Many hospitals and health systems have seen improvements in overall nurse retention post-pandemic. Turnover among early-career nurses, however, is still a major pain point.
In 2024, more than 22% of all newly hired registered nurses left their jobs within a year, according to the 2025 NSI National Health Care Retention & RN Staffing Report, which is based on data from 450 hospitals in 37 states. Turnover within the first two years accounted for the majority of all RN separations last year.
Kelley Kostich, PhD, RN, was named chief nurse of Springfield, Ill.-based Hospital Sisters Health System in March. Less than a year in the role, she is already leading work to strengthen nurse engagement across the 13-hospital system.
“Nurses will disengage quickly if elements that are of value to them aren’t in place, and it’s not because they aren’t committed, it’s because the transition to practice can feel overwhelming or isolating if the organization isn’t doing a purposeful job of that transition,” she told Becker’s.
Dr. Kostich is guiding the development and implementation of HSHS’ first systemwide strategic plan for nursing, designed to strengthen practice and ensure each nurse understands how their daily work contributes to organizational goals. Enhancing support systems for early career nurses is a key part of that plan, which ultimately fuels long-term retention.
Fostering engagement among newer nurses entering the field has become difficult in recent years in large part due to rising patient acuity, Dr. Kostich said.
“It’s a fundamentally different environment than the one I trained in and that a lot of our nursing profession as a whole trained in,” she said. “They’re graduating in this very high-acuity, high-complexity setting often with a very different clinical exposure than what was typical pre-pandemic.”
To build confidence and skill sets among new nurses, HSHS is updating its nurse residency program to establish clear competency milestones and stronger preceptor development, Dr. Kostich said. The system is also in the process of getting its residency program accredited through the American Nurses Credentialing Center.
Beyond supporting practice readiness, residency programs are a critical avenue for nurses to establish relationships with peers, Dr. Kostich said.
“I was just in one of our ministries and one of the residents shared how much he really values the residency program and being able to form connections with new graduates in other departments because his department doesn’t necessarily have a lot of new graduates.”
Another key aspect of improving engagement among new nurses is professional development. Newer nurses crave clarity and growth opportunities early on — they expect a clear vision of what’s next and what long-term career advancement can actually look like within an organization, Dr. Kostich said.
While many systems have career ladders to support nurses’ professional development, these programs shouldn’t live in a vacuum, she said. Nursing and HR leaders are constantly evaluating the program at HSHS to ensure it remains relevant as care delivery models evolve and include pathways for specialty roles.
“HSHS has a very purposeful plan of offering those to our early career nurses and more experienced nurses,” Dr. Kostich said. “That ranges to every level and to our specialty nurses,” she said. “Our infection prevention nurses have growth opportunities. We have to look at every role.”
Underpinning HSHS’ systemwide strategy is a focus on leadership visibility and shared decision-making. Dr. Kostich meets weekly with market chief nursing officers and conducts quarterly on-site visits with front-line teams to foster open dialogue and maintain alignment across the organization.
At the same time, the system is refreshing its shared governance structure to ensure nurses at all career stages have meaningful opportunities to shape care delivery. Systemwide councils and local structures are being designed to consistently gather input, support collaboration and reinforce that each nurse’s voice is considered in decisions that affect their practice.
