Nursing Specialties With High & Low Turnover

Although the economy has leveled the demand for nurses and temporarily hidden the shortage, many healthcare organizations are considering strategic approaches toward retention. Losing nurses means not only loss of institutional knowledge but considerable expense for hospitals when you factor in costs for hiring, training, lost productivity and overtime.   Nursing Specialties with High & Low Turnover

The 2011 National Healthcare & RN Retention Report by Nursing Solutions, Inc. found wide differences in turnover by nursing specialty. They were benchmarked against the national average turnover rate for bedside RNs, which in 2010 was 13.8 percent.

5 nursing specialties with the lowest turnover rates

 – Pediatrics: 4.4 percent

 – Surgical services: 10.3 percent (Nurses evaluate and prepare patients for anesthesia and surgery and may work in operating rooms, recovery and endoscopy areas.)

 – Telemetry: 11.1 percent (Nurses monitor and care for patients connected to machines that measure blood pressure, breathing rate, heart rate and blood oxygen level.)

Step down: 11.9 percent (Nurses generally care for patients in an intermediate or progressive care unit.)

Critical care: 12.6 percent

Behavior-health nursing has highest turnover

At the other end of the spectrum, the turnover rate for nurses working in behavior health (patients with mental-health issues) is higher than any other specialty at 24 percent, a rate which is the equivalent to virtually having a new workforce every four years. Turnover of nurses working in burn units, women’s health and med/surg all exceeded the national average at 18, 17 and 15 percent respectively, the study found.

Brian Colosi, vice president for Nursing Solutions, said the areas where the turnover is the highest tend to be areas "where (nurses) have less control and there is less cohesion on the units."

"In some of the areas you have greater tendency of nurses ‘eating their young’, such as the ICU and ER," where they are constantly being tested, he says. "In ORs you have long-tenured people, so you tend to see they become very much a part of a family. They work with the same people day in and day out."

Retaining nurses is recognized as a pressing problem for hospitals, but action doesn’t match the concern. While an overwhelming majority (91 percent) of organizations view retention as a "key strategic imperative" only 38 percent have a formal retention strategy, the survey found.

For the 2011 survey, Nursing Solutions received responses from 162 healthcare facilities representing 130,000 healthcare workers. Data spanned January 2010 through December 2010.

First two years critical

The survey found RN turnover is heavy within the first two years. Twenty-seven percent of all RNs who terminated had less than one year of service, accounting for 31 percent of all RN exits. Over half of all RN separations (52%) had less than two years of tenure.

Retention may become a problem at the other end of the experience spectrum as well. Even with the considerable awareness surrounding the aging RN workforce, only 19 percent of hospitals have developed a specific strategy to retain older RNs, the study found. The recession has made it more difficult for older nurses to retire, so hospitals may see this as less of a priority. In fact, 44 percent have no plans to develop a retention plan for older nurses, which raises the question of what happens when the economy rebounds?


©, Dice Holdings Inc., 2011

About Marcia Frellick

Marcia Frellick is a Chicago-based independent journalist with 25 years of experience writing and editing for newspapers, magazines and online news sites. A graduate of Northwestern University's Medill School of Journalism, Frellick’s work has appeared in, health care magazines including Nursing Spectrum, Hospitalists, Today in OT and Today in PT, Hospitals & Health Networks and Trustee and the Chicago Tribune, Chicago Sun-Times, Illinois Issues magazine, Northwestern magazine and several other publications.


  1. BY Phinehas Pratt says:

    Have recently switched from tele to psych. Find myself bending rules (i.e. crackers and juice whn pt. first admitted (God forbid that their blood sugar should be over 150 and how dare I should ever let them eat in the hall; sitting on the edge of their bed; patting them on the shoulder, much less a hug even though they are crying and scared, allowing a woman to borrow shoes from another woman to go to mental health court rather than appear in hospital non skid socks (Oh no imagine all the germs. Well when you go shopping and go into a changing room imagine all the people that have put those things on before you. Oh well that is different. How? Well it just is. I feel like asking the person to imagine how many times she has breathed in and out the air that others have breathed and then asking her to do us all a favor and not to breathe anymore, or wait until I put on a mask. And imagine how many have sat in the same fabric covered chair that she now sits in. Yet it is the patient that is obsessed with germs. now with the new alcohol based hand cleaners, have seen people sanitize their hands, entern a room, forget something, and come out,sanitizing their hands again, without having touched anything. Putting on gloves before touching a patient, yet touching the same blood pressure cuff and clipboard that has been in and out of all the rooms, including the woman with lice)). Yet the patients are crazy, and we fighting amongst ourselves and tattling on each other, are sane. Psych would be a wonderful place to work if all we had to deal with were the patients, who we KNOW are crazy.