Updated October 23, 2026
Nursing has never paid better. The median RN salary is $97,550, and demand is projected to grow 6% over the next decade. Yet hospitals are losing nurses faster. The 2026 NSI National Health Care Retention & RN Staffing Report found that hospital RN turnover rose to 17.6%, up 1.2 points.
The numbers
| Hospital staff RN turnover | 17.6% (up 1.2 points) |
| RN vacancy rate | 8.6%, about 43 unfilled RN posts per hospital |
| Unfilled RN positions (surveyed hospitals) | About 158,600 |
| Hospitals with vacancy of 10% or more | About 1 in 3 |
| First-year RN turnover | 22.7% of new hires |
| Cost of losing one bedside RN | $60,090 |
| Annual turnover cost for an average hospital | $4.2–$6.2 million |
| RNs hired vs RNs who left (2025) | 377,650 hired, 324,090 left: a net gain of about 53,500, but the net growth rate fell from 5.6% to 2.9% |
Units losing the most nurses
- Behavioral health: 22.5%
- Emergency: 20.7%
- Telemetry: 19.5%
- Step-down: 19.0%
Women’s health, pediatrics and surgical services tend to keep nurses longer.
Why nurses are leaving
- Stress and burnout: the top reason among nurses leaving for reasons other than retirement.
- Workload and understaffing: short staffing creates a cycle, because every nurse who leaves makes the job harder for those who stay.
- Workplace violence: assaults in emergency departments and behavioral health units are pushing experienced nurses into remote and outpatient roles.
- Schedules: nights, weekends, holidays and mandatory overtime.
- Retirement: the third most common reason for leaving, and rising.
- Pay: still cited, although strong 2026 contracts (raises of 13–21.5%, see our strike roundup) show that pay alone does not fix retention.
Looking ahead, NCSBN’s National Nursing Workforce Study found that 39.9% of RNs and 41.3% of LPN/LVNs intend to leave or retire within five years. More than 138,000 nurses have left the workforce since 2022.
The new-graduate problem
Almost 1 in 4 new RN hires leaves within the first year, and first-year departures make up 29% of all RN separations. Strong residency programs, protected orientation time and good preceptors make the biggest difference. If you’re a new grad choosing your first job, ask each hospital about its first-year retention rate and how long orientation lasts.
What keeps nurses in their jobs
- Safe, enforceable staffing levels.
- Flexible scheduling, including self-scheduling, shorter shifts and no mandatory overtime.
- Real action on workplace violence: security staffing, weapons detection and support after incidents.
- Clear career ladders, certification pay and tuition support.
- Managers who are present and listen.
Thinking of leaving the bedside? Options to consider
- Move to a lower-turnover specialty such as PACU, surgical services or pediatrics. See highest-paying RN specialties.
- Try travel nursing for more control over where and when you work.
- Advance to a nurse practitioner or CRNA role.
- Explore outpatient, school, telehealth, case management, informatics or education roles.
Sources: NSI 2026 National Health Care Retention & RN Staffing Report (via The Nursing Directory, May 2026, and Nurse.org, October 21, 2026); NCSBN 2024 National Nursing Workforce Study; BLS (May 2025).