Nurse Retention Strategies for Hospitals Losing 18% a Year

Bedside nurse turnover hit nearly 18% in 2025, and the people who study it keep saying the same thing: hospitals don't have a nurse supply problem so much as a problem keeping the nurses they already hired. If you run a unit, nurse retention strategies are now the whole job, whether or not they're in your title.

Becker's Hospital Review, summarizing an Oct. 19 Wall Street Journal report, says NSI Nursing Solutions put staff RN turnover at 17.6% for 2025, up 1.2 points in a year. Advisory Board followed up on Nov. 2 with the reasons: understaffing, violence, and patients who are sicker and more complex than they used to be.

I'm a comedian, and I also spend a lot of time in rooms full of nurses and nurse managers. They're the toughest, funniest audiences I work for, so this story is personal for me.

Why are nurses leaving the bedside?

The best quote in all this coverage came from Jeff Doucette, chief clinical officer at Qualtrics (which acquired Press Ganey), speaking to the Journal: "There is no shortage of nurses in this country. There's a shortage of nurses that want to work in the current environment." If you sign off on the staffing budget, tape that second sentence to your monitor.

The current environment looks like this. A 2026 survey found 43% of nurses were likely to leave a bedside role within a year, up from 38% the year before, according to Becker's. Press Ganey found 2.4% of nursing staff were attacked in 2025, a 26% increase from 2017. Advisory Board adds that a National Nurses United survey of 1,300 nurses found 33% had been slapped, punched or kicked in the past year.

Then there's the blame. One 29-year-old nurse quoted in the coverage said, "The nurse is the face of the hospital, and we're constantly blamed for things outside our control." She's right. The patient waiting 24 hours for a bed doesn't yell at the CFO. They yell at whoever walks in with the IV pump.

Early-career nurses are leaving fastest. Press Ganey's State of Nursing 2026 report found turnover of 22% among Gen Z RNs and 21% among millennials, against 14% for Gen X, per Becker's.

The nursing shortage of 2026 has a price tag

If compassion doesn't move your leadership team, try arithmetic. NSI's report put the average cost of losing one staff RN at $60,090 in 2025, and the average hospital lost about $5.19 million to RN turnover. Every 1% change in turnover costs or saves the average hospital $295,000 a year, Becker's reports. Emory Healthcare puts its own number at around $78,000 every time a nurse leaves, per Advisory Board.

The cost shows up at the bedside too. Dustin Bass, president of the Emergency Nurses Association, said in Advisory Board's roundup that he used to rely on nurses with a decade or more of experience to run triage. "Now you have nurses running massive emergency rooms with 133 care spaces, and they've only been working for two or three years," he said. Hospital leaders in the same reporting connect that experience gap to more falls, more errors and more missed cues.

What nurse retention strategies actually work?

The good news in this story is that the hospitals spending real money are getting real results.

Rome Health, a safety-net hospital in upstate New York, won a $5 million grant from the Mother Cabrini Health Foundation and used it on a residency program for new nurses and a coach who meets one-on-one with nurses. Turnover dropped from 50% to 28%, and falls and certain IV-associated infections went down with it, Advisory Board reports. Emory gave $150 million in raises, mostly to nurses, and its recently retired chief nurse executive said the move cut turnover and saved the system money.

CommonSpirit Health reported an 81% jump in new-hire nurse retention over the past year and credited a redesigned yearlong residency plus a model where experienced nurses support bedside staff remotely, according to Becker's.

Every one of those comes down to experienced people assigned to help newer nurses, money, or both. I didn't see a pizza party on the list. Ali Knight of Advisory Board made the point I'd want every CNO to hear: when support roles get cut, "their work often shifts to nurses without staffing being adjusted to account for it."

Nurse retention strategies a manager can start tomorrow

You can't approve a $150 million raise from the nurses' station. You can control how your unit feels to work on, and that's the part I teach. Here's where I'd start:

• Assign every new nurse a person they can go to on a bad shift, by name. Rome Health paid for a coach; you can at least make it somebody's actual responsibility.
• Take blame off the nurse in front of the patient. When the delay is a bed-management problem, say that out loud to the family, and back your nurse up.
• Ask what got dumped on the unit. If transport, sitters or unit clerks got cut, list the tasks that landed on nurses and take that list upstairs.
• Treat a threat or an assault as a staffing and safety issue, and follow up with the nurse personally. A form in a portal doesn't count.
• Let people laugh. A unit that can joke about the absurd stuff is a unit where people say when they're drowning. Humor gives people a safe way to tell the truth, and a manager who can laugh at themselves is easier to bring bad news to.

That last one is where comedy earns its keep. I've watched a tense room of nurse managers loosen up after one good laugh and start telling each other what's really going on in their units. Building that habit is exactly what we work on in our healthcare humor workshops for nurses and nurse leaders.

Nurse burnout is a leadership problem

Nurse burnout gets talked about like a personal weakness, as if the fix were yoga and a gratitude journal. The data in this story says otherwise. Nurses are leaving units that are understaffed and unsafe, where they get blamed for the hospital's failures. A University of Pennsylvania survey cited by Becker's found most nurses who left the bedside in recent years would come back, with adequate staffing the thing most likely to bring them.

Those nurses haven't vanished. Plenty of them are waiting for a unit worth coming back to.

I write more on why nurses deserve better from leadership, on humor in hard healthcare moments, and on how humor builds trust on teams. If your best nurses are eyeing the exit, let's talk about what a workshop could do for your managers.