Nurse retention remains a major challenge for U.S. hospitals, as emotional fatigue and generational differences reshape how healthcare leaders support their nursing teams.

Becker’s spoke with seven health system nursing leaders about difficulties they encountered in addressing burnout and supporting their nurses.

Question: What is one aspect of nurse retention that’s become more difficult over the past year, and how are you working to address it?

Stephanie Clements, BSN, RN. Chief Nurse Executive at Mercy (Chesterfield, Mo.): One aspect of nurse retention that has become more difficult over the past year is sustaining emotional resilience across our teams. The cumulative impact of post-pandemic fatigue, staffing challenges and the increasing complexity of patient care has left many nurses feeling stretched thin — not just physically, but emotionally.

To address this, we’ve shifted our focus from traditional retention strategies to more holistic support systems. We’re investing in mental health resources, peer support programs and leadership development that prioritize psychological safety and connection. But most importantly, we’re truly listening. Through our “Voice of the Caregiver” survey, nurses are telling us what matters most to them — and we’re leaning in. Their feedback is shaping our priorities, from flexible scheduling and career development to recognition and workplace culture.

We’re also maximizing our investment in technology advancements to support nursing innovation. By reducing the burden of tasks like electronic medical record documentation, we’re giving time back to our nurses — time they can spend with patients, with their teams and on their own well-being. These kinds of improvements directly impact the day-to-day experience of our frontline caregivers and reinforce our commitment to making their work more meaningful and sustainable.

Above all, we’re striving to ensure that nurses find joy in the workplace and a deep sense of connectedness to our mission. When nurses feel aligned with our purpose and supported in their calling, retention becomes less about staying — and more about belonging.

Jessica Huffman, DNP, RN. Assistant Vice President of System Nursing Services at WVU Medicine (Morgantown, W.Va.): We are proud of the retention supports we have launched to ensure nurses see both a future and a fulfilling career at WVU Medicine. With several exciting recruitment initiatives underway, it is equally important to emphasize retention. Our strategies meet nurses where they are: from student nurse, throughout a fulfilling professional journey and until retirement.

This year, we expanded residencies, transition-to-practice programs and externships; supported more than 600 future nurses through our Aspiring Nurse Program; and launched West Virginia’s first hospital-based RN diploma program. Retention also means prioritizing market-competitive compensation and innovative benefits. Our Work-Life Balance Program allows qualifying nurses near retirement to work part-time with full-time benefits, retaining essential expertise.

Through professional growth opportunities within our clinical advancement for professional excellence clinical ladder, celebrating nursing excellence with The Daisy Award, elevating nurses’ voices through shared governance, and piloting new care models and technologies, we are deeply committed to meeting evolving workforce needs and advancing nurse well-being.

Peggy Norton-Rosko, DNP, RN. Senior Vice President and System Chief Nurse Executive at University of Maryland Medical System (Baltimore): Like most health systems, we’ve done a great deal of work focusing on the first-year retention of new graduate nurses. We have improved our overall retention and first-year turnover rates. Now, turnover is happening most frequently between years two and three. We’re working with our nurses and our nursing leadership teams to determine how we can support these early career nurses who are moving beyond the novice practitioner phase toward more independent practice. Managers are conducting purposeful career conversations with these nurses to engage them in programs that help them explore other options if they want to move to a different clinical specialty.

A very important aspect of retaining all nurses, particularly those early in their career, is the relationship they have with their manager. We are creating a standard approach to the nurse manager span of control that will enhance leadership touch points and mentoring of nurses while adding structured support to nurse managers with large spans of control. This will allow nurse leaders to be more available to respond to the needs of our nurses.

Betty Jo Rocchio, DNP. Chief Nursing Executive for Advocate Health (Charlotte, N.C.): One of the biggest challenges this past year has been reducing the cognitive burden on our nurses working. To address this, we’re expanding our internationally renowned virtual nursing program and partnering with Microsoft to broaden our use of ambient-listening technology to support our complex and highly specialized nurse workflows. We estimate our virtual nursing program reduced cognitive burden for our nurses by saving them more than 72,000 hours in 2025. And both of these innovations empower our nurses to focus on what they do best — care for their patients.

Cynthia Salisbury, MSN, RN. Executive Director of Nursing Operations at Providence (Renton, Wash.): One aspect of nurse retention that has become increasingly difficult over the past year is ensuring that nurses genuinely feel included, heard and empowered in decisions affecting their practice and delivery of patient care. A driving factor to this challenge is the rapid transformation of nursing, fueled by the adoption of new models of care and the integration of advanced technology solutions. As care systems evolve at pace, it is essential that nurses remain at the heart of these changes — not only as practitioners, but as partners and decision-makers whose insights shape the future of healthcare.

At Providence, as we transition from implementing new models of care to optimizing them systemwide, we recognize that meaningful, effective program improvements stem from the insights of those delivering care. This is further true as we expand technology more broadly in nursing care delivery.

To effectively include and empower nurses, we are focused on strengthening partnerships with our care teams, prioritizing inclusive and transparent communication and maintaining the flexibility to take meaningful action in response to caregiver feedback. We collaborate with governance councils and form advisory groups so nurses from every division have a true voice in shaping their work and technology adoption.

This deliberate, transparent and responsive approach facilitates nurse engagement, supports retention, and creates an environment where nurses are seen, heard and valued — helping build an empowered, future-ready nursing workforce.

Amanda Shrout, DNP, RN. Chief Nursing Officer and Vice President of Patient Care Services at Sinai Hospital and Grace Medical Center (Baltimore): The most challenging aspect of nursing retention today is balancing the rising patient acuity within the hospital with the ongoing drive for evidence-based improvements in patient safety, quality and access. To support our teams, we are focused on ensuring resources are available at the point of care — such as dedicating free charge nurses as throughput nurses, adding a critical care resource nurse 24/7 and expanding our flex pool. Just as importantly, we are committed to celebrating both small wins and major accomplishments, doubling down on recognition and making sure our team members feel valued and appreciated every day.

Deana Sievert, DNP, RN. Chief Nursing Officer at Ohio State University Wexner Medical Center University Hospital and Ross Heart Hospital (Columbus): I think the different generational needs and desires have made it more challenging to approach retention. With the many different generations that we have working in healthcare nursing today, the standard one-size-fits-all tools need to be examined. The key to being more successful is designing strategies that appeal to a multitude of groups and individuals, which requires innovation and meaningful discussion between organizations and nursing teams.

Here at the Ohio State University Wexner Medical Center, one of the structures we have put into place is our student nurse associate and student nurse externship programs. These programs allow us to work closely with each student nurse associate to better understand how they want to grow as they move into the registered nurse role and beyond. We begin educating them on the many different resources of our organization at that first touchpoint and get them connected. This creates strong affiliations and helps them build the foundation of their RN careers. Our commitment to supporting them continues well beyond their initial placement, providing continuing education and opportunities to advance their professional practice. These programs have been very successful in their first two years, and we are excited to see where this continues to evolve in our ongoing efforts in nurse retention.

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