News Release

Nurses cite employer failures as their top reason for leaving

Poor working conditions are the reason nurses left healthcare, a new study finds

Peer-Reviewed Publication

University of Pennsylvania School of Nursing

PHILADELPHIA (EMBARGOED UNTIL APRIL 9, 2024 at 11:00 AM EST) – A new study from the University of Pennsylvania School of Nursing’s Center for Health Outcomes and Policy Research (CHOPR) – published in JAMA Network Open today –  showed that, aside from retirements, poor working conditions are the leading reasons nurses leave healthcare employment.  These study findings come at a time when hospital executives cite staffing problems as their most pressing concern.

“Prior studies evaluate nurses’ intentions to leave their job. Our study is one of the few evaluating why nurses actually left healthcare employment entirely,” said lead author K. Jane Muir, PhD, RN, a CHOPR Postdoctoral Research Fellow, Associate Fellow of the Leonard Davis Institute for Health Economics, and a National Clinician Scholar at the University of Pennsylvania. The study surveyed 7,887 registered nurses in New York and Illinois who left healthcare employment between 2018 and 2021.

Across a variety of healthcare settings including hospitals, long-term care facilities, and ambulatory care, planned retirement was the most cited reason nurses are leaving healthcare employment. Closely behind retirements, insufficient staffing, burnout, and poor work-life balance topped the list. Among retired nurses in the study, only 59% stated their retirement was planned, suggesting nearly half of nurse retirements are premature exits due to poor working conditions.

“Nurses are not principally leaving for personal reasons, like going back to school or because they lack resilience. They are working in chronically poorly staffed conditions which is an ongoing problem that predates the pandemic," said senior author Karen Lasater, PhD, RN, Associate Professor, the Jessie M. Scott Term Chair in Nursing and Health Policy, and Senior Fellow of the Leonard Davis Institute for Health Economics.

Study authors say that healthcare employers could also retain more nurses through solutions that enhance nurses’ work-life balance. This includes greater flexibility in work hours such as shorter shift-length options, higher pay-differentials for weekend/holiday shifts, and on-site dependent care.   

“Nurses are retiring early and leaving employment in the healthcare sector because of longstanding failures of their employers to improve working conditions that are bad for nurses and unsafe for patients. Until hospitals meaningfully improve the issues driving nurses to leave, everyone loses,” said Muir.

The study was led by researchers at the Center for Health Outcomes and Policy Research, in partnership with the National Council of State Boards of Nursing. Funding for the study was from the National Council of State Boards of Nursing, the National Institute of Nursing Research/NIH (T32NR007104; R01NR014855), and the Agency for Healthcare Research and Quality (R01HS028978).  

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Editor’s Note: You can request a copy of the study by emailing: mediarelations@jamanetwork.org. Please request a copy of the study by paper title, not number.

About the University of Pennsylvania School of Nursing

The University of Pennsylvania School of Nursing is one of the world’s leading schools of nursing. For the eighth year in a row, it is ranked the #1 nursing school in the world by QS University. For the second year in a row, our Bachelor of Science in Nursing (BSN) program is ranked # 1 in the 2023 U.S. News & World Report’s Best Colleges rankings. Penn Nursing is also consistently ranked highly in the U.S. News & World Report annual list of best graduate schools and is ranked as one of the top schools of nursing in funding from the National Institutes of Health. Penn Nursing prepares nurse scientists and nurse leaders to meet the health needs of a global society through innovation in research, education, and practice. Follow Penn Nursing on: Facebook, X, LinkedIn, YouTube, & Instagram.

About the Center for Health Outcomes and Policy Research

The Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing is dedicated to building the actionable evidence base needed to advance effective policy, practice, and health system reforms that improve health outcomes, cultivate clinician well-being, and promote health equity across communities.

About the Leonard Davis Institute of Health Economics

Since 1967, the University of Pennsylvania’s Leonard Davis Institute of Health Economics (Penn LDI) has been the leading university institute dedicated to data-driven, policy-focused research that improves our nation’s health and health care. Penn LDI’s priority areas include (1) health care access and coverage; (2) health equity; (3) improving care for older adults; (4) opioid epidemic; and (5) population health. Penn LDI connects all twelve of Penn’s schools, the University of Pennsylvania Health System, and the Children’s Hospital of Philadelphia through its more than 300 Senior Fellows. Learn more at https://ldi.upenn.edu.


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