If you run a hospital unit, you already feel the churn before any report confirms it.
Shifts go unfilled.
New hires leave faster than they can be trained. Charge nurses absorb the gap.
The 2026 data backs up that experience with hard numbers. National RN turnover climbed to 17.6% in 2025, reversing two years of gradual improvement, while the average cost of losing a single bedside RN reached $60,090, according to the 2026 NSI National Health Care Retention & RN Staffing Report.
That single number touches everything from recruitment budgets to patient care continuity.
This article breaks down what changed in 2026 for Nurse Turnover in Hospitals, where attrition concentrates by specialty, and what the numbers mean for staffing strategy, not just for finance teams tracking cost per hire.
Registered nurses, rn staffing, and hospital turnover rate figures move together but tell different stories. A hospital-wide number can mask a crisis happening in one unit. Reading these figures side by side gives a clearer picture of where nurse turnover actually hurts care delivery.
The 2026 Turnover and Vacancy Snapshot
The 2026 NSI National Health Care Retention & RN Staffing Report, compiled by NSI Nursing Solutions, Inc., surveyed 527 acute care hospitals across 40 states, covering nearly 966,000 healthcare workers and more than 262,000 registered nurses.
It remains one of the most widely cited sources for RN turnover rate and rn vacancy rate benchmarking in the country, alongside recruitment metrics that track how long it takes to backfill open nursing positions.
Related: Nursing Shortage Statistics
RN Turnover Rate Versus Hospital-Wide Turnover
Staff RN turnover reached 17.6% in 2025, while the broader hospital turnover rate, covering all employee types, hit 18.5%, according to The Resource Company’s 2026 healthcare turnover analysis. These are related but distinct measures. Hospital-wide turnover includes support staff roles that often churn faster than registered nurse turnover, which can inflate the overall figure if read without context.
RN Vacancy Rate and Unfilled FTE Positions
The national RN vacancy rate stands at 8.6%, meaning the average hospital carries 43 unfilled RN full-time equivalent positions at any given time. One in three hospitals reported vacancy rates of 10% or higher. Magnet-recognized hospitals fared modestly better, with a 7.3% vacancy rate and 37 unfilled FTEs on average.
How 2025 Results Compare With Pandemic-Era Peaks
RN turnover dipped to 16.4% in 2024 before climbing back to 17.6% in 2025, a 1.2 percentage point increase that reversed prior gains. Over the past five years, the average hospital has turned over 102% of its entire RN workforce, according to reporting from nurse.org. The current rate sits below the sharpest pandemic-era spikes, but it has not returned to pre-pandemic stability.
How to Read National Benchmarks Responsibly
National averages hide wide variation. RN turnover ranged from 5.6% to 40.0% depending on hospital size and geography. Every single percentage point change in RN turnover costs or saves the average hospital roughly $295,000 a year, which means small shifts in the national figure translate into real budget swings at the facility level.
Where RN Attrition Is Most Concentrated
RN turnover by specialty varies sharply, and the gap between the highest and lowest units has widened. Behavioral health and emergency services post the steepest attrition, while pediatrics and surgical services stay comparatively stable, according to Becker’s Hospital Review’s specialty breakdown.
Behavioral Health and Emergency Services
Behavioral health led all nursing specialties in 2025 at 22.5% turnover, followed by emergency services at 20.7%. These units combine high emotional intensity, unpredictable patient acuity, and frequent exposure to workplace violence, factors that compound faster burnout compared to other departments.
Telemetry, Step-Down Units, and Critical Care
Telemetry turnover reached 19.5%, with step-down units close behind at 19.0%. Over a five-year period, telemetry and step-down units posted cumulative turnover rates above 115%, meaning these departments effectively replace their entire RN staff in under four and a half years. Critical care units face similar pressure from constant acuity swings and rapid clinical decision-making demands.
Medical-Surgical Nursing and High-Acuity Workloads
Med/Surg turnover sat at 18.1% in 2025, still above the national average. High patient-to-nurse ratios and frequent unit transfers make this specialty a common entry point for new grads, which also makes it vulnerable to early-tenure departures.
