Nurse turnover: causes and how to reduce it

The impact of high nurse turnover rates

Inadequate staffing strains a hospital or healthcare facility’s business and quality of service. The 2026 NSI staffing report notes that each percent change in RNs' turnover can cost/save the average hospital $295,000 per year.

Many facilities turn to travel nurses and overtime to balance out a staff shortage. But staffing agencies often cost hospitals more financially and in patient safety. Adequate hospital staffing ratios in California are mandated by law and have been shown to reduce burnout and nurse turnover.

Why nurse retention is important

According to the 2026 NSI staffing report, specialty areas from behavioral health to emergency to telemetry saw the highest rates of nurse turnover.

The U.S. Census Bureau also reports that the U.S. population aged 65+ is projected to increase by 2050. This means there will be an increased need for geriatric care and, yes, nurses.

By prioritizing nurse retention, organizations can build a thriving workplace where nurses feel supported, encouraged to grow and satisfied at work.

1. Stress and employee burnout

Stress and burnout are the top reasons for nurse turnover, followed by workload and understaffing. These reasons aren’t mutually exclusive.

As frontline workers, RNs experience high levels of workplace stress, compounded by heavier workloads from understaffing. As stress continues, it can lead to burnout, diminishing productivity and job satisfaction over time.

How to stop it: There is no easy one-size-fits-all solution to recover from burnout. However, organizations can get ahead of stress and burnout by improving the employee experience through recognition, encouraging breaks and understanding and supporting your staff’s needs.

Building employee trust and appreciation builds a positive work environment, where RNs can feel a sense of purpose and motivation.

To get started, gather feedback using employee surveys. The survey results can help you understand sentiment levels and prioritize staff needs into an action plan, whether that’s reviewing shift strategy and scheduling or workload distribution. This builds employee trust, creating a more positive work environment where RNs feel appreciated and motivated.

Related: Employee surveys

2. Compassion fatigue and patient abuse

As frontline healthcare workers, nurses occupy an emotionally demanding role. RNs manage everything from complex care and long patient stays to patients of all ages and needs. Nurses sometimes even encounter abuse from uncivil patients or their loved ones.

With many institutions short-staffed, RNs are under constant pressure to see one patient after the other, giving them no time to recover in between. It takes a toll, with 64% of nurses’ well-being impacted by compassion fatigue and 17% rating their employer wellness support as excellent.

How to stop it: Develop a wellness program that helps your employees find a sustainable solution to cope with mental health issues and stress.

While speaking to host John Duisberg on the "Love your people" podcast, Linda Matzigkeit, Chief Administrative Officer at Children’s Healthcare of Atlanta, shared how the organization addressed clinicians’ mental health needs. After seeing staff members struggle to find mental healthcare providers for themselves and their family members, they decided to cover these services for employees and dependents fully.

“We want to help our clinicians in their units, where they are,” said Linda. “So they have a number of resources.” The organization runs multiple programs on site, such as free mental health counseling, and recurring events like a tea and meditation workshop for stress relief and a visiting massage therapist.

Related: Innovative strategies to foster a supportive work environment

3. Inadequate recognition

Nurses continue to feel undervalued, with 84% of healthcare workers reporting they feel underappreciated at their current employer. And with staff shortages, lack of leadership support and inadequate recognition, 18% of new RNs quit the profession in the first year.

How to stop it: Meaningful recognition from peers or managers can make a huge difference in employee engagement and motivation, encouraging behaviors or teaching core values. When used early and often, recognition instills a sense of purpose and belonging that retains new hires.

A variety of recognitions, like monthly awards, years of service, or peer-to-peer shoutouts, offer structure and consistency.

For example: Stability Healthcare used ITA Group’s recognition technology to centralize employee engagement with points-based recognition and online challenges.

Stability team members connected on the platform regardless of level or role. A live newsfeed publicized team shoutouts, giving everyone insight into everyday wins. As a result, 94% of employees agreed they could be themselves at work and 97% said they were in a positive working environment.

Related: Employee recognition supports remote worker well-being

4. Lack of team culture and connection

The 2026 NSI National Health Care Retention & RN Staffing Report cited a lack of company culture as one of the reasons leading to nurse attrition. The emotional demands and high-stress environment healthcare inhabits can wear down any individual.

The relationships we build with our peers and managers every day create a supportive, engaging workplace where team members feel like they belong. Organizations with a deeper sense of belonging and connection experience 50% lower turnover risk.

How to stop it: Frontline workers are often on their feet all day and work across different shifts and locations. Create a central and consistent employee engagement program that employees can count on. 

For example: Stability Healthcare turned to ITA Group’s recognition technology, accessible via desktop or mobile, as the go-to spot for employee experience. RNs could issue recognition, join online challenges or earn employee incentives all in one spot.

“ITA Group’s recognition platform allowed us to share our wins with the entire company,” said Samantha Wisniewski, People Operations Manager at Stability Healthcare. “It’s now the central spot for our team to stay informed and celebrate together, whether they’re on a different team or on the other side of the country.”

6. Inadequate pay

Nurses play an essential role in a hospital or clinic’s reputation and their patients’ recovery and health. Understaffed, overworked and highly stressed RNs often leave for more competitive pay or better opportunities elsewhere.

While 55% of RNs received a modest salary bump in the past year, raises are often modest, and many nurses use overtime to keep up with cost of living expenses. Institutions can address salaries but also support by focusing on a holistic employee experience program that provides additional employee benefits.

How to stop it: Free learning and development resources help RNs advance their careers. Total well-being programs like free mental health counseling, financial health resources or gym stipends help individuals save on costs. Employee rewards and incentives, such as gift cards from favorite stores and high-end merchandise, additionally award hard work and help ease the burden of expenses.

Platforms like ITA Group’s recognition technology can track participation and engagement of employee programs, like recognition or rewards. Admins can measure effectiveness of programs on retention and engagement over time.

However, the best incentives align with employee needs. Gather RN feedback or work with focus groups to better understand what programs would be beneficial. Including staff members in the process encourages participation and ensures you’re offering the right solutions.

7. Decreased trust and collaboration

Poor management and leadership and a lack of teamwork are the kinds of issues that create a deficient work experience for nurses, especially those newly entering the workforce. Lack of supportive leadership, organizational commitment and culture are significant predictors of nurse turnover.

Building community amongst your staff creates connection and loyalty, so focus on building a positive workplace culture. Shared core values offer structure and unify teams through a mission and vision.

How to stop it: Focus on building trust through inclusion and open communication. Create opportunities for staff members to chat with leaders candidly, either through town halls or quarterly open office hours. Use feedback strategically, capturing employee survey responses and sharing results and an action plan each time.

Build support through company events and team-building activities separate from work tasks, such as volunteering, employee resource groups or training cohorts. These opportunities encourage team members to work together and understand one another better, building trust and loyalty.

Reduce nurse turnover with the right retention programs

High nurse turnover leads to understaffed teams, increased workloads and mounting stress and burnout, leading to more turnover and even worse staff shortages.

Paired with inadequate management of the workplace environment and lack of culture, qualified staff members have very little reason to feel supported or to stay.

Healthcare institutions can break the cycle of turnover by fostering an environment that keeps nurses aligned, motivated and heard. Recognition, learning and development, rewards and employee well-being work together to support RNs’ employee journey, ensuring retention and building loyalty.

If you’re looking to engage nurses at your hospital or staffing agency, read ITA Group’s ultimate guide on aligning employee experience programs.