If you are asking how much does nurse turnover cost, the number every hospital leader needs to know is $60,090. See the nurse turnover guide.

That is the average price tag on losing a single bedside RN in 2026, and it adds up fast once you multiply it across a busy floor.

For a typical hospital, RN turnover now drains somewhere between $4.2 million and $6.2 million a year, money that could otherwise go toward staffing, pay, or the kind of support that keeps nurses from walking out the door in the first place.

The 2026 NSI National Health Care Retention & RN Staffing Report, built from survey data covering 527 acute care hospitals and more than 262,000 registered nurses, lays out exactly where that money goes and why it keeps climbing.

  • Recruitment fees
  • Training costs
  • Productivity loss while new hires get up to speed
  • Reliance on temporary staff all stack on top of each other
  • The pattern shows up across nursing turnover more broadly, not just at the bedside

Key Takeaways

  • RN turnover rose again in 2025, reversing two years of improvement and pushing hospital losses higher.
  • New hires and certain specialties, like behavioral health and emergency services, are leaving at much faster rates than the rest of the workforce.
  • Vacancy rates, retirement waves, and expensive travel nurse staffing are keeping pressure on hospital budgets and patient care.

RN Turnover Ticked Back Up in 2025-2026

The U.S. national RN turnover rate jumped to 17.6% in 2025, up from 16.4% the year before. That 1.2 percentage point rise came straight out of the 2026 NSI National Health Care Retention & RN Staffing Report, published by NSI Nursing Solutions, and it broke a two-year streak of gradual improvement.

Turnover varied a lot depending on where you looked. Some hospitals reported registered nurse turnover as low as 5.6%, while others saw as high as 40.0%.

The dollar impact is easy to calculate once you know the formula. Every one-point shift in staff RN turnover costs or saves the average hospital about $295,000 a year. That 1.2-point increase alone added roughly $360,000 in extra losses, pushing average annual RN turnover costs to $5.19 million.

Zoom out five years and the trend gets harder to ignore. The average hospital has now turned over 102% of its entire RN workforce since 2021, meaning it has effectively replaced every bedside RN it employs, and then some.

For hospital finance teams, this is not a one-year blip to wait out. It is a workforce cost that keeps compounding, and it tracks closely with staffing decisions made at the unit level. If you want a deeper breakdown of what drives that cost of nurse vacancies, the per-position math tells its own story.

Related: Nurse Turnover in U.S. Hospitals

Retirement Is Becoming a Bigger Driver of Departures

Retirement has climbed into third place among the top reasons RNs quit, right behind personal issues and relocation. Hospitals surveyed for the report picked from a list of 20 possible reasons, and the shift toward retirement stands out as a change worth watching.

The top five reasons nurses resigned, in order, were personal issues, relocation, retirement, career advancement, and scheduling conflict. Rounding out the top ten: education, salary, commute, working conditions, and workload or staffing ratios.

This retirement trend is only going to build.

Every Baby Boomer will reach retirement age by 2030, and the report calls out surgical services and behavioral health as two specialties likely to feel the impact hardest as experienced nurses head out the door.

That matters because retiring nurses take years of clinical judgment with them.

A new hire can learn a task quickly, but the pattern recognition that comes from decades at the bedside does not transfer overnight. Hospitals losing veteran nurses to retirement are losing more than a line on the schedule; they’re losing institutional memory that keeps units running smoothly during hard shifts.

Some Specialties Are Being Hit Harder Than Others

Behavioral health carries the highest RN turnover rate of any specialty, at 22.5% in 2025. Emergency services followed close behind at 20.7%, then telemetry at 19.5%, step down at 19.0%, and med/surg at 18.1%.

Pediatrics sits at the other end, with the lowest turnover rate at 13.4%. Surgical services and women’s health also came in below the national average, at 14.9% and 15.0%.

The five-year picture is where the real damage shows up. Telemetry, step down, and emergency services units have each posted cumulative turnover above 113% over that span. That means these departments turn over their entire RN staff in less than four and a half years.

