Surveyed nurses consider leaving direct patient care at elevated rates

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Healthcare workers and their organizations continue to face unparalleled demands stemming from the COVID-19 pandemic. Thirty-two percent of registered nurses (RNs) surveyed in the United States in November said they may leave their current direct-patient-care role, according to McKinsey’s latest research. That is an increase of ten percentage points in under ten months.

To retain frontline clinicians and, over time, help begin to address widespread staffing shortages, healthcare leaders are designing and deploying strategies focused on supporting their workforce. In the exhibits below, we share eight insights to help stakeholders shape their approaches.

Given the contents below and our broader research, we see two key implications for healthcare organizations to consider over the medium to longer term.

  1. Identifying opportunities for workforce retention strategies to be more directly tailored to employee needs and preferences, including more personalized programs and support, will continue to be important. This may include the following:
    • doubling down on environmental factors (for example, team dynamics, purpose or meaning of work, feeling valued by organization), flexibility, and professional development opportunities
    • ensuring total rewards offering is aligned with organizational strategy and meets a holistic set of needs (for example, dependent care and mental-health services)
    • amplifying continuing-education programs, roles, and resources that support novice clinicians and “in need” skill sets (for example, behavioral health)
    • providing training and resources for leaders to support the individual needs of their team members, as well as collective team health

  2. Minimizing workload strains, where possible, will require innovation but provide much needed relief. For example:
    • deploying advanced analytics to improve accuracy and timeliness of demand forecasting, workforce alignment, and real-time labor management
    • redesigning roles and processes (including through digitization and automation where appropriate) to reduce friction points, increase flexibility, and incorporate support to enable top-of-license practice
    • exploring new ways to grow the talent pipeline, including ensuring that end-to-end hiring processes are as efficient as possible and exploring partnerships and career pathway designs focused on highest need roles/skill sets, untapped pools of talent, and diverse cohorts

We also recognize the need for society at large to continue to support and elevate the role of nursing and other frontline healthcare workers. We take this opportunity to thank healthcare professionals and their organizations for what they do every day, particularly during the COVID-19 pandemic.

Surveyed nurses said staffing, pay, and lack of support are factors affecting decision to leave

Surveyed nurses express an increased intention to leave direct patient care.

Surveyed nurses cited alternate roles/careers, retirement, education, and focus on family/life goals as potential plans if considering leaving

Of the surveyed nurses likely to leave their current roles, less than one-third intend to stay in direct patient care.

There are a variety of challenges for surveyed nurses

Challenges for surveyed nurses exist across settings of care and roles.

Pay was cited as a bigger factor for early and midtenured nurses

Early and midtenured nurses surveyed are most at risk of leaving their current roles.

What’s keeping nurses in the profession and what’s driving them to consider leaving?

Key factors differed in importance among surveyed nurses based on intent to leave

Surveyed nurses who plan to stay in their current roles cite caring teammates and meaningful work as critical factors.

Breaks and sufficient recognition continue to be most valued by surveyed nurses

Surveyed nurses say that traditional support levers, while important, go only so far.

Surveyed nurses cited behavioral-health skills as a potential gap

Surveyed nurses report feeling less equipped in the behavioral-health skills needed for patient care.

While broader solutions—and collaboration across the public and private sector, for example, to increase nurse educator capacity and elevate the role of nursing—are critical in the long term, healthcare organizations can consider a number of medium and longer-term strategies to support their workforces. Examples include doubling down on retaining critical talent grounded in the specific needs and preferences of the front line; minimizing workload strains where possible through advanced analytics (planning, deployment) and workflow redesign; and innovating around new ways to grow the talent pipeline (including with partners).

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