Hospitals face a two-part nursing problem: a constrained pipeline and difficulty keeping the nurses they have, as burnout, staffing challenges and workplace violence continue to drive nurses out of bedside roles, The Wall Street Journal reported Oct. 19.
The U.S. is projected to face a deficit of more than 250,000 RNs by 2028, but many nursing leaders argue the core challenge is retention, not supply. Bedside registered nurse turnover reached nearly 18% in 2025, and more than four in 10 nurses say they are likely to leave a bedside role within a year.
Still, the nursing pipeline faces its own constraints. More than 65,000 qualified applicants were turned away from nursing programs in 2023 because of a shortage of nursing faculty, the American Association of Colleges of Nursing found.
Eight things to know:
1. The Journal cited data from nurse-placement firm NSI Nursing Solutions showing that bedside nurse turnover has increased from 11% about 15 years ago. Turnover rose during the COVID-19 pandemic. It then declined as hospitals raised compensation, but climbed again in 2025. NSI’s report puts the national staff RN turnover rate at 17.6%, up 1.2 percentage points from the prior year. Hospitals hired RNs at a 2.9% net add rate in 2025, down from 5.6% the year before, according to NSI.
2. A 2024 survey of 800,000 nurses found that about 40% planned to leave the workforce or retire within five years, and a separate 2026 survey found that 43% were likely to leave bedside roles within the next year, up from 38% in 2025, the Journal reported.
3. Retention is especially hard among early-career nurses. Press Ganey’s “State of Nursing 2026” report found turnover rates of 22% among Generation Z RNs and 21% among millennials, compared with 14% for Generation X nurses.
4. Nurses also have more career options outside hospitals, including advanced practice, virtual nursing and urgent care roles. The median annual salary for nurses has reached $97,550, and nursing schools continue to graduate thousands of new nurses annually, according to the Journal.
“There is no shortage of nurses in this country,” Jeff Doucette, DNP, RN, chief clinical officer at Qualtrics, following its acquisition of Press Ganey, told the Journal. “There’s a shortage of nurses that want to work in the current environment.”
5. Workplace violence is also rising. Press Ganey found that 2.4% of nursing staff experienced an attack in 2025, a 26% increase from 2017, according to the Journal. In a 2026 Nurse.org survey, more than half of nurses said they had experienced verbal threats or aggressive language in the past year, and 27% reported physical assault.
6. High turnover also carries significant financial implications for hospitals. The average cost of turnover for one staff RN was $60,090 in 2025, and the average hospital lost about $5.19 million to RN turnover. Each 1% change in RN turnover can cost or save the average hospital $295,000 a year, according to the NSI report.
7. Some systems are seeing retention gains. In September, Chicago-based CommonSpirit Health reported an 81% jump in new-hire nurse retention over the past year. The system credited a virtual integrated care model, in which experienced nurses remotely support bedside staff, along with a redesigned yearlong nurse residency program.
8. Many nurses who have left may also be willing to come back. A University of Pennsylvania survey published in February showed that most nurses who left bedside roles in recent years are willing to return, and adequate staffing is the factor most likely to bring them back.
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