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Critical Factors in Nursing Retention


Nursing in Crisis: Rebuilding the Talent Supply Chain from Within and Reversing the Nursing Shortage served as a very blunt examination of challenges impacting the sophisticated pipelines for nursing education and employment, and how data-driven insights could serve as a solution to hire – and especially to retain – qualified nursing professionals. View the webinar here.

CastleBranch is deeply involved in examining what drives nurse retention, and what forces contribute to dropout and/or attrition during an individual’s journey to and through professional life (TTPL). In a survey sent to your industry peers, we asked the following question:


“What are the top 3 determining factors that your organization has found to be critical for a nurse to remain in place for more than 2 years?”


Respondents indicated the following to be the biggest determining factors:



  • Compensation and/or Benefits
    • Respondents mentioned competitive compensation, benefits to match needs, incentives, and pay in line with individuals at other facilities
  • Career, Growth and/or Development Opportunities
    • Respondents mentioned clinical ladders, upward mobility, promotion opportunities, and professional development
  • Work Environment
    • Respondents mentioned belonging, inclusiveness, job quality, physician/nurse interaction, support, respect, and having a voice in decisions

Factors mentioned the least included consistency, critical thinking, location, clinical fit, satisfaction, schedule, tuition reimbursement, and work-life balance.


While many in the industry identified “Compensation and Benefits” as the most important factor in retaining a nurse, other schools of thought exist. According to an article published by Becker’s Hospital Review in May of 2021, “On paper, monetary bonuses look great. However, if systems have a reputation that they don’t support nurse well-being, people aren’t going to come. Or the people who do come aren’t the nurses organizations want – they come for the money, but aren’t fully engaged in the profession. Gone are the days when organizations can just offer bonuses to attract people. Systems need all the other pieces, and should invest in initiatives that attract and keep talent.”


While new-hire or sign-on bonuses are a way to attract new talent, there must also be a plan internally to retain nurse talent within an organization. An additional point to consider is the impact sign-on bonuses have on currently employed nurses within an organization, as they don’t receive the monetary incentive despite their dedication and hard work within their organization. This can negatively impact both the relationship between new-hire nurses and employed nurses, as well as the relationship between employed nurses and the administration within an organization, resulting in turnover of experienced nurses.


When reviewing the non-critical factors or practices provided by respondents to our survey, a large number are driven by organizational culture:

  • Work-life balance
  • Work environment
  • Transparency
  • Teamwork
  • Team-focused
  • Support
  • Staffing
  • Satisfaction
  • Safe ratios
  • Resilience
  • Recognition
  • Leadership
  • Flexibility
  • Feeling valued as an employee
  • Engagement
  • Empathy
  • Economy
  • Consistency

While compensation and benefits, career, growth and development opportunities are the factors or practices respondents identified as most critical, the majority of factors respondents provided are connected to the expectations, values and practices that organizations establish that also heavily contributes to the retention of newly licensed registered nurses (NLRNs).


This idea is supported by an article published in The Journal of Nursing Administration. Through the authors’ research and evaluation, the Nursing Turnover Measurement Form was used to both accurately measure turnover and serve as a reference for evidence-based retention protocol. It focused on the organizational commitment components of autonomy, recognition/rewards, and communication, which they summarize as key components in retaining nurses:


“The profession of nursing will be unable to compete with other career opportunities unless we provide adequate rewards and recognition to our most valuable assets – our employees – and develop better communication standards in the clinical setting and provide clinical practice opportunities and responsibilities that match the registered nurse’s knowledge and skill and facilitate autonomy and empowerment of staff.”


So what are we learning? The substantive takeaway from our recent survey seems to indicate that although compensation and benefits, along with growth, career, and development opportunities are key factors in nursing retention, a large focus should also be placed on the work environment and organizational culture – as well as finding candidates that match well to your facility’s culture and values – so nurses feel supported, a sense of belonging, and can realize long-term fulfillment.

Nursing in Crisis: Rebuilding the Talent Supply Chain from Within and Reversing the Nursing Shortage