The Cost of Nurse Turnover

The COVID-19 pandemic wore down registered nurses, causing many to leave and retire early, leaving vacant spots in hospitals. Due to this, hospitals have been paying astronomical prices in turnover costs, according to the “2021 NSI National Health Care Retention & RN Staffing Report.”

In this report, 226 facilities from 37 states participated and were asked to report data from January to December 2020. The survey covers 501,764 health care workers and 144,300 registered nurses.

Here are eight important facts about the cost of nurse turnover, by the numbers:

1. Since 2016, the average hospital turned over 83% of its RN staff.
2. In 2020, the turnover rate for staff RNs was at 18.7%, a 2.8 percentage point increase from 2019.
3. The average cost of turnover for a bedside RN is $40,038. Each percent change in RN turnover costs or saves the average hospital $270,800 per year.
4. Hospitals with 200 to 349 beds had the highest RN turnover rate of 22.9%, a 5.8 percentage point increase from 2019. Hospitals with more than 500 beds had the lowest turnover rate of 17.4%, a 2.1 percentage point increase from 2019.
5. RN turnover depends on specialty. Step-down had a turnover rate of 24.4% in 2020, compared to 18.5% in 2019. Behavior health had a turnover rate of 22.7% in 2020, compared to 20.6% in 2019. Emergency had a turnover rate of 20% in 2020, compared to 18.5% in 2019.
6. About 24% of RN turnover are those in their first year. Those with more than five years had a higher level of commitment, accounting for about 14% of turnover.
7. The top three reasons for RNs resigning were relocation and career advancement tied for first and retirement as the third reason. This is the first time retirement has been in the top three.
8. The RN vacancy rate is almost a full point higher than 2020 at 9.9%, and 62% of hospitals have an RN vacancy rate of higher than 7.5%, brought on by the economy and COVID-19.