The cost of nurse turnover in 10 points | 2026

Nurse shortages and mounting labor costs remain among health system CEOs’ top concerns, and the newest NSI survey puts fresh numbers on the financial risks hospitals face from vacancies and churn.

The 2026 NSI National Health Care Retention & RN Staffing Report features input from 527 hospitals in 40 states on registered nurse turnover, retention, vacancy rates, recruitment metrics and staffing strategies. It covers 965,886 healthcare workers and 262,405 registered nurses.

It found the average cost of turnover for one staff RN moved to $60,090 throughout 2025, a slight decrease from the prior year even as turnover ticked back up and hospitals continued losing an average of roughly $5.19 million per year to RN churn. 

Below are 10 takeaways with 30 key numbers that illustrate the current cost of nurse turnover, according to the most recent edition of the report.

1. The turnover rate for staff RNs grew by 1.2% in 2025, resulting in a national average of 17.6% — reversing last year’s decline. RN turnover ranged from 5.6% to 40.0% given hospitals’ varying bed counts. Top reasons cited for exits were personal issues, relocation, career advancement, retirement and education. 

2. The average cost of turnover for a staff RN is $60,090 (down slightly from $61,110 the year prior). Each RN turnover causes the average hospital to lose between $4.2 million and $6.2 million, with total annual losses averaging $5.19 million per hospital.

3. Each percent change in RN turnover stands to cost or save the average hospital $295,000 per year. The 1.2% uptick in RN turnover inflated hospital losses by roughly $360,000.

4. The RN vacancy rate improved to 8.6% nationally, down from 9.6% the year prior, though NSI changed its calculation method this year, so the drop isn’t a clean comparison. The average hospital still has 43 RN FTEs unfilled, with 33.1% of hospitals reporting a vacancy rate of 10% or higher.

5. The average time to recruit an experienced RN ranged from 56 to 102 days in 2025, with the RN Recruitment Difficulty Index sitting at 78 days — five days quicker than the year prior, but still over 2.5 months.

6. Regional RN turnover was mixed in 2025. The South-East saw the high end of the average (18.7%) while the North-Central region saw the low end (16.2%). All regions except South-Central recorded increases, with the North-East posting the biggest jump (+3.3 points).

7. Over the past five years, RNs in telemetry, step down and emergency services were most mobile with cumulative turnover rates of 117.8%, 115.4% and 113.6%, respectively. “Essentially, these departments will turn over their entire RN staff in less than four and a half years,” the report states.

8. RNs in surgical services and pediatrics were least mobile over that five-year timeframe, exiting at cumulative rates of 78.8% and 75.6%, respectively.

9. Behavioral health nurses continue to lead all specialties in turnover at 22.8%, followed by step down (20.3%), emergency (19.1%) and medical/surgical (18.0%), all above the national RN average.

10. In 2025, 324,090 acute care RNs exited their positions. Hospitals responded by hiring 377,650 RNs, adding roughly 53,500 nurses to the rolls — a 2.9% add rate, down sharply from 5.6% the prior year and reflecting a slower pace of hiring.

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