Nurse Turnover Is Rising Again — And It's Costing Hospitals Millions
- The national RN turnover rate rose to 17.6% in 2025, a 1.2% increase from the prior year, costing the average hospital $5.19 million annually — with every single percentage point shift worth $295,000.
- Behavioral health, emergency, and telemetry nurses are leaving at the highest rates, with those three specialties collectively turning over their entire staff roughly every four years.
- Hospitals are still sitting on an estimated 158,600 unfilled RN positions nationwide, with the average facility carrying 43 vacancies and taking over two and a half months to recruit a single experienced nurse.
Nurse turnover is heading in the wrong direction again.
After several years of gradual improvement following the post-pandemic staffing surge, the national RN turnover rate climbed back up in 2025 — and hospitals are paying a steep price. According to the 2026 NSI National Health Care Retention & RN Staffing Report, published by NSI Nursing Solutions, Inc., the average cost of losing a single bedside RN has hit $60,090. For the typical hospital, that adds up to somewhere between $4.2 million and $6.2 million in losses every year.
The report, which draws on survey data from 527 acute care hospitals across 40 states — covering nearly 966,000 healthcare workers and more than 262,000 registered nurses — is one of the most comprehensive annual snapshots of nurse workforce trends in the country. And the 2026 edition carries a clear message: the staffing crisis is far from over.
RN Turnover Ticked Back Up in 2025
After dipping to 16.4% in 2024, the national RN turnover rate rose to 17.6% last year — a 1.2 percentage point increase. The report notes that RN turnover ranged widely depending on hospital size and geography, from a low of 5.6% to a high of 40.0%.
That 1.2% uptick doesn't sound like much. But in dollar terms, it translates to an additional $360,000 in losses for the average hospital. Every single percentage point change in RN turnover costs or saves a hospital approximately $295,000 per year. On average, hospitals lost $5.19 million to RN turnover in 2025 alone.
Looking at the bigger picture: over the past five years, the average hospital has turned over 102% of its entire RN workforce.
Retirement Is Becoming a Bigger Driver of Departures
Respondents were asked to identify the top reasons staff RNs voluntarily resigned, choosing from a list of 20 common causes. The top five were personal issues, relocation, retirement, career advancement, and scheduling conflict.
What stands out: retirement has been steadily climbing in frequency and now ranks as the third most common reason nurses leave. With all Baby Boomers reaching retirement age by 2030, this trend is expected to accelerate. The report specifically flags surgical services and behavioral health as specialties that will feel the impact of retirements most acutely.
Rounding out the top 10 reasons RNs voluntarily resigned: education, salary, commute, working conditions, and workload/staffing ratios.
Some Specialties Are Being Hit Harder Than Others
Not all nursing units are experiencing turnover at the same rate. The report breaks down RN turnover by specialty, and the gaps are significant.
Highest turnover specialties in 2025:
- Behavioral Health: 22.5%
- Emergency Services: 20.7%
- Telemetry: 19.5%
- Step Down: 19.0%
- Med/Surg: 18.1%
Lowest turnover specialties in 2025:
- Pediatrics: 13.4%
- Surgical Services: 14.9%
- Women's Health: 15.0%
Zooming out over five years, telemetry, step-down, and emergency services nurses have had cumulative turnover rates of 117.8%, 115.4%, and 113.6%, respectively. As the report puts it, these departments will effectively turn over their entire RN staff in less than four and a half years.
Nearly 1 in 4 Newly Hired RNs Leaves Within a Year
One of the more striking findings in the report is how quickly new nurses are walking out the door. Over 22.7% of all newly hired RNs left their position within the first year, with first-year turnover accounting for 29% of all RN separations.
Across all hospital employees (not just RNs), close to 30% of new hires left within their first year — and that group alone accounted for more than a third of all turnover. The majority of employees who left (56.8%) had less than two years of service.
The data underscores why onboarding and early retention efforts are so critical. The report found that 74% of hospitals have a formal retention strategy, and 80.8% have a specific strategy for newly hired nurses. Nurse Residency programs are among the most common approaches, earning a 3.9 out of 5 effectiveness rating from respondents.
158,600 RNs Short — And Hospitals Still Can't Fill the Seats
The national RN vacancy rate currently stands at 8.6%, which translates to the average hospital carrying 43 unfilled RN FTE positions. One in three hospitals (33.1%) reported a vacancy rate of 10% or higher.
Based on survey responses, NSI estimates that 158,600 RN positions currently sit vacant across the country.
Magnet-recognized hospitals fared somewhat better, reporting a vacancy rate of 7.3% — about 1.3 percentage points below the national average — and an average of 37 unfilled RN FTEs.
When it comes to filling open positions, the math is frustrating. The RN Recruitment Difficulty Index — which measures how long it takes to hire an experienced nurse — currently sits at 78 days, or about two and a half months. That's five days faster than the year before, but still a significant gap in coverage. Telemetry RNs were the hardest to recruit, averaging 87 days to fill, while Med/Surg and PCU nurses averaged 83 and 88 days, respectively. Even ER nurses — the fastest to hire — required more than two full months (70 days) to place.
Travel Nurses Remain Expensive — But Hospitals Can't Quit Them
Hospitals know travel nurses are costly. The average travel nurse fee runs $91.23 per hour (or about $189,758 annually), compared to $59.46 per hour for an employed staff RN including benefits — a difference of more than $66,000 per year, per nurse.
Despite that, travel and agency staffing remains a go-to fix when units run short. Last year, 73.5% of hospitals projected they would decrease their reliance on travel staff — yet it stayed a top strategy when shortage hit. This year, 70.7% say they want to reduce travel nurse usage, even as vacancy rates keep the pressure on.
The Regional Picture: Where Turnover Is Worst
RN turnover increased in every region of the country in 2025, except the South-Central (which saw a slight 0.9% decline). The North-East recorded the largest single-year jump, rising 3.3 percentage points to reach 17.9%. The South-East and West came in above the national average, while North-Central and South-Central remained below it.
| Region | Staff RN Turnover | Year-Over-Year Change |
|---|---|---|
| North-East | 17.9% | +3.3% |
| South-East | 18.7% | +1.4% |
| West | 18.4% | +2.3% |
| North-Central | 16.2% | +0.4% |
| South-Central | 17.1% | -0.9% |
| National Average | 17.6% | +1.2% |
What This Means for Nurses
The numbers in this report reflect a reality nurses are already living. Short staffing, heavier patient loads, retirement-driven knowledge gaps, and the constant churn of colleagues leaving — these aren't abstract workforce metrics. They're the conditions nurses show up to every shift.
The report is also a reminder that the profession's stability is tied to decisions made at the institutional level. Whether hospitals invest in nurse residency programs, competitive pay, sustainable staffing models, and strong workplace cultures will directly shape whether these numbers improve or keep climbing.
The numbers in this report reflect a reality nurses are already living. The question isn't whether hospitals can afford to invest in retention — at $60,090 per lost RN, the report makes clear they can't afford not to.
🤔Nurses, what do you think about the data in this new report? Share your thoughts below.
If you have a nursing news story that deserves to be heard, we want to amplify it to our massive community of millions of nurses! Get your story in front of Nurse.org Editors now - click here to fill out our quick submission form today!
