Image of a nurse contemplating leaving his job for an article about nursing turnover

What Causes Nursing Turnover?

Nurse turnover is a huge issue for a career field that’s already facing shortages of licensed staff. In many areas, qualified nurses can be difficult to find and hire, so losing them to burnout and turnover can mean shrinking an already small pool of potential candidates.

Both facilities and nursing staff have a huge impact on nursing turnover. Here are the top reasons behind turnover and how the nursing field can work to help lessen the issue, so patients can get consistent, expert care, and nurses can focus more on patient care than workplace problems.

Factors that Cause Nursing Turnover

Regardless of whether you’re working in a hospital, private clinic, or for a home health or staffing agency, there will always be reasons why nurses leave, just like in any other job. Some of the most common factors that cause nursing turnover include the following:

Personal Reasons

Personal reasons can include any number of life events or factors. It could mean the nurse is getting married, having a child, moving to a new city or state, or leaving to continue their education. 

But it could also be a direct result of something on the job. For instance, burnout and compassion fatigue are very real issues, particularly in units with high-acuity patients. If a nurse feels they’re burned out and have stopped caring, they’re much more likely to want to find a new job or even a new career.

Other Opportunities

It’s no secret that there’s a nursing shortage. There are many employers hoping to hire well-qualified staff, and not enough qualified staff to satisfy every open job posting. 

If a nurse feels like they could get better pay or find better benefits for similar work in another job, it’ll be difficult to stay. Some nurses may also feel like they’ve learned and advanced all they can in their current job and are eager to find another opportunity that will give them the career growth they want.

Work Conditions

Work conditions, like high patient-to-nurse ratios, pay rates, or a negative workplace environment, can have a major impact on burnout and turnover rates. This includes leadership issues especially. If staff nurses feel like supervisors and the administrators aren’t listening to them or simply don’t care, they’re more likely to suffer burnout and leave as soon as they can.

The Impact of High Nursing Turnover 

High turnover rates among nursing staff have a direct and negative impact on patient safety and care. Turnover rates also affect burnout rates and staff morale and health.

Experienced vs New Nurses

Experienced nurses are well-versed in their unit’s protocols and procedures. They know where equipment is, how to contact other staff when needed, and how best to treat their particular patient demographic.

With turnover, new nurses in training for the unit are a constant. Although they bring in new energy and anticipation, the consistency and knowledge of an experienced nurse who knows their unit well are lacking.

Burnout and Patient Safety

High turnover rates often also mean high burnout rates. Emotionally drained nurses often find it difficult to think critically, respond quickly, and care empathetically. Without all those skills, patient safety is in jeopardy, and patients and their families don’t receive the highest quality care they’d receive from an otherwise healthy and happy nurse.

Poor quality patient care affects the patients, which often affects the nursing staff and the facility, which then contributes to more burnout and turnover. The cycle continues, and facilities stuck in it struggle to keep their units sufficiently staffed to prevent more burnout.

Financial Impact

Turnover is also incredibly pricey. The 2020 NSI National Health Care Retention & RN Staffing Report estimated that hospitals lose $3.6 to $6.1 million, on average, in bedside registered nurse turnover. 

How Nurses Can Help Reduce Turnover

Sometimes, nurses can feel powerless when it comes to impacting a negative work environment. However, there are several ways that nurses can help contribute to improving the work culture around them.

Refrain from Favoritism

For nurses who are promoted to nurse manager or work in a leadership role, make the effort to listen to all of the staff. Take special care not to subconsciously favor the nurses who are your friends or nurses on one shift over another. If your unit follows the rules of seniority, don’t make exceptions for the people you like best.

Welcome New Nurses

When new nurses are hired onto your unit, help them feel welcome. Many of us are told early on in our careers that nurses eat their young and competition can be fierce ― don’t let yourself or other nurses around you contribute to that type of culture. 

We all remember our first days or weeks on the job and how stressful it can be. A friendly face or an earnest question about how they’re doing can go a long way.

How Facilities Can Prevent Turnover

Facilities don’t have any control over how nurses feel or think, but they have a strong influence on helping to develop and enforce workplace culture. 

If nurses are leaving for personal reasons, in most cases, there isn’t much a facility can do, except make the job, culture, and workplace environment pleasant enough that a nurse would love to come back if given the chance. 

For personal reasons that are tied directly to the job, a lot of personal burnout issues come directly from the type of working conditions that the facility has. A recent study found that when the workplace environment was improved, the overall nurses’ emotional exhaustion fell 81%

That’s a huge jump, and facilities and their administration and supervisors are the biggest factors in guiding those improvements. 


What sort of improvements, you might ask? Leadership is one major point that affects the nursing staff’s emotional health. Good leaders who help the people they supervise feel like they’re heard and understood contributes greatly to a positive work environment. They ask and take into account staff opinions and make it a point to involve staff in decisions.

Encourage and Empower

A good work environment also encourages and empowers staff to advance in their careers. At the same time, it encourages teamwork over competition. When nurses are promoted to manager positions or a new manager is assigned to a new unit, administrators need to listen to staff to understand their needs or issues, like if staff complain that a nurse manager is favoring a certain shift or nurse.

Satisfaction Surveys

One way facilities can monitor issues is through regular surveys to check employee satisfaction. But if surveys are used, then whatever data comes from the surveys needs to be addressed through transparent action and communication.

When employees feel like they’re a valuable and appreciated part of a team, they’re more likely to feel emotionally and mentally healthy. And healthy, happy nurses mean a better workplace environment and better, quality patient care.

If you’re a health care professional who’s looking for good pay and a flexible schedule, Clipboard Health could be a good solution for you. Apply today. And if you’re an administrator who needs to fill open shifts, our health care professionals could also be a good solution for your hospital, long-term care center, or unit.