RN & Advanced Practice Turnover Rates and the Hidden Costs

RN & Advanced Practice Turnover Rates and the Hidden Costs in 2025

The nursing workforce crisis in the United States continues into 2025. Healthcare systems are navigating rising turnover among both registered nurses (RNs) and advanced practice providers (APPs), while the national nurse vacancy rate remains stubbornly high. Most hospital executives recognize the issue, but many still underestimate the full financial impact of nurse turnover—both visible and hidden.

Why Are Staffing Shortages Still Worsening?

Several forces are contributing to today’s workforce shortages:

• Retirements: Baby Boomers now represent less than 20% of the labor force, down from 25% pre-pandemic. Over 60,000 RNs retire each year, and in 2025, over 500,000 RNs are age 55 or older.
• Inadequate pipeline: The number of new nursing graduates isn’t keeping pace. Nursing school enrollment fell by 2.6% in 2024 for BSN programs, per the AACN.
• Rising care demands: The U.S. population is aging, and by 2030, 1 in 5 Americans will be over age 65. Chronic illness and post-acute care needs are driving demand for skilled nursing.
• Retention breakdowns: Economic pressure, workplace strain, and burnout are accelerating exits—not just from jobs, but from the profession entirely.

Turnover Trends: Nurses and APPs in 2025

The latest NSI National Health Care Retention & RN Staffing Report (2025) reveals:

• National RN turnover sits at 22.8%, a slight improvement from the 2021 peak of 27.1% but still far above pre-pandemic levels.
• Nurse practitioner turnover is up to 16.4% in 2025, compared to 15.3% in 2021.
• Certified RN anesthetist (CRNA) turnover rose to 24.2%, reflecting increased demand and mobility.
• Certified nursing assistants (CNAs) and patient care techs still experience the highest churn, with 2025 turnover rates at 38.7% and 39.2%, respectively.

Emergency departments, step-down units, and behavioral health specialties continue to report the highest RN turnover. Conversely, pediatrics and perioperative units report lower turnover but still higher than historic baselines.

The True Cost of Nurse Turnover in 2025

Replacing a single bedside RN now costs hospitals an average of $52,700, up from $46,100 in 2021. For many hospitals, turnover expenses range between $6.6 million and $9.5 million per year, depending on size and geography.

Direct costs include:

• Recruitment and sign-on bonuses
• Travel nurse or agency temp labor
• Interview, onboarding, and credentialing
• Training and orientation for replacements

Hidden costs are just as critical:

• Lost institutional knowledge
• Reduced care quality and continuity
• Increased risk of medical errors
• Staff morale decline and burnout contagion
• Disruption to patient outcomes and satisfaction

Some systems mistakenly view turnover as a chance to save money by hiring newer, lower-paid nurses. But this short-term savings rarely outweighs long-term productivity losses and increased training costs.

Why Retention Is Cheaper Than Replacement

Hospitals with strong nurse retention programs report:

• Lower spend on recruitment ads and bonuses
• Fewer gaps in scheduling or diverted patients
• Better patient outcomes and HCAHPS scores
• Improved teamwork and clinical culture
• Higher net promoter scores (NPS) among staff

Workplaces with reputations for long-term retention have a competitive edge. Word-of-mouth among clinicians is powerful, and trusted employers attract applicants even without the highest salaries.

Recruitment Strategies for 2025

To reduce hiring costs and speed up onboarding, leading hospitals are embracing:

• Mobile-first hiring tools that let nurses apply and communicate by text
• Transparent salary ranges in job listings, now required in 12+ states
• On-demand interviews using calendar integrations
• Streamlined credentialing workflows powered by automation

For example, Goodwork allows hospitals to apply to nurses instead of the reverse, with algorithms matching RNs to jobs that fit their preferences. Some clients report cutting hiring time from 90 days to under 30 days using this method.

Creating a Work Culture That Retains Nurses

Culture is the backbone of retention. Here are five proven strategies to boost retention through culture:

1. Modernize your onboarding experience: Make orientation engaging, hands-on, and tech-enabled to help new hires connect faster.
2. Build mentorship into the process: Mentorship helps new nurses feel seen and supported while also giving experienced RNs leadership opportunities.
3. Celebrate wins early and often: Publicly acknowledge team and individual achievements to boost morale.
4. Establish consistent communication: Use recurring newsletters, quick huddles, or leadership Q&A to ensure staff feel included and informed.
5. Foster psychological safety: Create space for nurses to suggest improvements, report concerns, or innovate without fear.

The path forward is clear. Hospitals that invest in retention, pay transparency, and modern hiring strategies will not only save millions but also build stronger clinical teams that improve patient outcomes. Nurse turnover is no longer just an HR issueit is a system-wide operational priority.

Explore how Goodwork helps hospitals and nurses connect faster, smarter, and more affordably:
👉 https://goodwork.world/explore-jobs