For the first time since the COVID-19 pandemic, nurse retention efforts are shifting to midcareer nurses.
Mid-career nurses, defined as those with five to 15 years of experience, are facing significant pressure at work and home.
In a reversal from 2022, midcareer nurses are the most burned-out group, a finding that comes as no surprise to nurse leaders.These nurses are the go-to person in personal and professional life, as well as dealing with increased workload, workload inefficiencies, pace of change and complexity of care — a recipe for burnout.
Among RNs, 43% of those under 35 reported feeling emotionally drained at least a few times per week in 2024, compared to 44% of nurses aged 35-49. Among young RNs planning to leave, 60% cited inadequate salary — compared to 49% of nurses aged 35-49.
The national nursing turnover rate of 17% has held steady for the past few years and the average U.S. hospital lost $5.19 million from registered nurse turnover in 2025. Generation Z and baby boomers had the highest turnover rates at 22%, followed by millennials at 21% and Gen X at 14%.
What’s driving midcareer nurse turnover
Many factors drive midcareer nurse turnover, but most come back to one thing: a complicated time of life.
Mid-career nurses are navigating more complex responsibilities in their personal lives, such as raising children and caring for aging parents while working physical shift work. Many nurses also serve as the backbone of the care teams, mentoring younger generations while leading improvement projects. They are also seeking big career moves, such as pursuing advanced degrees or leadership positions.
Changes in career path may be one of the most overlooked aspects of midcareer nurse turnover, and it often starts with career plateauing and profession stagnation, Rob Rose, DNP, RN, senior vice president of nursing and chief nursing officer of St. Louis-based Ascension Health, told Becker’s.
“Most hospital career advancement pathways are binary,” Dr. Rose said. “You can stay at the bedside indefinitely or move into direct administration and management. Mid-career nurses often crave non-traditional growth like leading clinical quality projects, shaping product selection, or designing workflows. They want this growth without giving up bedside practice. When systems offer no lateral mobility, nurses experience professional stagnation.”
To increase career opportunities and their practice, many mid-career nurses pursue advanced degrees. However, nurses with an MSN, DNP or PhD had 55% higher odds of turnover than BSN nurses. Nurses enrolled in a degree program were 84% more likely to turn over, which could be due to the incompatibility of rigid work schedules with academic demands, as well as the career mobility an advanced degree provides.
But the nurses with advanced degrees who do stay are still looking for changes in their work.
“CNOs need to recognize that nurses who invest in their education have different expectations and that our organizations need to advance and evolve with them,” Cathy Stankiewicz, DNP, RN, CNO of AdventHealth Central Florida in Altamonte Springs, told Becker’s. “Higher education often changes what nurses want from their work. That may include more autonomy, more flexibility, more opportunity to lead or more room to use advanced skills without necessarily moving away from direct patient care.”
The factors that cut mid-career nurse turnover
Hospitals and health systems are cutting nurse turnover rates by creating programs that focus on professional governance, flexible scheduling, paying for certifications and tuition assistance, leaders told Becker’s. Implementing retention programs specifically for advanced degree nurses is also showing promise.
A May study found that a 10% increase in patient care responsibility reduces the odds of nurses quitting by more than 54%. Nurses trusted with real responsibility reported feeling more central to the work on the unit, being seen by the organization as capable and important, and a deeper sense of ownership. Leaders can apply these findings by training nurses to manage complex patients, operate sophisticated equipment and giving them latitude to use their clinical judgment.
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