skills and certifications that are top of mind in their searches for future employees; the current challenges and successes that organizations are experiencing with nurse recruiting; and investments that hospitals and health systems are making to advance nurse recruitment and retention efforts.
More than three-quarters of the 115 survey respondents work at hospitals or health systems, and close to two-thirds (63.4%) work at organizations with more than 250 beds.
Please select the most accurate description of your organization.
Flexibility is an important retention tool and strategic differentiator
Interestingly, 42% of the CNOs surveyed indicated that “reducing nurse workload” was one of the top-three most difficult things to offer or change as part of their organization’s nurse retention strategy.
Although it may be difficult for hospitals and health systems to reduce nurse workloads, many recognize the value of flexibility to employees and are leveraging it in their nurse retention strategies.
More than half (60.9%) of CNOs who participated in the survey indicated that flexible work schedules and arrangements are very important to their nurse retention strategies. For 48% of respondents, “flexible work arrangements” ranked as one of the top-three most necessary changes or updates to attract and retain the younger generation of nurses.
Flexible work arrangements take a variety of forms. While the most popular option among survey participants is self-scheduling, only 31.3% of respondents said their organizations offer that to employees. Interest is strong, however; among the 68.7% of organizations that don’t offer self-scheduling, 88.7% of CNOs said they were considering technology that would allow nurses to pick their own shifts.
“Clinicians are no longer tolerating pre-pandemic working conditions, and the next generation of nurses expects flexibility. We’re starting to see hospitals optimize their current workforce by leveraging digital tools to track talent data. At Mercy, we partnered with Trusted’s Works platform to create Mercy Works On Demand.”
Betty Jo Rocchio, DNP, CRNA, CENP, Senior Vice President & Chief Nurse Executive, Mercy
Other popular types of flexible work arrangements cited by the survey participants include the ability to pick up extra shifts according to preferences, part- time work with hour requirements and the ability to work across different care settings.
What types of flexible work arrangements does your organization offer?
Self-scheduling
31.3%
Ability to pickup extra shifts, according to preferences
29.6%
Part-time work with hour requirements
28.7%
Ability to work across different care settings
28.7%
Choosing which weekends to work
26.1%
Schedules to accommodate new mothers
25.2%
Hybrid shift lengths
24.3%
Hybrid roles
23.5%
Gig work without hour requirements
23.5%
Virtual nursing
22.6%
9 a.m. to 5 p.m. schedules
22.6%
Four-day work weeks
21.7%
12-hour shifts starting at anytime
21.7%
Figure 2: Types of flexible work arrangements offered by survey respondents’ organizations
High demand for nurses with compassion, empathy, and strong communication skills
When asked to identify the most important characteristics or skills they look for in potential nursing recruits, CNO survey respondents rated compassion and empathy highest, followed by strong communication skills. CNOs prioritized these qualities above characteristics like attention to detail and clinical competence.
While many nurses may be innately compassionate and empathetic people, it’s important to keep in mind that without sufficient bandwidth on the job, it’s difficult to display these traits to patients and peers.
What are the most important characteristics or skills you look for in potential nursing recruits?
0%
10%
20%
30%
40%
50%
60%
70%
80%
Compassion and Empathy
27%
18%
25%
Strong Communication Skills
23%
26%
17%
Critical Thinking and Problem-Solving Abilities
18%
20%
17%
Attention to Detail and Clinical Competence
12%
24%
18%
Adaptability and Flexibility
19%
11%
23%
1
2
3
Figure 3: Survey respondents’ most important characteristics or skills in potential nursing recruits
Embracing technology is essential to recruit the next generation of nurses
When asked what aspect of their organization’s nurse retention strategy was most difficult to offer or change, CNOs ranked “embracing new technologies meant to alleviate burdens” as the least difficult.
When it comes to leveraging technology as a differentiator, more than one-third of CNOs (39.1%) indicated that digital recruitment platforms are an effective recruitment strategy to attract the next generation of nurses.
Nearly half (48%) of the CNO survey respondents ranked “embracing technology” as one of the top- three most necessary changes or updates to attract and retain the younger generation of nurses.
