In terms of where they are going, nurses are both leaving the profession entirely as well as simply changing employers or roles. 4 David Auerbach, Peter Buerhaus, Karen Donelan, and Douglas Staiger, “A worrisome drop in the number of young nurses,” Health Affairs Forefront, April 13, 2022. A Health Affairs study published in April 2022 found that the RN workforce fell by about 100,000 by the end of 2021, which is a “far greater drop than ever observed over the past four decades.” This decline was particularly pronounced among midtenure nurses (aged 35 to 49). 3 2023 NSI national health care retention & RN staffing report, March 2023. In the latest NSI report (March 2023), turnover reduced to 23 percent in fiscal year 2022 but still remains elevated compared with prepandemic levels. 2 2022 NSI national health care retention & RN staffing report, NSI Nursing Solutions, March 2022. (NSI) showed that actual reported hospital and staff RN turnover increased from 18 percent in fiscal year 2020 to 27 percent in fiscal year 2021 the same March 2022 study reported that the workforce lost about 2.5 percent of RNs in 2021. Recent analysis of studies comparing intent to leave to actual turnover show that both jumped meaningfully over the course of 2021. In our most recent pulse survey of inpatient RNs, we saw intent to leave rise again, from 35 percent in fall 2022 to over 40 percent in March 2023. For example, inpatient registered nurses (RNs) have consistently reported a higher intent to leave than the average of all surveyed RNs. Our research further shows that the intent to leave varies across settings. 1 Gretchen Berlin, Meredith Lapointe, and Mhoire Murphy, “ Surveyed nurses consider leaving direct patient care at elevated rates,” McKinsey, FebruGretchen Berlin, Meredith Lapointe, Mhoire Murphy, and Molly Viscardi, “ Nursing in 2021: Retaining the healthcare workforce when we need it most,” McKinsey, May 11, 2021. In our most recent nursing survey, 31 percent of respondents indicated they were likely to leave their current role in direct patient care, a figure that has stabilized over the past six to 12 months yet is still higher than the 22 percent rate observed in our first survey in February 2021 (Exhibit 1). Nursing turnover continues to be a substantial challenge for healthcare organizations as the number of individuals with the intent to leave their jobs remains high. The examples, tools, and systems have not been vetted and are not endorsed by McKinsey. Additionally, publicly shared examples, tools, and healthcare systems referenced in this article are representative of actions that stakeholders are taking to address workforce challenges. Key insights shared are statistically significant and represent populations with a sample size of n > 30 for smaller sample sizes (for example, n < 100), results should be taken as directional. All survey questions were based on the experiences of the individual professional. All respondents said they spend more than 70 percent of their time delivering direct patient care and that they had at least one year of work experience. What’s been happening in the nursing workforceįrom September 9 to 30, 2022, McKinsey surveyed 368 frontline nurses providing direct patient care in the United States to better understand their experiences, needs, preferences, and career intentions. We offer these insights as resources for organizations as they continue their journeys of attracting, supporting, and retaining a vibrant workforce, as well as promoting longer-term workforce stability. In this article, we share the latest data from our September 2022 frontline nursing survey of 368 frontline nurses providing direct patient care in the United States (see sidebar, “About the research”). That said, we are cautiously optimistic that some of the practices implemented by healthcare organizations to improve the experience of nurses are bearing fruit. And there is still cause for concern: today, 31 percent of nurses still say they may leave their current direct patient care jobs in the next year, according to our most recent survey. In fact, we have seen some of this reported anticipated turnover actually occur, as well as a decrease in the overall active nursing workforce. This article is a collaborative effort by Gretchen Berlin, Faith Burns, Connor Essick, Meredith Lapointe, and Mhoire Murphy, representing views from McKinsey’s Healthcare Practice.īut that is what has happened in the wake of the COVID-19 pandemic.
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