The forces that have long shaped the healthcare workforce have not gone anywhere in 2026: strikes with thousands of workers are still occurring, a long-term nursing shortage keeps widening and labor costs continue to rise.
Alongside those pressures, Becker’s has also reported on several specific changes in how health systems are finding and developing talent this year — including who they are promoting into leadership, who they are hiring and who they are willing to hire back.
Here is what that reporting shows.
1. Fewer nurses appear willing to move into management. Nurse managers can oversee anywhere from 30 to 80 direct reports while owning staffing, budgets and quality metrics, a role Joshua Crocker, vice president of the HR center of excellence at Greenville, N.C.-based ECU Health, described as “essentially a mini-CEO of that unit.” Crystal Kohanke, chief people officer at Little Rock-based Arkansas Children’s, said the issue is less a readiness problem than what she called a “value-proposition problem”: bedside pay and schedule flexibility increasingly compete with what management offers. A similar hesitation shows up in a broader, cross-industry survey: just 6% of Gen Z and millennial workers name a leadership role their top career goal, according to Deloitte’s 2026 survey.
2. Some health systems are investing directly in developing leaders internally. At Houston-based MD Anderson Cancer Center, participants in the Leadership Institute’s Leading Self Accelerate program achieved an 80% higher promotion rate than non-participants, and those who completed its Leading Self Discover program saw a 133% higher promotion rate, according to Courtney Holladay, PhD, the system’s vice president and chief learning officer. At Renton, Wash.-based Providence, Chief Learning Officer Sandi Murray, PhD, said graduates of the Providence Leadership Academy turned over at just 2.9%, compared with 14.4% among leaders who did not go through the program.
3. Below the leadership level, one study is complicating a long-standing hiring assumption. Frequent job-changers, often viewed skeptically by hiring managers, reach full productivity in about two months on average, versus five months for typical new hires, according to a recent study from Ithaca, N.Y.-based Cornell University and New Brunswick N.J.-based Rutgers University. Scott Bentley, PhD, assistant professor of human resource management at Rutgers, said the finding applies across industries, including healthcare. The findings could carry particular weight for healthcare employers navigating persistent nursing shortages, with the national RN turnover rate standing at 17.6% in 2025, costing the average hospital $5.19 million a year, and experienced RN vacancies already taking 56 to 102 days to fill.
4. Some systems are reporting success rehiring former employees. Springfield, Ill.-based Hospital Sisters Health System brought back roughly 400 former colleagues in the past year, more than 10% of its annual new hires, and cut voluntary turnover 50% over two years. Thomas Ahr, senior vice president and chief human resources officer, credited a deliberate outreach effort to former employees. Hagerstown, Md.-based Meritus Health recently reported a similar pattern: Roughly 15% of its hires over the past two fiscal years, more than 350 people, were rehires. President and CEO Maulik Joshi, DrPH, tied the pattern to the system’s culture and mission-driven recruiting.
5. Some HR leaders describe a shift in who is applying in the first place. Teri Manno, vice president and head of career services at New Hyde Park, N.Y.-based Northwell Health, told Becker’s she has seen a wider mix of career changers applying for healthcare roles than in past years, including teachers, principals and nursery school teachers, alongside a rise in interest from veterans and retirees. Leaders attribute this partly to job security and mission-driven work, and partly to anxiety over AI-driven job loss in other industries.
6. Several health system leaders have said they are moving away from across-the-board raises. At least 43 hospitals and health systems have raised wages for workers in 2026. Several leaders described spreading raises evenly, sometimes called “peanut butter raises,” as a practice that fails to reward high performers, and said their systems favor merit-based differentiation instead. Others are blending the two approaches, providing broad-based increases while separately recognizing a smaller share of employees who consistently exceed expectations. Not every leader agreed that merit pay is the better model. One hospital COO said tenure-based step increases are viewed as fairer by most clinical teams, and that merit-based raises have only a short-lived effect on morale. That shift toward targeted pay strategies is not isolated to a handful of interviews; a broader review of 2026 compensation data found health systems recalibrating, rather than abandoning, across-the-board raises in favor of more data-driven allocation.
Taken together, these trends describe a workforce still facing the pressures that have defined it for years: strikes have climbed to at least 17 so far in 2026, and nurse practitioner and RN shortages are still projected to reach 362,000 by 2032. In parallel, a number of health systems and researchers are questioning some long-held assumptions about who makes a strong hire and how leaders are developed.
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