If you manage a nursing unit, work the floor, or study healthcare workforce trends, you have probably seen wildly different turnover numbers thrown around.

  • One report says 17.6% for Nurse Turnover Rates in the United States.
  • Another says 18.5%.
  • A hospital down the street might report something else entirely.
  • These differences are not a mistake.

Nurse turnover in the United States typically ranges from roughly 16% to 19% annually for registered nurses in hospitals, though the exact figure depends heavily on how it is measured, which care setting is studied, and which year’s data is used.

According to the 2026 NSI National Health Care Retention Report, RN turnover climbed to 17.6% after a period of gradual decline, reversing earlier improvement.

This article breaks down what these numbers actually mean, why they shift from source to source, and what tends to drive nurses toward the exit. It also looks at what turnover costs care teams and patients, and what realistic retention support looks like on the ground. If work stress or emotional strain feels like part of your daily routine, resources like remote, complementary wellness support from services such as Ne Ste Al exist alongside your regular care team, though they are not a substitute for addressing staffing or systemic workplace pressures.

How Nurse Turnover Rates in the United States Are Measured

Turnover sounds like a simple concept, but hospitals and researchers calculate it differently depending on what they want to track.

Some numbers reflect people leaving a specific unit, while others track people leaving the profession entirely. That distinction matters a lot when you compare reports.

Turnover, Vacancy, and Intent-to-Leave Metrics

Turnover rate usually means the percentage of nursing staff who left a job over a set period, often a year. Vacancy rate measures unfilled budgeted positions at a single point in time, which is a different thing entirely.

Intent-to-leave surveys ask nurses whether they plan to leave soon, which can signal future turnover before it shows up in the data. As explained on Shiftkey’s overview of nursing turnover, turnover is the inverse of retention, so a 20% turnover rate means a facility retained about 80% of its nursing staff that year.

Voluntary and Involuntary Departures

Voluntary turnover includes nurses who resign for a new job, retirement, family reasons, or burnout. Involuntary turnover covers terminations, layoffs, or contract non-renewals.

Researchers reviewing nursing literature have called for turnover to be reported clearly as voluntary or involuntary, and as avoidable or unavoidable, according to a systematic review published in Nursing Outlook. Without that breakdown, a single headline percentage can hide very different workforce stories.

Why National Estimates Differ

National estimates often rely on different survey samples, time periods, and definitions of “nurse.” Some studies include only RNs, others fold in support staff like certified nursing assistants.

A Health Affairs Scholar analysis using the National Sample Survey of Registered Nurses found a self-reported turnover rate of 28.7%, a notably different figure from hospital-survey based estimates. Sample size, response rate, and the years covered all shape the final number.

Recent National Benchmarks and Trends

National RN turnover sat near 17.6% in the most recent hospital survey data, up from a lower figure the year before. Trends have moved in both directions since the pandemic, with some years showing improvement and others showing a reversal, and the numbers also shift depending on whether you look at hospitals, other care settings, or specific nursing specialties.

Hospital and Health System Patterns

Hospital-wide turnover across all roles, not just RNs, reached 18.5% according to a 2026 turnover analysis. That figure includes support staff and other clinical roles, which is why it runs higher than RN-only turnover.

RN turnover specifically rose by 1.2 percentage points in a recent year, landing at 17.6% nationally, as reported in Becker’s Hospital Review’s cost analysis. That increase reversed a decline seen the year prior, when turnover had dropped to around 16.4%.

Individual hospitals vary widely. Some report RN turnover as low as 5.6%, while others report as high as 40%, based on survey data covering hundreds of hospitals.

Differences by Care Setting

Acute care hospitals are the most closely tracked setting, largely because of consistent annual surveys. Other settings, including outpatient clinics, long-term care, and home health, are studied less consistently, which makes direct comparisons harder.

The national RN vacancy rate in acute care settings stood at 8.6%, down slightly from 9.6% the prior year, according to the AACN Nursing Shortage Fact Sheet. Vacancy and turnover often move together, though not always at the same pace.

Regional and Specialty Variation

Turnover varies noticeably by clinical specialty. Becker’s Hospital Review’s specialty breakdown draws on survey data from 450 hospitals across 37 states, showing that high-acuity and high-stress units often report different turnover patterns than lower-acuity settings.

Early-tenure nurses, meaning those in their first few years on the job, tend to show different turnover trends than more experienced staff. AONL’s report on early-tenure retention breaks this down by specialty and shows meaningful gaps between early-career and all-tenure turnover rates.

Related: Nursing Shortage Statistics

Factors Driving Nurse Departures

No single cause explains why nurses leave a job or the profession. Workload, pay, scheduling, safety concerns, and emotional strain all appear repeatedly in research, often overlapping rather than acting alone.

Workload, Staffing, and Scheduling

Heavy patient loads and inflexible schedules show up consistently as reasons nurses consider leaving. A JAMA Network Open study examining nurses in New York and Illinois between 2018 and 2021 identified specific workplace conditions tied to nurses ending healthcare employment altogether, not just changing jobs.

Nurses balancing school or advanced degrees also show higher actual turnover, likely because rigid schedules clash with academic demands, according to Health Affairs Scholar research. The same study found nurses in a union or collective bargaining unit had a lower likelihood of turnover.

Compensation and Career Mobility

Pay matters, but it rarely stands alone as the only factor. Nurses weighing a move often consider career advancement opportunities alongside salary, according to Nurse.com’s research on retention strategies, which found that fair compensation paired with clear advancement pathways tends to matter more than pay alone.

