The Nurse Executive: What Actually Works for Nurse Retention?
Spoiler: We don’t actually know - yet.
f you’re looking for a tidy list of evidence-based strategies guaranteed to boost nurse retention, I have bad news—and good news.
The bad news: The strategies most often used by hospitals to retain nurses are not actually backed by strong evidence. Two recent reviews confirm this. A 2022 scoping review of 13 interventional studies found a wide range of retention strategies, but the authors concluded that the quality of research was poor, with little rigorous testing and minimal real-world evaluation. Similarly, a 2022 systematic review of 27 retention studies found that few strategies had actually been tested and NONE stood out as consistently effective, largely due to weak study designs.
The good news? We’re starting to get a clearer picture of what factors are associated with nurses’ decisions to stay or leave—and how these might vary across different segments of the workforce. That opens the door for smarter, more tailored interventions.
Take our own recent study, for example. We analyzed career plans from over 12,000 new graduate nurses and found that those with a BSN or higher degree were significantly more likely to plan to leave their first job within three years, even though they intended to stay in nursing. Why? Their reasons weren’t about dissatisfaction or burnout. They were about career advancement. These nurses were leaving because they had more options—and they were taking them. This is a crucial distinction.
'“Retention isn’t always about preventing someone from leaving the profession. Sometimes it’s about keeping them within your organization by helping them grow.”
This means a “one-size-fits-all” retention strategy won’t cut it.
It might be easier to throw broad interventions at the wall—bonuses, pizza parties, generic wellness programs—but those don’t address the underlying dynamics. Instead, we need to understand the different segments of our nursing workforce, including their career goals, educational background, and values.
For example, our findings suggest that targeted interventions for BSN new grads could include clearly defined career pathways, introduced during nurse residency and reinforced over time. This isn’t just a feel-good strategy—it’s a testable intervention. Career pathway programs could be evaluated using quasi-experimental or even randomized controlled trial designs to assess their actual impact on retention. And that’s exactly what the field needs right now: rigorous, targeted, replicable research.
Bottom line: If we want real change in nurse retention, we have to move beyond assumptions and start investing in strategies tailored to the workforce we actually have—not the one we wish we had.
Keep leading,
Pam
Want to learn more?
DeGuzman, P. B. et al. (in press). Impact of BSN educational preparation on new graduate nurses’ intent to leave. Journal of Nursing Administration.
Williamson, L. et al. (2022). A scoping review of strategies used to recruit and retain nurses in the health care workforce. Journal of Nursing Management, 30(7), 2845-2853.
Woodward, K. F., & Willgerodt, M. (2022). A systematic review of registered nurse turnover and retention in the United States. Nursing Outlook, 70(4), 664-678.
