The 2023 NSI National Health Care Retention & RN Staffing Report reveals that in 2022, hospitals experienced a 22.5% registered nurse (RN) turnover rate, resulting in losses of millions of dollars. The report is based on survey responses from 273 hospitals across 35 states, representing over 200,000 RNs. The study shows that RN turnover is still a significant challenge for hospitals, with labor competition, provider burnout, and retirement causing retention issues. The report suggests that hospitals may be able to manage these challenges by increasing RN compensation and implementing successful compensation programs for critical staffing.
The healthcare industry is slowly recovering from the impact of the COVID-19 pandemic, and the registered nurse (RN) turnover rate remains a significant challenge for hospitals. According to the 2023 NSI National Health Care Retention and RN Staffing Report, the RN turnover rate in 2022 was 22.5%, resulting in hospitals losing millions of dollars. The report reflects survey responses from 273 hospitals across 35 states, representing more than 730,000 healthcare workers and over 200,000 RNs. This article will explore the key findings of the report and discuss the implications of the RN turnover rate for the healthcare industry.
RN Turnover Rates
In 2022, hospitals regained 5.65% of the workforce that was lost during the “Great Resignation,” which translated to 975,000 employees. The number of workers leaving their jobs declined in the later part of 2022, leading to reduced hospital turnover. The hospital turnover rate decreased by 3.2% from 2021 but was still 22.7% in 2022. Labor competition, provider burnout, and retirement are still causing retention challenges.
The mean hospital turnover rate was 23%, ranging from 7.3% to 40.5% due to varying hospital sizes. Resignations accounted for 94.7% of hospital exits, with personal reasons, career advancement, and relocation as the most common reasons workers resigned. Workers also reported leaving their job due to salary, retirement, and scheduling reasons.
RN workforce
The RN workforce gained 142,000 workers back in 2022, for a 4.17% add rate. RN turnover increased by 8.4% in 2021 but fell by 4.6% to 22.5% in 2022. The median turnover rate was 21.7%, ranging from 6.5% to 64.5%.
The report states that the average cost of staff RN turnover is $52,350 and can be anywhere from $40,200 to $64,500. With a 22.5% turnover rate, the average hospital lost $8.55 million in 2022, ranging from $6.57 million to $10.53 million. Each percent change in RN turnover will either cost or save the average hospital $380,600 annually.
Reasons for Turnover
Similar to the hospital staff, most RNs left their jobs due to personal reasons, career advancement, and relocation. To manage these staffing challenges, hospitals asked RNs to volunteer for overtime, authorized critical staffing pay, relied on travel nurses, and increased the RN salary scale. Respondents noted that the compensation programs related to critical staffing were the most successful strategies.
RN Specializations
Within the RN workforce, telemetry (27.1%), step-down (23.7%), and medical/surgical (23.1%) RN turnover were the highest and exceeded the national average. Step down, telemetry, behavioral health, and emergency services departments will likely turn over their entire RN staff in less than five years, the report said.
Future Plans
The current RN vacancy rate is 15.7%, while the RN Recruitment Difficulty Index ranges from 61 to 120 days. These figures indicate that hospitals will continue to face labor shortages. Despite these indications, hospitals have hopeful plans for the future. Sixty-two percent of hospitals expect to increase their labor force, and 69% expect to increase their RN complement. Additionally, 37% of hospitals anticipate an increase in the recruitment budget, while 20% plan to boost their recruitment staff.
