Nurse Retention Strategies That Start on Your Unit
Turnover is expensive and contagious. The fixes that work most are often local.
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Hospital staff RN turnover averaged 17.6% in the most recent NSI national survey, with a range from 5.6% to 40.0% across hospitals (NSI Nursing Solutions, 2026 National Health Care Retention & RN Staffing Report, nsinursingsolutions.com/documents/library/nsi_national_healt). The same report found that 74% of responding hospitals have a formal retention strategy and 62.4% have strategies aimed specifically at tenured nurses (same URL).
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National data show why nurses leave. In NCSBN's 2024 workforce study, 39.9% of RNs said they intended to leave or retire within five years. Among those planning to leave, about 41.5% cited stress and burnout, followed by workload, understaffing and inadequate pay (NCSBN, released April 2025, ncsbn.org/news/ncsbn-research-highlights-small-steps-toward-).
Not every lever belongs to the unit manager, since pay scales and system staffing budgets often sit higher up. But a lot of what makes a nurse stay or go is local: whether breaks happen, whether the schedule is fair, whether concerns get a response, whether anyone notices good work. AACN's Healthy Work Environment standards (skilled communication, true collaboration, effective decision-making, appropriate staffing, meaningful recognition and authentic leadership) are a practical checklist. AACN reports that units implementing them do better on staffing, retention, moral distress and workplace violence (American Association of Critical-Care Nurses, Healthy Work Environments, aacn.org/nursing-excellence/healthy-work-environments).
Practical takeaways:
- Track your own unit's turnover by tenure. First-year losses and five-plus-year losses need different fixes.
- Hold stay interviews (Article 4) before exit interviews.
- Fix one visible frustration per quarter (missed breaks, a broken process) and tell staff you fixed it.
- Use AACN's free team assessment tool to baseline your unit's work environment.
- Give experienced nurses roles that use their expertise (precepting, charge, committees) along with recognition for doing them.
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Sources: NSI (2026), NCSBN (2025), AACN HWE, links above