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To remedy this and prevent the loss of an entire generation of nurses, the healthcare industry urgently needs to shift outdated paradigms, embrace new career paths and build more flexibility into the profession.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.
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.
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.
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.
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.
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.
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.
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.
