Healthcare Industry Faces Critical Staffing Stability Challenges

Healthcare employee turnover remained a major workforce issue in 2026, with the national hospital turnover rate reaching 18.5% and registered nurse turnover rising to 17.6%. Frontline support roles reported much higher separation rates, including 33.8% for patient care technicians and 32.5% for certified nursing assistants. First-year turnover also remains a major retention issue, with 29.5% of new hospital hires leaving within the first year. These benchmarks show that healthcare turnover is concentrated in high-demand clinical units, early-tenure employees, and roles with heavy physical or schedule demands.

This report uses data from NSI Nursing Solutions, the American Hospital Association, the U.S. Bureau of Labor Statistics, HRSA, and peer-reviewed healthcare workforce research. Figures should be treated as national benchmarks because turnover varies by role, care setting, region, tenure, and local labor market conditions.

What You’ll Learn in This Report:

• Healthcare Turnover by Role: Current turnover rates for clinical and support positions
• RN Turnover by Specialty: Which nursing units report the highest separation rates
• Financial Cost of Turnover: Replacement costs for bedside RNs and hospital-level impact
• Turnover by Care Setting: How turnover differs across healthcare environments
• Turnover by Tenure: Why first-year and early-career employees carry a higher risk
• Top Turnover Drivers: Workload, staffing, retirement, and schedule pressure

Healthcare Employee Turnover Rate by Role

Turnover varies across healthcare roles because each position carries different workload, schedule, training, and career mobility pressures. Frontline support roles continue to report some of the highest separation rates.

NSI Nursing Solutions reported a national hospital turnover rate of 18.5%, with median hospital turnover at 19.5% across surveyed facilities.

Key Insights:

• Frontline support roles remain the highest risk: Patient care technicians and certified nursing assistants both exceeded 30% turnover.
• RN turnover increased after two years of decline: Registered nurse turnover rose to 17.6%, up 1.2 percentage points from the prior year.
• Advanced practice roles remain more stable: Nurse practitioners reported the lowest listed turnover rate at 9.8%.

RN Turnover Rate by Specialty

Registered nurse turnover differs by unit because workload intensity, emotional strain, and patient acuity vary. High-stress clinical environments continue to report above-average RN turnover.

NSI reported first-year RN turnover at 22.3%, with first-year separations accounting for 29.0% of all RN turnover at the average hospital.

Key Insights:

• Behavioral health and emergency services remain above average: Both specialties reported turnover above 20%.
• Telemetry turnover rose sharply: Telemetry RN turnover increased from 17.4% to 19.5%.
• First-year RN retention is a major issue: Nearly one-third of RN turnover came from first-year separations.

Turnover Rate by Healthcare Setting

Care settings create different retention patterns because staffing models, patient needs, and schedule demands vary. Higher-acuity and physically demanding environments tend to face greater turnover pressure.

Care-setting turnover benchmarks range from 17.6% for specialty practices to 32.1% for long-term care facilities. These figures should be treated as directional benchmarks unless validated by a named source dataset.

Key Insights:

• Long-term care remains a high-risk setting: The 32.1% benchmark reflects physically demanding work and persistent staffing pressure.
• Acute units carry higher emotional strain: ICU and emergency department roles face pressure from high-acuity cases.
• Predictable settings show lower turnover: Outpatient clinics and specialty practices reported lower turnover than higher-acuity settings.

Financial Cost of Healthcare Turnover

Turnover creates direct costs through recruitment, onboarding, training, overtime, and temporary coverage. RN turnover is especially expensive because bedside staffing affects both capacity and continuity.

NSI estimated the average cost of replacing one bedside RN at more than $60,000, with average hospital RN turnover losses of $5.19 million annually.

Key Insights:

• RN turnover has a measurable margin impact: A 1% change in RN turnover can affect annual hospital costs by roughly $295,000.
• Coverage strategy affects cost: Travel nurse rates remain higher than staff RN hourly costs with benefits.
• Replacement cost varies by role: Specialty clinical roles usually carry higher replacement costs because training, supervision, and productivity ramp-up take longer.

 

Healthcare Turnover by Employee Tenure

Tenure is one of the clearest predictors of healthcare turnover risk. Early-tenure employees account for a disproportionate share of all separations.

NSI reported that 29.5% of all new hospital hires left within the first year, and employees under one year accounted for 35.6% of all hospital turnover.

Key Insights:

• First-year turnover remains the largest risk: More than one-third of all hospital turnover came from employees with less than one year of tenure.
• Most turnover occurs before year five: Employees under five years made up most hospital and RN separations.
• Longer-tenured employees are more stable: Workers with more than five years of tenure accounted for a smaller share of turnover.

 

Top Drivers of Healthcare Turnover

Healthcare turnover is shaped by workload, staffing levels, physical demands, schedule control, and career expectations. Retirement is also becoming a larger part of the resignation picture.