Staffing and flexibility drive nurses’ return to hospital work

Most registered nurses who recently left hospital employment are motivated to return to health care work-and safe nurse staffing levels is the top factor that would bring them back, according to new research from the University of Pennsylvania School of Nursing's Center for Health Outcomes and Policy Research (CHOPR).

Published in JAMA Network Open, the study analyzed data from 4,043 actively licensed registered nurses who left direct care hospital positions within the last five years. Among them, 8% were employed outside health care, 36% were unemployed, and 56% were retired.

Most unemployed nurses had searched for health care work within the past year and said they were likely to return to nursing. One-quarter of nurses working outside health care said they had also searched for nursing positions recently.

Adequate staffing emerged as the top factor that nurses said would increase their likelihood of returning to nursing work. "Unsafe staffing drives nurses away from hospital employment – and adequate staffing is the key to bringing them back," said lead-author Karen B. Lasater, PhD, RN, FAAN, the Jessie M. Scott Term Chair in Nursing and Health Policy, Associate Professor in the Department of Biobehavioral Health Sciences and CHOPR Associate Director. "The problem and the solution are the same. High nurse turnover is a solvable crisis, because the reasons nurses leave are the same reasons they would return, if addressed."

Another key factor included flexible scheduling options. "Nurses are often locked into rigid shift schedules that limit their ability to transition between shifts or chose different work blocks," said senior author K. Jane Muir, PhD RN, FNP-BC, Assistant Professor in the Department of Family and Community Health. "Hospitals can reattract an existing nurse workforce by reconsidering these arrangements to remain competitive."

The study also revealed that over one-third of retired nurses (37%) left earlier than planned, despite 90% being satisfied with nursing as a career. "The findings suggest premature workforce exits are driven by modifiable organizational issues, not problems with the profession itself," said coauthor Matthew D. McHugh, PhD, JD, RN, CRNP, FAAN, the Independence Chair for Nursing Education, Professor of Nursing and CHOPR Director. "Warnings about nursing shortages should be treated with caution given the existence of an untapped latent labor force willing to work at the bedside if working conditions were better."