Around the world, nurses say meaningful work keeps them going

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The effects of the COVID-19 pandemic on the nursing workforce are explored in a new global survey from McKinsey, which asked frontline nurses in various countries if they want to stay in their current role. Between 20 and 38 percent of nurse respondents in the United States, the United Kingdom, Singapore, Japan, France, and Australia indicated they were likely to leave their current role in direct patient care in the next year.

The reasons for leaving vary. In some countries, more than half of respondents said their decision to leave was not directly related to the pandemic. Yet responses may reflect some weariness with direct patient care—in the United States, for example, surveyed nurses who said they anticipate leaving their direct-patient-care roles increased by about ten percentage points between February 2021 and November 2021.1Surveyed nurses consider leaving direct patient care at elevated rates,” McKinsey, February 17, 2022. In Australia, the percentage of nurses who indicated they are more likely to leave their direct patient-care roles since the start of the pandemic increased by ten percentage points from November 2021 to March 2022.

While compensation and a view of total monetary rewards remain important for nurse respondents who plan to stay in their jobs, those respondents also cited reasons that go beyond salary: factors such as feeling engaged by work, doing meaningful work, and maintaining good health were the top drivers in surveyed nurses’ decisions to stay.

The survey findings highlight a striking degree of consistency around how nurses feel in their roles today, despite the different healthcare systems and delivery networks in each of the seven countries. While more research is needed to understand the intricacies of nurses’ viewpoints in each country, one thing is becoming clear: a substantial population of nurses are expressing a desire to leave direct patient care. This means nursing shortages may be a rising risk in many countries. For example, we recently estimated that in the United States there may be a shortage of between 200,000 to 450,000 nurses (10 to 20 percent) by 2025.2Assessing the lingering impact of COVID-19 on the nursing workforce,” McKinsey, May 11, 2022.

By learning and sharing promising paths forward across nations, stakeholders could support their clinical workforce and look to solve what has become a consequential global problem. Positive leadership initiatives—such as directors rounding once a week to show support—have been correlated in studies with higher retention, reduced medical errors, and administrative efficiency.3

In the exhibits below, we explore the details of these findings, as well as steps employers could consider to provide nurses with better support. (For more information about the survey, see sidebar, “Methodology.”)

In most surveyed countries, a substantial proportion of nurses indicated they were likely to leave.

More than a fourth of nurse respondents in most countries said they are likely to leave direct patient care.

The decision to leave is not always related to COVID-19.

A substantial portion of nurse respondents said the COVID-19 pandemic did not influence their decision to leave.

Doing meaningful work is a top reason to stay, nurse respondents said.

Respondents cited recognition and more work breaks as helpful for well-being.

Most respondents highlighted more recognition as effective for well- being support.

Many respondents prioritize the ability to set their hours.

Flexibility, including ability to take time off, is important to most nurse respondents.

Many surveyed nurses indicated uncertainty around whether they had enough advanced clinical skills.

Outside of Brazil, many surveyed nurses indicated uncertainty around whether they had enough advanced clinical skills.

Even countries with slowing rates of COVID-19 may face continued staffing shortages and departures of nurses in direct patient care. As we wrote recently, “If companies make a concerted effort to better understand why employees are leaving and take meaningful action to retain them, the Great Attrition could become the Great Attraction.”4Winning back your workers,” McKinsey Quarterly Five Fifty, March 28, 2022. No matter the country, examining what is important to nurses and why they leave could help organizations adjust. Healthcare stakeholders in all countries may consider strategies to recognize the contributions of nurses, embed more breaks, create positive interactions, and build caring teams, all with the goal of boosting well-being in the workforce. In the long term, these efforts could improve retention.

Examining what is important to nurses and why they leave could help health systems improve retention.

While this survey is far from exhaustive, it offers a snapshot of the factors that could help retain nurses in the future, especially for those on the front lines. Health systems may find that positive environments reflecting nurses’ priorities may attract new workers or lure back those who have left direct patient care over the past two years. In the long run, investment in nurses could offer stability and support top-quality care for patients.

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