Top 4 Reasons Nurses Leave

Key takeaways:

  • Nurse turnover is estimated to cost organizations between $4.4-$7 million annually.
  • Negative work environment was identified as the most influential factor for why nurses decide to leave an organization.
  • Nurses may be influenced to stay in positions by different factors depending on their age group or seniority.

According to a 2018 Press Ganey Nursing Special Report of 250,000 nurses, the study identified four trends in nurse retention/ turnover which help explain how different external factors affect nurses across different specialties and age groups.

  1. Work environment. It probably comes as no surprise that the most recent Press Ganey study identified work environment as the most influential factor in nurse turnover. According to the survey, “42% of the 250,000 nurses surveyed said the work environment was the main reason they planned to leave their job within the next year”1.
    • However, the study also found that work environment affects different generations of nurses differently. Younger nurses were found to be slightly less concerned with work environment than their older counterparts.
    • “Of respondents under 30 years old, 39.7% said they intended to leave their jobs within the next year due to the work environment compared to 45.4% of nurses aged 40 to 49”1.
  2. Younger nurses experience higher turnover rates. Nurses who have been in practice between 2-4 years were found to have the highest risk for attrition
    • Another important finding identified that nurses under 30 were more likely to express a desire to leave the unit while staying with the facility than other age groups. This indicates that younger nurses may change units in an effort to identify their career path while remaining loyal to their organizations. 
    • Additionally, nurses in the same age group expressed a similar desire to leave patient care while remaining in nursing1.
  3. Job recognition. Younger nurses were found to place value on job recognition while more tenured nurses place more value in leadership.
    • For nurses that had been practicing for two years or less “the predictors of intent to stay were things like praise, recognition, nurse manager support, certification, and joy in work”1.
    • However, “for those who’ve been practicing for more than 20 years, [intent to stay] was about leadership, influence over their schedule, and quality of care”1.
  4. At-risk specialties. Nurses in more demanding specialties like critical care and step-down units were found to be at higher risk of turnover.
    • According to Press Ganey, nurses in higher acuity units were more likely to express a desire to leave their units within the next 1-3 years1.

Strategies to minimize turnover:

Of course, the correlation between turnover trends and different nursing groups does not mean causation. After all, not every nurse working in a supportive work environment can be expected to stay forever, nor should every new nurse be expected to leave within two years. Nevertheless, in an effort to minimize turnover through supportive leadership, the following 7 characteristics have been attributed to competent leaders who are more likely to retain nurses:

  • Visibility
  • Accessibility
  • Open discussion/consultative leadership approach
  • Support of nurses in the provision of quality care through high standards
  • Flexible scheduling
  • Strong relationships with staff
  • Giving recognition when due

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In case you missed it:


1Thew, J. (February 15th, 2019). 4 Reasons You Are Losing Nurses


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