In the News · Healthcare Workforce

Nurse Turnover Went Back Up. Nurses in Their First Year Now Account for 29% of It.

After several years of gradual improvement, the national staff RN turnover rate climbed again in 2025, rising 1.2 percentage points to 17.6 percent. The 2026 NSI National Health Care Retention and RN Staffing Report puts the average cost of losing a single bedside RN at $60,090, which works out to roughly $5.19 million a year for the average hospital.

The number worth pausing on is further down the report. First-year RN turnover sits at 22.3 percent, and first-year separations account for 29 percent of all RN turnover at the average hospital. Almost a third of the churn is coming from people who just arrived.

A Retention Problem That Starts in Month One

Most retention strategy is built around tenure. Clinical ladders, certification pathways, career mobility, all of it aimed at the nurse who has been on the unit for three years and is starting to look around. That work matters. It is also aimed at the wrong end of the curve.

If nearly three in ten departures are first-year nurses, the decisive window is the first twelve months, and what happens in that window is less about compensation than about whether someone feels supported, oriented and genuinely part of a team. You cannot pay a new nurse into feeling like they belong on a unit.

Every percentage point of RN turnover costs the average hospital roughly $295,000 a year. First-year separations are almost a third of the total.

The math makes the case on its own. Moving first-year turnover by a few points is worth more than most retention line items in the budget, and the levers are largely cultural: preceptor quality, psychological safety on the unit, whether a new grad feels able to ask for help, and whether the charge nurse has any capacity left to notice they are struggling.

17.6%

National staff RN turnover in 2025, up 1.2 points year over year

22.3%

First-year RN turnover, making up 29% of all RN separations

$60,090

Average cost to replace one bedside RN

The vacancy picture compounds it. The national RN vacancy rate sits at 8.6 percent, and hospitals hired 377,650 RNs in 2025 against 324,090 departures, which is net positive but a much narrower margin than the headline hiring number suggests.

Source: NSI Nursing Solutions, 2026 NSI National Health Care Retention and RN Staffing Report, based on 527 acute care hospitals across 40 states, covering 965,886 healthcare workers and 262,405 registered nurses.

What This Means for a Nurse Leadership Agenda

If you are building a nursing leadership summit, a magnet conference session or a Nurses Week program this year, the data points at a specific room rather than a general one. The people who decide whether a first-year nurse stays are charge nurses, preceptors and unit managers, and they are the group with the least slack in the building.

A keynote aimed at that room has to do two things at once. It has to acknowledge that they are carrying more than they signed up for, and it has to give them something they can actually use on Monday without adding an hour to their shift. Speakers who only do inspiration tend to land poorly with clinical audiences. Speakers who only do frameworks lose them by the second slide.

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