2023 NSI National Health Care Retention & RN Staffing Report

Published by: NSI Nursing Solutions, Inc.
Full report at www.nsinursingsolutions.com.

Executive Summary

Recruiting and retaining quality staff remains the top healthcare issue. Last year, hospitals were
able to recapture 5.65% of the talent lost during the “Great Resignation”, essentially adding
975,000 employees back to the rolls. Of this, 142,375 RNs returned which represents a 4.17%
RN add rate. This slower rate begs the question, why are nurses hesitant to return?

Although welcome news, the labor gap remains prevalent and hospital turnover continues to be
elevated. Nationally, the hospital turnover rate stands at 22.7%, a 3.2% decrease from 2021, and
RN turnover is recorded at 22.5%, a 4.6% decrease. Registered Nurses working in surgical
services, pediatrics and women’s health recorded the lowest turnover rate, while nurses working
in telemetry, step down and medical/surgical services experienced the highest.

The cost of turnover can have a profound impact on diminishing hospital margins and needs to be
managed. According to the survey, the average cost of turnover for a bedside RN is $52,350, a
13.5% increase, resulting in the average hospital losing between $6.6m – $10.5m. Each percent
change in RN turnover will cost/save the average hospital an additional $380,600/yr.

The RN vacancy rate remains critical and is 15.7% nationally. While 1.3% lower than last year,
over seventy-five percent (75.4%) reported a vacancy rate in excess of ten percent. The RN
Recruitment Difficulty Index jumped an extra eight (8) days to an average of 95 days. In essence,
it takes over 3 months to recruit an experienced RN, with med/surg presenting the greatest

Feeling the financial stress, hospitals are looking to decrease reliance on supplemental staffing.
The greatest potential to offset margin compression is in the top budget line item (labor expense).
Every RN hired saves $157,000. An NSI contract to replace 20 travel nurses could save your
institution $3,140,000. Contact Michael Colosi at (717) 575-7817 to learn how NSI can improve
your bottom line.