Pediatrics, Surgical Services, and Women’s Health
Pediatrics recorded the lowest specialty turnover at 13.4%, with surgical services at 14.9% and women’s health at 15.0%. Retirement pressure is still expected to hit surgical services hardest in coming years, as noted in nurse.org’s coverage of the 2026 NSI findings, even though current turnover in that specialty remains relatively low.
Related: Nurse Turnover Rates in the United States
Why Nurses Leave and Why New Hires Leave First
First-year turnover remains one of the most consequential patterns in the data. New RNs leave at a much higher rate than tenured staff, and the reasons span personal circumstances, retirement, and working conditions rather than any single cause.
First-Year RN Turnover and the Early-Tenure Risk
More than 22.7% of newly hired RNs left their position within the first year, accounting for 29% of all RN separations, according to the 2026 NSI report as summarized by Emerging Nurse Leader. Across all hospital roles, close to 30% of new hires exited within a year. This early-tenure risk is where retention investment tends to pay off fastest, since 74% of hospitals now run some form of formal retention strategy.
Retirement, Career Mobility, and Relocation
The top reasons staff RNs voluntarily resigned were personal issues, relocation, retirement, career advancement, and scheduling conflict. Retirement has climbed steadily and now ranks third overall. As Baby Boomers reach retirement age through 2030, this trend is expected to accelerate, with surgical services and behavioral health flagged as specialties likely to feel it most.
Scheduling, Workload, and Working Conditions
Working conditions and workload/staffing ratios both appear in the top ten reasons nurses leave. Bedside RN dissatisfaction correlates strongly with self-reported burnout, and nurses who report dissatisfaction are more than 2.5 times more likely to leave, according to research summarized by HealthExec.
The Ripple Effect on Bedside Teams and Care Delivery
When registered nurse turnover concentrates in one unit, remaining staff absorb heavier assignments and more frequent orientation duties for new hires. This cycle can strain morale even among nurses who have no immediate plans to leave, creating a slow drag on unit stability that outlasts any single departure.
The Financial and Operational Cost of Turnover
Turnover costs extend well past a single exit interview. Recruitment delays, agency staffing gaps, and support-role attrition all compound the price tag attached to each departure.
Replacement Costs for a Bedside RN
The average cost of replacing one bedside RN reached $60,090 in 2025, pushing total annual losses for the typical hospital between $4.2 million and $6.2 million. On average, hospitals lost $5.19 million to RN turnover last year alone, based on figures from the 2026 NSI report.
Recruitment Delays and Coverage Gaps
The RN Recruitment Difficulty Index, which measures time to hire an experienced nurse, sits at 78 days nationally. Telemetry positions take longest to fill at 87 days, while Med/Surg and PCU roles average 83 and 88 days respectively. Even emergency services, the fastest specialty to recruit, still requires about 70 days to place a nurse.
Overtime, Agency Staffing, and Travel-Nurse Reliance
Travel nurses cost hospitals an average of $91.23 per hour, compared to $59.46 for an employed staff RN including benefits, a gap of more than $66,000 annually per nurse. Despite the cost, 70.7% of hospitals say they want to reduce travel nurse usage this year, yet agency staffing remains a common stopgap when vacancy rates spike, according to MedSource’s analysis of the 2026 data.
Why Support-Role Turnover Cannot Be Ignored
Frontline support roles show even steeper separation rates than RNs. Patient care technicians reported 33.8% turnover and certified nursing assistants reported 32.5%, according to The Resource Company’s 2026 turnover report. Losing these roles increases pressure on nurse practitioners and bedside RNs who depend on support staff for daily workload distribution.
Retention Strategies That Address the Workforce Reality
Retention efforts work best when they target the specific pressure points shown in the data, rather than applying the same fix across every unit. Staffing strategies grounded in onboarding, scheduling flexibility, and unit-level analysis tend to outperform generic incentive programs.
Strengthening Onboarding, Residency, and Preceptor Support
Nurse residency programs earned a 3.9 out of 5 effectiveness rating from hospitals surveyed in the 2026 NSI report, and 80.8% of hospitals now maintain a specific retention strategy for newly hired nurses. Strong preceptor pairing during the first year addresses the early-tenure risk directly, since transition shock is a documented driver of new-grad turnover.