Mental health nursing, in particular, deserves a closer look. Behavioral health units already carry higher risks of workplace violence and emotional strain, and pairing that with the highest turnover rate in the industry creates a tough cycle to break. Fewer experienced hands on a psych unit means less mentorship for new nurses walking into one of the hardest specialties in the field.

If your facility runs any of these high-churn units, comparing your numbers against national data on high nurse turnover units can help you figure out where to focus retention dollars first.

Nearly 1 in 5 Newly Hired RNs Leaves Within a Year

More than 22% of newly hired RNs quit within their first year on the job. That single stat explains a huge chunk of the churn hospitals are dealing with, since first-year departures account for 29% of all RN separations.

The problem is not limited to nurses. Across all hospital employees, close to 30% of new hires left within twelve months, and that group made up more than a third of total turnover. Over half of all departing employees, 56.8%, had less than two years on the job.

New hires leave fast when onboarding falls short. Hospitals know this, which is why 74% now run a formal retention strategy, and 80.8% have a plan built specifically around new nurse retention.

Nurse residency programs remain one of the most trusted tools for keeping new grads on staff. Respondents rated these programs 3.9 out of 5 for effectiveness, a solid score that reflects real results on the floor. Strong preceptorship, where an experienced nurse walks a new hire through real patient scenarios for weeks or months, tends to matter just as much as the formal classroom side of onboarding.

If your facility is still building out an onboarding pipeline, this nurse turnover guide breaks down what a strong first-year retention plan looks like in practice.

158,600 RNs Short — And Hospitals Still Can’t Fill the Seats

The country is currently short 158,600 registered nurses, based on NSI’s survey data. That shortage shows up at the hospital level as a national RN vacancy rate of 8.6%, which translates to 43 unfilled RN full-time positions at the average facility.

One in three hospitals, 33.1%, reported vacancy rates of 10% or higher. Magnet-recognized hospitals fared a bit better, holding a 7.3% vacancy rate and averaging 37 open RN slots, about 1.3 points below the national number.

Filling those seats takes time. The RN Recruitment Difficulty Index, which tracks how long it takes to hire an experienced nurse, sits at 78 days, five days faster than last year but still a long stretch to run short-staffed. Telemetry positions took the longest to fill at 87 days, followed by PCU at 88 and med/surg at 83. Even ER roles, the fastest to recruit, still took 70 days on average.

Every open shift on that list means someone else on the team is absorbing extra patient load. Persistent understaffing pushes nurse-to-patient ratios past what’s sustainable, and that pressure is a big reason the nursing shortage keeps feeding back into higher turnover. Acute care hospitals that invest in sustainable staffing models, rather than constantly scrambling to backfill, tend to see steadier numbers year over year.

For a full picture of how vacancy rates compare across regions and specialties, the nurse turnover rates in the United States breakdown lays out the state of the nursing workforce in more detail.

Travel Nurses Remain Expensive — But Hospitals Can’t Quit Them

Travel nurses cost hospitals significantly more than staff RNs, yet most facilities still lean on them to cover gaps. The average travel nurse fee runs $91.23 an hour, or close to $189,758 a year, compared to $59.46 an hour for an employed staff RN with benefits included. That’s a gap of more than $66,000 per nurse, per year.

Hospitals know the math does not favor agency staffing long term. Last year, 73.5% of facilities said they planned to cut back on travel nurse use, yet travel staffing stayed a go-to fix whenever a unit ran short. This year, 70.7% say they want to reduce it again, even as vacancy rates keep the pressure on.

The cycle is hard to break because travel nurses fill gaps fast, while recruiting a permanent staff RN takes 78 days on average. Until hospitals close that hiring gap, agency staffing will keep showing up in the budget, even when leadership wants it gone.

The Regional Picture: Where Turnover Is Worst

The North-East saw the sharpest jump in RN turnover in 2025, climbing 3.3 percentage points to 17.9%. Every region in the country reported an increase except the South-Central, which dropped slightly by 0.9 points to land at 17.1%.