“Leveraging technology for staffing and scheduling decisions in healthcare settings offers numerous advantages, primarily enhancing efficiency and introducing flexibility to scheduling systems. Automated algorithms can swiftly analyze vast amounts of data to generate optimized schedules that meet staffing requirements and individual preferences.”
Brian Weirich, DHA, MHA, RN, CENP, Chief Nurse Innovation Officer, Bon Secours Mercy Health
In your organization’s nurse retention strategy, which of the following have been the most difficult to offer or change?
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Reducing nurse workload
17%
11%
14%
Reducing nurse stress and burnout
17%
5%
17%
Recognizing nurse contributions
5%
20%
13%
Offering work-life balance/flexible options
11%
11%
15%
Fostering a healthy workplace culture
14%
8%
14%
Offering career advancement opportunities
12%
13%
10%
Offering competitive compensation and benefits
9%
17%
3%
Addressing staffing shortages
6%
11%
9%
Embracing new technologies meant to alleviate burdens
10%
3%
6%
1
2
3
Figure 4: Most difficult aspects to offer/change in nurse retention strategies, per survey respondents
What changes or updates do you believe are necessary within the nursing profession to attract and retain younger generations?
0%
10%
20%
30%
40%
50%
60%
Embracing Technology
23%
10%
15%
Flexible Work Arrangements
14%
23%
11%
Focus on Diversity and Inclusion
11%
17%
19%
Enhanced Benefits Packages
16%
11%
18%
Professional Development and Career Advancement
16%
12%
14%
Emphasis on Work Environment and Culture
12%
16%
10%
Holistic Well-Being Initiatives
9%
11%
13%
1
2
3
Figure 5: Changes or updates survey respondents believe are necessary to attract and retain younger nurses
Ready to get introduced to works?
As hospitals and health systems compete to attract nursing talent, technology and flexible work arrangements are key pathways to success. Works offers an industry-pioneering workforce management platform that helps healthcare organizations bolster nurse retention through a centralized staffing model, while driving clinical cost savings.
Works drives clinical cost savings and bolsters nurse retention through flexibility and workforce optimization. With Works, clinicians move across units and hospitals and you fill more shifts with your own labor resources.
2021 Nurse Career & Satisfaction Survey: Engaging a New Generation of Nurses
2021 Nurse Career & Satisfaction Survey: Engaging a New Generation of Nurses
2021 Nurse Career & Satisfaction Survey: Engaging a New Generation of Nurses
Trusted Health’s 2021 Nurse Career & Satisfaction Survey seeks to understand the crisis in the nursing profession. Read more now.
Trusted Health
2021 Nurse Career & Satisfaction Survey: Engaging a New Generation of Nurses
2021 Nurse Career & Satisfaction Survey: Engaging a New Generation of Nurses
By Trusted Health
Overview
For decades, nurses have followed a linear career path: they got hired, moved up the clinical ladder, and stayed with the same employer—often within the same specialty—throughout the span of a career. Now, these same nurses are retiring in droves.
In contrast, nurses that have entered the profession more recently expect something different and less linear from their careers. Like their peers in other industries, this younger generation seeks greater flexibility and a more diverse set of experiences and settings in which to grow their skill sets. Since the pandemic started, many have turned to travel nursing for the first time, giving them a taste of that flexibility. Now, they aren’t interested in returning to a traditional setting. In fact, nearly one in five said that nothing would interest them in taking a full-time role. What’s more, only 6% of our surveyed nurses plan to move into nurse leadership in the next three years—which will soon create a vacuum at the top.
These statistics are alarming—and they demand a fundamental rethinking of what a nursing career looks like. Without a fulfilling path in sight, many may opt out of nursing entirely. And in fact, a Trusted Health study from earlier this year found that 39% of nurses under the age of 40 are less committed to the profession than they were pre-pandemic.
Taken together, these signs depict a profession in full-blown crisis. To remedy this and prevent the loss of an entire generation of nurses, the healthcare industry urgently needs to shift outdated paradigms, embrace new career paths and build more flexibility into the profession.
