Hospital nurse workforce shortages remain a persistent concern as many registered nurses (RNs) leave hospital employment while maintaining professional qualifications and interest in nursing. While policy responses often emphasise education pipelines and recruitment, organisational conditions within hospitals continue to influence workforce participation decisions. Survey data from nurses who left hospital staff roles within the past five years but are not currently working in healthcare provide insight into the factors that may support workforce re-entry. The responses indicate that employment conditions at the bedside, including workload sustainability, scheduling flexibility and compensation, play a central role in shaping nurses’ willingness to return to hospital practice. These findings highlight organisational decision-making as a critical component of workforce recovery strategies.
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Nurses Who Left Hospital Employment
The analysis uses cross-sectional survey data from registered nurses whose most recent position was as a hospital staff nurse and who left that role within the previous five years. Among 4043 respondents, 340 were employed outside healthcare, 1438 were not currently employed and 2265 were retired. The mean age across respondents was 57.2 years. Nurses employed outside healthcare and those not currently employed were younger on average, in their mid-forties, while retired nurses had a mean age of 66.3 years. Respondents reported an average of 27.5 years working as nurses, with retired nurses reporting 36.7 years of experience.
Most respondents remained satisfied with nursing as a profession despite leaving hospital employment. Overall, 79% reported being very or moderately satisfied with nursing as a career. Satisfaction was highest among retired nurses, with 90% reporting positive career satisfaction. Patterns of job searching differed across groups. Among nurses not currently employed, 51% had searched for healthcare work within the past year. This compares with 25% of nurses working outside healthcare and 10% of retired nurses, most of whom reported not searching for employment.
Likelihood of returning to nursing followed similar patterns. Among nurses not currently employed, 38% reported being very likely to return to work as a nurse and 29% somewhat likely. Nurses employed outside healthcare were less likely overall to return, though 20% reported being very likely to do so. Retired nurses were largely unlikely to return to nursing work, with 62% reporting being very unlikely. Many retired respondents reported retiring earlier than planned, but their limited job-search activity suggests low probability of workforce re-entry. Retired nurses were therefore excluded from subsequent analyses focused on reattraction.
Organisational Factors Influencing Return
Further analysis examined responses from 1778 nonretired nurses who were either not currently employed or working outside healthcare. Respondents identified organisational conditions that would increase their likelihood of returning to nursing work. Three factors emerged consistently across groups: adequate staffing or manageable workload, flexible scheduling and better wages and benefits.
Adequate staffing or manageable workload was identified by 65% of respondents. Flexible scheduling was selected by 59%, and better wages and benefits were also selected by 59%. These priorities appeared across all age categories, though they were reported more frequently among younger nurses. Among nurses aged 30 years or younger, 74% selected staffing or workload, 65% flexible scheduling and 71% wages and benefits. Nurses aged 31 to 40 years reported similar patterns, with 70% selecting staffing, 64% flexible scheduling and 70% wages and benefits. Among those aged 41 to 50 years, 71% selected staffing, 62% flexible scheduling and 60% wages and benefits.
In older age groups, the same factors remained important but were selected less frequently. Among nurses aged 51 to 60 years, 58% selected staffing or workload, while 50% selected flexible scheduling and wages and benefits. Among nurses aged 61 years or older, 49% selected staffing, 45% flexible scheduling and 33% wages and benefits. Opportunities for career advancement were selected by 31% of respondents overall and were more frequently identified by nurses aged 31 to 40 years than by older respondents.
Only a small proportion of respondents reported barriers unrelated to organisational conditions. Eight percent reported wanting to work in nursing but being unable to find employment, and another 8% reported that nothing would bring them back to nursing work. Most respondents therefore identified workplace conditions that could influence their decision to return.
Organisational Responses and Workforce Strategy
The findings indicate that reattracting nurses who recently left hospital employment may depend on addressing workplace conditions that contributed to their departure. Many nurses who were not currently employed reported recent job-search activity in healthcare and a high likelihood of returning to nursing work. Nurses employed outside healthcare reported lower but still notable interest in returning. Retired nurses were generally unlikely to re-enter the workforce, suggesting that reattraction strategies may be most relevant for nonretired nurses.
Staffing adequacy and workload sustainability were consistently identified as leading factors associated with return intentions. Flexible scheduling and compensation were also prominent. These organisational conditions correspond with commonly reported reasons for leaving hospital staff roles, indicating continuity between departure decisions and potential return motivations. Opening additional bedside RN positions and offering flexible scheduling arrangements were identified as potential organisational responses associated with workforce re-entry.
The survey included only nurses who maintained an active licence, which may mean respondents were more likely to consider returning than nurses who allowed licences to lapse. Even with this limitation, the findings indicate that dissatisfaction is more closely related to employment conditions than to nursing as a profession.
Survey responses from nurses who recently left hospital staff roles but remain outside healthcare employment indicate that workforce reattraction may be achievable through organisational change. Adequate staffing and manageable workload, flexible scheduling and improved wages and benefits were consistently identified as factors associated with returning to nursing work. Many nonretired nurses reported satisfaction with nursing as a career alongside willingness to return under improved workplace conditions. For healthcare leaders addressing workforce shortages, organisational improvements in staffing, scheduling and compensation may represent practical approaches to re-engage experienced nurses who have left hospital practice.
Source: JAMA Network Open
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