Adequate staffing, flexible scheduling, and better compensation were the leading factors that would draw registered nurses back to hospital employment, according to a cross-sectional study of more than 4,000 registered nurses who left hospital staff positions within the past 5 years.
The findings, published in JAMA Network Open, suggested that nurse retention challenges may be partially reversible through organizational changes rather than workforce expansion alone.
Researchers from the University of Pennsylvania analyzed survey responses from 4,043 registered nurses (RNs) across 10 states who had left hospital staff positions between 2019 and 2023 and were no longer working in health care. Among respondents, 340 (8%) were employed outside health care, 1,438 (36%) were not currently employed, and 2,265 (56%) were retired.
Among nonretired nurses, 65% identified adequate staffing or a manageable workload as a factor that would increase their likelihood of returning. Flexible scheduling and better wages and benefits each resonated with 59% of respondents. Only 8% said nothing would bring them back to nursing.
Age-stratified analysis revealed these factors were particularly important to younger nurses. Among RNs aged 40 and younger, approximately 70% cited staffing adequacy and compensation as key to their potential return, compared with roughly half of nurses over age 50. Career advancement opportunities showed the steepest age gradient, with 47% of nurses aged 31 to 40 ranking this factor highly vs 9% of those 61 and older.
Despite leaving their positions, most nurses expressed satisfaction with their career choice. Overall, 79% reported being very or moderately satisfied with nursing as a career, though satisfaction was notably higher among retirees (90%) than among those not currently employed (65%).
The survey found substantial interest in returning among nonretired nurses, with 67% saying they were likely to return to nursing work, and 51% reporting that they had searched for health care employment within the past year. More than one-third of retired nurses reported leaving the workforce earlier than planned.
The researchers acknowledged that their sample was limited to RNs who maintained active licenses, potentially biasing results toward those more inclined to return to practice.
"Nurses are often locked into rigid shift schedules that limit their ability to transition between shifts or choose different work blocks," said senior author K. Jane Muir, PhD, RN, of the University of Pennsylvania School of Nursing. "Hospitals can reattract an existing nurse workforce by reconsidering these arrangements to remain competitive."
The study was supported by grants from the National Institute of Nursing Research and the Agency for Healthcare Research and Quality. The funders had no role in the design, conduct, or reporting of the study.
The authors reported no conflicts of interest.
Source: JAMA Network Open, Press Release