Here’s how each region stacked up against the 17.6% national average:

Region Staff RN Turnover Year-Over-Year Change
North-East 17.9% +3.3%
South-East 18.7% +1.4%
West 18.4% +2.3%
North-Central 16.2% +0.4%
South-Central 17.1% -0.9%
National Average 17.6% +1.2%

South-East and West both came in above the national number, while North-Central and South-Central stayed below it. If you manage staffing in a high-turnover region, checking regional trends against your own hospital’s numbers can flag problems before they show up in your annual budget.

What This Means for Nurses

These numbers describe the shift you’re already working, not some distant statistic. Short staffing, heavier patient loads, and constant churn among coworkers show up in real time on the floor, not in a spreadsheet somewhere.

High turnover has a direct line to patient care. Research on nurse staffing consistently connects understaffed units to more medical errors, higher rates of pressure ulcers, longer length of stay, and even higher mortality in the most extreme cases. When your team is stretched thin, quality of care suffers even when everyone is doing their best.

Retention comes down to choices made above the bedside. Hospitals that invest in manageable workloads, flexible scheduling, competitive pay, and a genuinely healthy work environment see steadier staff retention. Nurse managers and CNOs who build real career advancement paths and professional development opportunities tend to keep their nursing team intact longer.

Workplace culture plays a bigger role than most job postings let on. Staff morale and employee morale both drop fast in units dealing with chronic understaffing or workplace violence, and that drop feeds directly into job satisfaction and burnout. Magnet-recognized hospitals, which report lower vacancy rates across the board, tend to invest more consistently in these areas.

Patient satisfaction and patient outcomes both track closely with how stable a nursing team stays over time. A formal retention strategy is not a nice-to-have anymore; it is the difference between a unit that holds onto experienced nurses and one that keeps starting over.

🤔Nurses, what do you think about the data in this new report? Share your thoughts below.

Frequently Asked Questions

If you are asking cost to hospitals of onboarding new nurses after you’ve recruited them, the number every hospital leader needs to know is total cost is equal to 150% starting with $60,090.

What is the average cost of replacing a registered nurse?

The average cost to replace one bedside RN is $60,090, according to the 2026 NSI National Health Care Retention & RN Staffing Report. This figure covers recruitment, hiring, and training, plus the productivity loss that comes from having an unfilled position or a new hire still learning the job.

How is the financial impact of nurse turnover calculated?

Hospitals calculate turnover cost using each RN’s salary, recruitment fees, onboarding time, and lost productivity while a position sits open or a new hire ramps up. Every one percentage point change in RN turnover shifts hospital costs by about $295,000 a year, which is how the industry translates turnover rate into real budget impact.

What factors contribute to the cost of losing nursing staff?

Recruitment and advertising fees, sign-on bonuses, training time, and lost productivity all add to the price tag. Reliance on travel nurses to cover gaps pushes costs even higher, since agency staff cost more than $66,000 more per year than an employed staff RN with benefits.

How does nurse turnover affect hospital budgets and patient care?

High turnover pulls millions of dollars a year out of hospital budgets that could otherwise fund staffing or pay raises. It also connects to worse patient outcomes, including more medical errors and longer hospital stays, since understaffed units struggle to keep up with patient loads.

What is the typical nurse turnover rate in U.S. hospitals?

The national RN turnover rate reached 17.6% in 2025, up from 16.4% the year before. Rates vary widely by specialty and region, ranging from as low as 5.6% at some hospitals to as high as 40.0% at others.

What strategies can healthcare organizations use to reduce nurse turnover?

Strong nurse residency programs, solid preceptorship for new hires, competitive pay, and manageable staffing ratios all help hospitals hold onto nurses longer. A formal retention strategy focused on the first year of employment matters most, since nearly one in four newly hired RNs leaves within twelve months.

Related

Global Nurse Shortage & Retention Data