In the last few years, hospitals and nurse leaders have homed in on improving nurse retention.
And their efforts are paying off. Since the pandemic, the nursing workforce has shown signs of stabilizing. In 2024, turnover rates for staff registered nurses decreased by 2.4%, resulting in a national average of 16.4%. RN turnover ranged from 5.2% to 36.4% in that span, depending on the facility. The RN vacancy rate also decreased 0.3% to 9.6% in 2024.
Despite this progress, nearly 40% of RNs said they intend to exit the field within the next five years, either through retirement or for other reasons, such as stress or burnout.
Becker’s reached out to four leaders about nurse retention strategies that have been effective at their systems.
Editor’s note: responses have been lightly edited for length and clarity.
Maria Brennan, DNP, RN. Chief Nursing Officer at University Hospital (Newark, N.J.): The greatest return I’ve seen from our strategic efforts has been our shared governance model, which we’re now transitioning into a professional governance model. This year, we launched a unit-based council model. Each unit has its own unique needs, and that’s why these councils are so important. They ensure the voices closest to patient care are the ones helping to shape how we operate — and I’m just blown away by the projects our direct care nurses are taking on. In critical care, for instance, they’re deeply involved in developing policies and procedures that directly affect patients. Right now, they’re working on an early extubation protocol. They’re not just participants — they’re leading the revision of practices that impact patient care every day.
When I first came here two years ago, I had 186 FTEs open — that was nearly a 25% vacancy rate. Now, we’re down to just 2%. I credit a lot of that to creating a positive work environment where nurses have a real voice in practice decisions. That’s a powerful retention strategy.
Another big piece of retention, I believe, is education. It’s so important to assess what your nurses need, provide ongoing education and offer clinical support on the units. If nurses know there’s strong orientation and support, they’re more likely to stay.
Debbie Burke, DNP, RN. Senior Vice President for Patient Care and Chief Nurse at Massachusetts General Hospital (Boston): At Massachusetts General Hospital, our shared decision-making model includes an interprofessional Recruitment, Retention and Recognition Council. The RRR Council is co-chaired by a clinical nurse and respiratory therapist and includes representation from every clinical unit, clinic and setting throughout the organization. Guided by clearly defined charges, the RRR Council is empowered to make strategic decisions that foster a professional practice environment of staff well-being and growth. Key areas of focus include initiatives such as award and recognition programs, career planning initiatives, well-being activities and learning opportunities.
Examples of key retention strategies driven by the RRR Council include identification of best practices for ensuring lunch breaks and microbreaks, creating a welcoming environment and promoting belonging, and promoting effective communication across the healthcare team. The council members serve as champions to promote acquisition of professional certification and clinical ladder advancement.
In addition, the RRR Council identifies the criteria for the administration of Nursing Wellness grants funded by a generous benefactor. Last year, 65 unit/clinic grants totaling $325,000, — ranging in uses from attendance at Red Sox baseball games to yoga to harbor cruises — were awarded. These initiatives have influenced sustainment of a staff nurse turnover rate between December 2023 and December 2024 in a range of 6.8% to 7.8%. This reflects a significant improvement from prior years, when turnover rates exceeded 9%.
Athena Minor, DNP, RN. Chief Nursing and Chief Clinical Officer at Ohio County Hospital (Hartford, Ky.): We have found improved clinician satisfaction through hiring full-time nursing and surgical tech call clinicians in hospice and the OR, which are areas that maintain historically high call rates. There are clinicians who are at a time in their lives that they are looking for a way to “ease” into retirement but still have a great deal of skill and experience to offer. For this group of clinicians, offering a full-time position and stable salary to take the majority of call allows them to keep practicing but with limited time commitment, while still receiving reasonable compensation for their services. On the other hand, there are clinicians who are motivated to tackle a busy schedule but only want to work during specific hours or on specific days, and a heavy call schedule is a source of great dissatisfaction to them. For these clinicians, drastically reducing their call requirement increases satisfaction and encourages retention.
Annette Sy, DNP, RN. Chief Nursing Executive for Keck Medical Center of USC (Los Angeles): Keck Medical Center of USC, which includes Keck Hospital of USC and USC Norris Cancer Hospital, launched a program to assist RNs obtain their BSN degrees. The medical center pays up to 75% of their tuition. As a result, we now have over 80% of our nursing workforce with a BSN or higher nursing degree.
