Staffing, Not Lack of Resiliency, Is Why Nurses Are Leaving Health Care

For their cross-sectional study, the nurse researchers surveyed all RNs in New York and Illinois from April 13–June 22, 2021. Of the 70,072 respondents, 15,797 said that they had left the profession. After adjusting the sample for nurses who left the profession more than three years before the time of the survey, the researchers analyzed data from the 7,887 RNs who left between April 2018 and June 2021. The sample represented 7,372 (93%) female and 515 (7%) male nurses and 679 (9%) Asian, 641 (8%) Black or African American, 6,147 (78%) White, and 373 (5%) were multiracial or other (American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander, or other) nurses.

On the survey, the nurses said they left because of retirement (n = 3,047 [39%]), burnout or emotional exhaustion (n = 2,039 [26%]), and insufficient staffing (n = 1,687 [21%]). Notably, only 2,884 of the 3,047 retired nurses (59%) indicated that their retirement was planned—and even retired nurses said that they retired because of burnout (n = 1,099 [22%]) and insufficient staffing (n = 888 [18%]).

Other reasons included a need for better benefits, wages, and work flexibility (n = 193 [28%]); not enough opportunity for professional growth and advancement (n = 150 [22%]); and unsafe working conditions (n = 136 [20%]). Among nurses who were not currently employed (n = 2,287), family obligations (n = 724 [32%]) was the highest ranked factor. “I am itching to return to the workforce,” an RN in their 30s said. “One thing that has dampened my efforts is childcare available that works with the shifts offered. Another drawback is working every other weekend.”

Overall, the researchers said that the survey results demonstrate that most nonretired nurses are leaving health care because of systemic issues rather than personal reasons such as returning to school. “More than two decades of evidence, including data generated during the COVID-19 pandemic, consistently finds that the most promising solution, endorsed by physicians and nurses, to reducing clinician burnout and ensuring high-quality, safe patient care is to ensure safe nurse staffing ratios,” the researchers wrote.

“These findings are useful to inform policy- and organizational-level solutions for recruiting and retaining nurses in health care,” they concluded.

Advocating for proper nurse staffing and other oncology nursing workforce safety and well-being policies is an ONS health policy priority (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy/health-policy-priorities-and-agenda). Learn more about ONS’s policy goals and current initiatives in the Center for Advocacy and Health Policy (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy), then join us in advocating (https://voice.ons.org/advocacy/get-involved-in-onss-health-policy-advocacy) for systemic change. Your voice shapes a better future for yourself, your colleagues, and the profession.