Improving Staffing Strategies and Schedule Flexibility
Flexible or non-traditional scheduling models can improve job satisfaction and reduce turnover intent, according to research highlighted by NYU. Staffing strategies that account for unit acuity, rather than fixed ratios alone, help reduce the burnout that fuels voluntary resignation.
Using Unit-Level Data Instead of One-Size-Fits-All Targets
National rn staffing benchmarks published by the american hospital association and the u.s. bureau of labor statistics offer useful context, but unit-level tracking captures the real drivers of nurse turnover in US hospitals in a specific hospital. Behavioral health, emergency services, and telemetry each need distinct retention plans given their differing attrition patterns.
Supporting Sustainable Working Conditions and Wellbeing
Chronic understaffing and repeated exposure to high-acuity shifts take a cumulative toll on nurses’ mental and emotional wellbeing. Employer-sponsored EAPs and licensed therapy remain the primary channels for addressing burnout and workplace stress. Some nurses also explore complementary, private wellness support, such as remote sessions offered by services like Ne Ste Al, alongside existing therapy or medical care, though these services are not a substitute for organizational staffing fixes or clinical treatment. Digital health tools that track workload and schedule fatigue are increasingly used to flag burnout risk before it turns into attrition.
Using Workforce Data Without Misleading Comparisons
Turnover statistics come from different surveys, years, and hospital samples, so comparing figures across sources requires care. A number pulled from one report year does not always match the methodology used in another.
Comparing NSI Reports, Public Data, and Hospital Benchmarks
NSI Nursing Solutions’ annual reports rely on direct hospital survey submissions, covering hundreds of facilities each year, while the u.s. bureau of labor statistics tracks broader labor market trends across the nursing healthcare sector. Both are useful, but they answer different questions. NSI data reflects acute-care hospital experience specifically, while federal labor data covers a wider workforce lens.
What Statista Access Levels Mean for Readers
Platforms like statista aggregate registered nurse turnover rates from sources including NSI reports, often behind premium statistics or free statistics access tiers. A figure cited from Statista’s RN turnover dataset may reflect a specific year or hospital sample that differs from the most current NSI release, so checking the underlying report year matters before citing a number in board materials or market insights presentations.
Questions Leaders Should Ask Before Acting on a Turnover Figure
Before using any turnover rate in planning, ask what year the data reflects, how many hospitals were surveyed, and whether the figure covers RNs specifically or all hospital staff. These distinctions determine whether a benchmark is actually comparable to your facility’s own reports.
Frequently Asked Questions
What is the current nurse turnover rate in U.S. hospitals?
National RN turnover reached 17.6% in 2025, up from 16.4% the year before, according to the 2026 NSI National Health Care Retention & RN Staffing Report. The broader hospital-wide turnover rate, covering all employee types, stood at 18.5% for the same period.
How is the nurse turnover rate calculated?
RN turnover is typically calculated by dividing the number of RNs who left their position during a year by the average number of RN positions during that same period. Most national reports, including NSI’s annual survey, gather this data directly from participating hospitals rather than relying on self-reported estimates alone.
What are the main causes of nurse turnover in hospitals?
The top reported reasons RNs voluntarily resign include personal issues, relocation, retirement, career advancement, and scheduling conflict. Working conditions and workload or staffing ratios also rank among the top ten causes, reflecting the cumulative strain of high-acuity assignments.
How much does nurse turnover cost a hospital?
The average cost of replacing one bedside RN reached $60,090 in 2025, pushing total annual losses for a typical hospital between $4.2 million and $6.2 million. Every one percentage point change in RN turnover shifts hospital costs by roughly $295,000 per year.
How do nurse turnover rates vary by state and hospital type?
Turnover ranged from 5.6% to 40.0% depending on hospital size and geography in the 2025 data. The North-East recorded the sharpest single-year increase, rising 3.3 percentage points to 17.9%, while the South-Central region saw a slight decline.
What strategies can hospitals use to reduce nurse turnover?
Nurse residency programs, structured preceptor support, and flexible scheduling models are among the most commonly cited retention tools. Using unit-level data instead of applying one national benchmark across every department helps target retention efforts where attrition actually concentrates, such as behavioral health or emergency services.
