Improving Nurse Retention in 2020 and Beyond

April 1, 2021
April 1, 2021

Nurses continue to play a critical role in healthcare, and there are more nurses than any other profession in the healthcare industry. In the United States alone, there is estimated to be 3.9 million nurses, with a projected need for a million more nurses as soon as this year (Haddad & Toney-Butler, 2020). Shortages in the number of nurses occur for multiple reasons—some are connected to an educational system that cannot turn out nurses fast enough, and others are related to burned out nurses leaving the profession. A concurrent challenge is the unequal distribution of nurses nationwide, which is especially relevant when many places are experience explosive growth while others are stagnant.

Why Nurse Retention Is Important

Here are some statistics that demonstrate why nurse retention is so important:

  • Our Aging Population – By 2029, when the last of the baby boomers retire, the population of those aged 65 or older will be 71 million, a 73% increase from the 41 million of 2011.
  • Our Aging Nursing Workforce – one million nurses are aged 50 or older, meaning 1/3 will likely retire within the next 15 years
  • Greater Need for Nurses – Even the states with the lowest growth rates are anticipated to need at least 11% more nurses through 2022
  • Turnover among nurses remains a problem, at rates that vary from nearly 9% to 37%, depending on location and specialty (Haddad & Toney-Butler, 2020)

Strategies for Improving Nurse Retention

A Nurse Residency Program – One place where organizations can make an impact on keeping nurses in their positions is at the critical juncture when new graduate nurses begin their first jobs. Due to lack of confidence or expectations that don’t match reality, many new graduates leave within the first year. A way to counter this risk is through a nurse residency program in which “new graduate nurses are engaged, satisfied, feel empowered, have a high level of organizational commitment, and are confident” (Wildermuth et al., 2020).

Focus on Creating a Positive Work Environment – A recent HCA survey assessed what newer generations of RNs identified as factors influencing their nursing career choices. For this cohort, a favorable work environment in which they were likely to stay in their jobs had some strong characteristics. These included: relationships with colleagues, career advancement opportunities, flexible scheduling, communication and decision-making authority, modern facilities and technology, and an acceptable workload, often measured in terms of the patient-nurse ratio (Thew, 2020).

Counteract Nurse Burnout – Nurses can experience burnout for multiple reasons that come together to crat a toxic environment of stress and futility. Nurse leaders can defuse this feeling with three important strategies:

  1. Invest in nurses’ mental health with training, counseling options, and stress management advice.
  2. Praise and encourage nurse so that they feel appreciated and respected. A supportive environment is far less stressful.
  3. Deal with staffing needs before they become a disaster. The stress of nursing in an environment that is understaffed is a great contributor to burnout. Do whatever you can to solve this problem before it gets worse (Caulfield, 2019).

Partnering with top nursing associations, HealthStream offers online orientation programs for a variety of clinical areas, including Pediatric and Neonatal; Critical Care; Perioperative; and Perinatal Care. HealthStream’s award-winning* Nurse Residency Pathway is a structured yet flexible program designed to address the challenges faced by new graduate nurses as they make the transition to professional practice. By providing the necessary support new nurses need, the Pathway helps to effectively close the academic-to-practice gap, so that hospitals retain safe, competent, and confident nurses who are prepared to continue their professional growth.


Caulfield, C., “3 ingredients to reduce nurse burnout,” October 15, 2019, McKnight’s Long-Term Care News, Retrieved at https://www.mcknights.com/marketplace/3-ingredients-to-reduce-nurse-burnout/.
Haddad, L., and Toney-Butler, T., “Nursing Shortage,” February 18, 2020, Retrieved at https://www.ncbi.nlm.nih.gov/books/NBK493175/.
Hilton, L., Wildermuth et al., “Transition experiences of nurses as students and new graduate nurses in a collaborative nurse residency program,” Journal of Professional Nursing, Volume 36, Issue 1, January–February 2020, Pages 69-75, Retrieved at https://www.sciencedirect.com/science/article/pii/S8755722319300870.
Thew, J., “What CNOs Should Know about Millennial and Gen Z Nurses,” February, 7, 2020, HealthLeaders, retrieved at https://www.healthleadersmedia.com/nursing/what-cnos-should-know-about-millennial-and-gen-z-nurses.