Career mobility, including the ability to move into leadership, specialty certifications, or advanced practice roles, can influence whether a nurse stays with an organization long term.

Burnout, Moral Distress, and Workplace Safety

Burnout and moral distress, meaning the discomfort nurses feel when they cannot act according to their professional judgment, are associated with higher turnover intentions. A favorable practice environment tends to reduce turnover, while an unfavorable one raises intent to leave, according to research on nursing practice environments.

Workplace safety concerns, including exposure to violence or unsafe staffing ratios, may also contribute to a nurse’s decision to leave a unit or the field. These pressures are real and worth naming directly, without suggesting individual coping alone can resolve them.

Consequences for Care Teams and Patients

Turnover ripples outward from HR spreadsheets into daily patient care. The costs are financial, but they also touch care continuity and the well-being of the nurses who stay behind.

Financial Costs for Employers

Replacing one bedside RN costs hospitals an average of over $60,000, according to the 2026 NSI National Health Care Retention Report. A separate estimate places the average cost per RN turnover at $56,300, resulting in $3.9 million to $5.8 million in annual losses for the average hospital, based on research published in a nursing journal.

A 1.2 percentage point rise in turnover translated to a $360,000 negative impact on one hospital’s bottom line, according to the NSI retention report. These figures cover recruitment, onboarding, and lost productivity during ramp-up.

Continuity of Care and Patient Experience

When experienced nurses leave, patients lose access to staff who know their history and care preferences. Research on primary care teams found that nurse turnover disrupted patient access and continuity within Veterans Health Administration care teams, according to a study on team-based primary care.

Hospitals with lower turnover rates also report fewer patient falls. Facilities with 100 to 200 beds saved roughly $105,000 annually tied to reduced falls, while larger facilities saved closer to $616,000, based on Press Ganey’s analysis of turnover and patient safety.

Pressure on Remaining Staff

Every departure adds strain to the nurses who remain. Short-staffed units often mean higher patient ratios, less time for breaks, and more reliance on overtime or temporary staff to fill gaps.

This cycle can compound itself: heavier workloads may increase the risk of further departures, based on findings summarized in a review of the economic and noneconomic impacts of nurse turnover. Addressing turnover early can help interrupt that pattern before it deepens.

Retention Strategies That Support Sustainable Practice

Retention efforts work best when they target root causes rather than surface-level perks. Leadership behavior, flexible scheduling, career growth, and support for emotional strain all play distinct but connected roles.

Leadership, Recognition, and Psychological Safety

Responsive, visible leadership consistently appears as a factor in nurse retention. Strategies that combine transparent communication, recognition, and manageable workloads tend to outperform one-off perks, according to Nurse.com’s retention research.

Person-centered approaches, where leaders actively connect with nursing staff to strengthen communication and involvement, are linked to stronger workplace culture and retention, based on practical strategies published for frontline leaders.

Flexible Work Design and Professional Development

Rigid scheduling is a recurring complaint among nurses balancing school, family, or health needs. Offering flexible shift options and clear paths toward certifications or leadership roles can support longer tenure.

Structured professional development programs, including mentorship and skill-building pathways, are increasingly used to address root causes of turnover rather than applying temporary fixes, according to research on professional excellence programs.

Wellness Support Alongside Clinical Care

Organizational fixes, such as staffing ratios and scheduling reform, remain the primary lever for reducing turnover. Alongside that work, some nurses look for additional, optional support to manage day-to-day stress and emotional load.

Remote complementary wellness options, such as those offered by Ne Ste Al, are sometimes used by working professionals seeking short, private sessions to help manage stress and emotional overwhelm. These services are not medical, psychiatric, or psychotherapy treatment, and they are not positioned as a fix for staffing shortages or systemic workplace pressures. They may be used alongside, not instead of, organizational retention efforts and any existing mental health care a nurse already has in place.

Frequently Asked Questions

What is the current nurse turnover rate in the United States?

Recent hospital survey data puts RN turnover at around 17.6% nationally, according to the 2026 NSI National Health Care Retention Report. Individual hospitals can report rates far above or below that average, so the national figure is best used as a benchmark, not a universal standard.

How has nurse turnover changed in recent years?

Turnover dropped to around 16.4% in one recent year before rising again to 17.6%, based on Becker’s Hospital Review’s cost analysis.

This up-and-down pattern reflects ongoing staffing pressure rather than a steady trend in either direction.

What is considered a high turnover rate for nurses?

There is no single agreed-upon cutoff, but hospital-level RN turnover has ranged from  facilities, according to recent turnover statistics. Rates well above the 17% to 18% national average generally s5.6% to 40% across surveyedignal deeper staffing or workplace concerns worth investigating.

How is a nurse turnover rate calculated?

Turnover rate is typically calculated as the percentage of nursing staff who left their position over a specific period, usually a year. Different organizations may include or exclude voluntary departures, involuntary terminations, or internal transfers, which is why transparent reporting definitions matter when comparing numbers across sources.

What does nurse turnover cost hospitals and healthcare organizations?

Replacing a single bedside RN costs an average of over $60,000, according to the 2026 NSI retention report. Average hospitals lose millions of dollars annually to turnover-related recruitment, onboarding, and lost productivity costs, based on nursing workforce research.

Which factors contribute most to nurses leaving their jobs?

Workload, scheduling rigidity, limited career advancement, and burnout are frequently cited factors, according to a study on frontline RN turnover. Moral distress and unfavorable practice environments are also associated with higher turnover intentions, based on nursing practice environment research.

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