The losses kept building after that. An estimated 100,000 RNs left during the pandemic, and roughly 800,000 said they intend to leave by 2027, according to the 2022 National Nursing Workforce Survey.
Retention does not improve on its own. Running the same playbook produces the same results. The strategies below come from three experienced nurses on what actually keeps staff at the bedside.
1. Advocate for the Change You Want
Nurses are practiced advocates for their patients. The same skill applies to the profession. Healthcare management often sits with people juggling other priorities, which leads to decisions that do not serve nursing staff.
One option is a nurse ally, often a nurse whose job is to push for better working conditions and to address disparities, including the ones nurses themselves face in representation and workplace environment.
Adina Maynard, a certified oncology nurse, points to the core problem: hospitals tend to react instead of plan. "There is a need for adequate staffing and a need for healthcare systems to be proactive vs. reactive," she says. She encourages nurses to join advocacy efforts like #TheLastPizzaParty, which pushes for safe workplaces and safe patient care through legislation.
2. Open Up Access to New Skills
Nurses can leave the bedside without leaving the profession. Nursing is versatile, and organizations that support internal moves through education and mentorship keep more of their staff.
Heather Sweeney, a senior talent sourcing partner who spent more than eight years as an RN, names three things that help:
- RN career coaches as standard practice. Coaches mentor, map career paths, and point nurses toward growth inside the organization.
- Training for emotional wellness and mental health. Nurses care for people at their worst moments and need tools to stay resilient.
- Specialty training for new and veteran RNs. Moving from med-surg to the OR is hard in most systems. When the path does not exist internally, nurses leave to find it elsewhere.
3. Take Mental Health Seriously
Prioritizing mental health supports both nurses and patients. During a crisis, the mental toll on nurses raises burnout, which raises turnover, which raises the staffing shortage, a cycle that feeds itself.
"The units I support that have the best retention rates are units where the nurses report feeling supported, heard, valued, and feel like they are part of a family," Sweeney says. She adds that a wellness website and a phone number are not enough: "Organizations need to implement hands-on training and deliver it to their nurses at orientation and then throughout their career as needed."
4. Support Mandated Staffing Ratios
Safe nurse-to-patient ratios are one of the biggest challenges in the profession. According to a Johns Hopkins study, roughly 250,000 people die each year from medical errors, which the researchers ranked as the third leading cause of death in the U.S. (a widely cited figure that other researchers dispute).
National staffing ratios will not fix the shortage overnight, but they improve patient care while new nurses finish training. National Nurses United is one organization advocating for them.
5. Raise Base Pay
Nurses should be paid for the work they do. Pay alone will not solve the shortage, though. Chris Crady, RN, who works for the startup SmileMD, puts it plainly: "Until we resolve the real issues that nurses face, more money will always be just a buffer to buy more of your time until you can't take it anymore, and then no amount of money would be worth it."
6. Offer Better Benefits
Benefits matter, especially when staff nurses watch travel nurses earn double or triple for the same work. Most fulltime nurses get paid time off, but the gaps are real: 13% get no employer-subsidized health insurance, only 24% are offered bonuses or incentives, and 9% work fulltime with no benefits at all. LPNs receive fewer benefits than RNs or advanced practice nurses. Lower-cost options like flexible scheduling, in-house education, and certification reimbursement also move the needle.
7. Address Nurse Bullying
An unsafe work environment drives people out. Ten to 12 hours a day with overwhelmed colleagues, plus rising workplace violence from patients and families since the pandemic, creates a culture problem. Bullying shows up as verbal attacks, condescension, and exclusion.
The response starts at the top. If a manager tolerates a coworker undermining you or dismisses verbal abuse, the behavior continues. When leadership refuses to tolerate it, the workplace gets safer and seasoned nurses stay.
8. Let Nurses Be Heard
People need to be recognized and appreciated. Money is not the main driver of job satisfaction. One 2019 study found employees valued a strong company culture over compensation. Managers who take time to connect with their staff have an outsized effect on morale. Communities like the #AsaNurse campaign on social media also give nurses a platform to share experiences and educate the public.
9. Respect the Work
During the pandemic, nurses left over disputes about protective equipment and felt treated as disposable. Nurses have ranked as the most trusted profession in the U.S. for more than two decades, yet they faced more workplace violence during COVID-19. "Respect what we do, respect the hours we put in, respect the stress we are in, and respect our emotional well-being," Crady says. "It goes a long way."
10. Expand Mentorship and Career Coaching
Mentors and coaches give nurses a sense of belonging and a focus on career fulfillment. Some relationships form naturally; more often a nurse has to seek one out. Good mentors are trustworthy, available, reliable, and willing to listen. Some systems run internal programs, and where they do not, nurses look outside. "Offering RNs a personal mentor, the opportunity to work with another RN who has been in their shoes, is such a huge asset," Sweeney says.
Frequently Asked Questions
Why are so many nurses leaving the profession? Short staffing, long hours, burnout, low pay, weak benefits, bullying, and thin administrative support. The 2022 National Nursing Workforce Survey estimated about 100,000 RNs left during the pandemic, with roughly 800,000 intending to leave by 2027.
Does pay alone fix nurse retention? No. Higher pay helps recruit and retain, but nurses in this piece are clear that money is a buffer, not a fix. Without safe staffing, respect, and mental health support, raises only delay the decision to leave.
How does burnout affect nurse turnover? Burnout feeds a cycle: it raises turnover, which worsens the shortage, which raises burnout again. CDC NIOSH found 44% of health workers intended to look for a new job in 2022, up from 33% in 2018.
What actually keeps nurses at the bedside? Feeling supported, heard, and valued, plus realistic staffing ratios, career coaching, internal specialty training, real mental health resources, and leadership that refuses to tolerate bullying.
Do mandated nurse-to-patient ratios help? Advocates argue they improve patient safety and working conditions. They will not end the shortage overnight, and the often-cited figure of 250,000 medical-error deaths per year is disputed by some researchers, but safer ratios remain a central retention demand.
What can managers do right now to retain nurses? Listen and respond, recognize good work, connect nurses to mentors, protect staff from bullying and violence, and deliver hands-on wellness support at orientation and throughout a career, not just a phone number and a website.