Trusted’s 2021 Nurse Career and Satisfaction Survey seeks to understand the causes behind this crisis—and paint a clear picture of what nurses want from their careers. Our report is intended to serve as a roadmap for hospitals and healthcare systems to understand what nurses are looking for, to use these insights to attract and retain them, and to build effective incentives for leadership—populating the pipeline for the nurse leaders of the future.
About the Survey
This survey was conducted by email in October 2021 with a sample of 3,357 nurse respondents, of whom 54% currently work as travel nurses, 37% as staff nurses, and 9% in per-diem or other types of nursing roles.
TOP SPECIALTIES AMONG SURVEYED NURSES
CAREER TENURE AMONG SURVEYED NURSES
BREAKDOWN OF NURSES BY GENDER
Key Findings
Nurses want more diversity in their roles—beyond what’s currently available in a traditional staff position. More than one-third of nurses surveyed (35%) say their idea of a successful nursing career includes moving among hospitals, clinics, and units to gain varied experiences. Many have turned to travel nursing to achieve this. Of surveyed nurses who have taken a travel contract, 48% took their first one during the pandemic. Top drivers for doing so include money, career aims, and lifestyle preferences.
REASONS FOR TAKING A TRAVEL CONTRACT
Among the nurses surveyed who are travel and per diem nurses, 17% said nothing would make them consider a permanent, full-time hospital staff position. While higher pay remains a driver for travel and per diem nurses, some are looking for a better work/life balance or career enhancement.
REASONS TRAVEL AND PER DIEM NURSES WOULD TAKE FULL-TIME STAFF POSITIONS
Nurses want more flexibility with scheduling and staffing. Nearly three-quarters of nurses surveyed (71%) say their experience as a nurse would improve if they had more control over their schedule.
PERCENTAGE OF NURSES WHO AGREE WITH THE FOLLOWING STATEMENTS
The pipeline for nurse leadership is weak. Only 1 in 10 nurses surveyed (11%) say their idea of a successful career in nursing involves advancing into nurse administration and leadership roles, and just 6% of nurses say they plan to move into nurse leadership in the next three years.
CAREER PATHS NURSES INTEND TO TAKE OVER THE NEXT THREE YEARS
Nurses aged 25-34 and 35-44 were more likely than other age groups (71% and 66%, respectively) to cite a desire to avoid politics among reasons for not pursuing leadership.
NURSES WHO INTEND TO PURSUE NURSE LEADERSHIP IN THE NEXT THREE YEARS BY AGE
TOP REASONS NURSES AREN’T INTERESTED IN LEADERSHIP ROLES
Recommendations
Reinvent nursing career paths. Based on the large number of nurses that crave diverse professional experiences, hospitals need to provide greater flexibility on the job—and more opportunities to develop nursing skills across specialties, care settings, and even locations. Healthcare facilities should find ways to offer nurses more diversity on the job—through structured rotational programs and by embracing and providing mentorship for nurses who want non-traditional career paths.
Rethink shift scheduling. Traditional shift scheduling is a deterrent against sustaining a career in nursing: although nurses want more variety on the job, they also need greater predictability and control over their time. The COVID-19 pandemic has left many nurses feeling tired and burned out, which explains why more than half the nurses surveyed want the ability to schedule work around vacations, downtime, personal travel, and other life events. With the overall rise of the gig economy and increase in flextime across professions, shift scheduling should be modernized through a more data-driven approach that allows nurses to pick up shifts when and where they want.
Introduce better incentives for leadership. A paltry 1 in 10 nurses surveyed says that their idea of a successful career in nursing involves advancing into nurse administration and leadership roles. They see leadership as a trade-off between what drew them into nursing in the first place—patient care—and more exposure to nursing politics and the headache of staffing and scheduling. Hospitals need to root out cultural issues—including bullying and incivility—within their nursing teams in order to draw younger nurses into leadership and address the challenge of staffing and scheduling through technology that frees nurse leaders’ and managers’ time up for more meaningful work.
