Here’s Why Nurses Are Exiting Healthcare

by Shannon Firth, Washington Correspondent, MedPage Today
April 9, 2024
While planned retirement topped the list of reasons for nurses leaving healthcare, failures by employers also played a role, according to a cross-sectional study that analyzed survey data.
Among nearly 7,900 nurses who left the healthcare field in Illinois and New York from 2018 to 2021, 39% attributed their decision to a planned retirement, with others citing:

  • Burnout or emotional exhaustion (26%)
  • Insufficient staffing (21%)
  • Family obligations (18%)
  • Concerns related to COVID-19 (17%)
  • Unsafe working conditions (13%)

Of the 4,906 nurses who retired — as opposed to being unemployed or working in non-healthcare industries — 41% ended their employment in healthcare due to reasons other than planned retirement, including burnout or emotional exhaustion (22%) and insufficient staffing (18%), reported K. Jane Muir, PhD, RN, of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing in Philadelphia, and co-authors in JAMA Network.
Reasons for leaving also varied by age. Among nurses ages 61 and older, planned retirement (53%) was the most cited factor contributing to leaving the field. For those ages 30 and younger, burnout or emotional exhaustion (43%) and insufficient staffing (40%) were “considerably more salient,” the authors wrote. However, this might reflect survival bias — older nurses tend to report less burnout — or other confounding factors such as employment setting, they added.
While the survey was conducted during the pandemic, COVID-19 wasn’t the top factor for leaving.
“I think there’s a narrative that nurses no longer want to work in certain settings because of the pandemic. Our research really debunks this,” Muir told MedPage Today.
She said she also did not expect to see that only 59% of the nurses surveyed who retired had planned to retire, which means the other 41% had “an unplanned or premature exit from healthcare.”
Muir pointed out that many nurses said they would have worked longer had their jobs provided safer staffing levels.
“Nurse staffing is a modifiable feature … it’s something that hospitals can choose to invest in, and they must invest in it, if they want to have better outcomes for patients and reduce some of the high turnover and departures that they’re seeing in their institutions,” Muir said, noting that California implemented staffing ratios in 2004.
In 2023, Oregon’s governor also signed staffing ratios into law. Washington nurses attempted to pass such a policy, and a staffing ratios bill in Pennsylvania has passed in the state’s House of Representatives.
Some nurses said they would have stayed if…