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Here's Why Nurse Leaders Are Leaving the Workforce

Analysis  |  By G Hatfield  
   March 04, 2024

Turnover rates amongst nurse leaders are projected to be high, and CNOs need to strategize.  

The staffing shortage affects not only the bedside nurse, but also the nurse leader.

A new report from AMN Healthcare found that 31% of nurse leaders said they plan to be in a different role a year from now.

AMN Healthcare's 2024 Survey of Nurse Leaders also says that 17% of nurse leaders will look for a new place to work, 9% will leave nursing, 3% will stay in a non-administrative position in nursing, and 1% will retire.

The survey consisted of several different kinds of nurse leaders, at various levels of health systems. CNOs made up 36% of participants, 37% were nurse managers, 20% were directors of nursing, and 4% were CNEs. The remaining 3% were made up of associate CNEs, interim CNEs, senior VPs, and VPs of patient care services.

While this does mean that most nurse leaders will remain where they are, a 31% turnover rate is alarming. As seen with regular nurse turnover, this phenomenon at the CNO level has the potential to greatly impact the nursing workforce and overall efficiency.

The why

Nurse leaders are facing the same workforce challenges that they are responsible for handling.

The nurse leaders who participated in the survey reported that the top three challenges they are facing in the workforce: 43% said recruitment and retention, 32% said staff burnout, and 32% said labor shortages.

The survey emphasizes the impact of burnout, stating that 72% of the nurse leaders who responded reported sometimes, often, or always experiencing burnout in the jobs, while only 28% said they rarely or never experience burnout.

According to Allison Guste, Chief Nursing Officer at University Medical Center and Corporate Vice President of Nursing and Clinical Services for LCMC Health, workforce shortages and burnout are two of the biggest issues following the COVID-19 pandemic that CNOs have to face, along with rapid technological changes.

"We know that healthcare is always changing," Guste said, "and if you're not changing, you're probably going to fall behind."

The fix 

So, what should CNOs do?

There are many strategies for addressing workforce shortages, including staying competitive with compensation, building academic partnerships, and offering professional development, according to Guste.

"Recruitment and retention is the name of the game these days," Guste said.

As for burnout, CNOs need to take care of themselves as well as their nurses, and make sure they are still engaging with their nursing as a practice.

"What fills my cup every day is not when I'm in a lot of meetings," Guste said, "it's really going out there and just rounding on the floors and seeing the nurses do what they do best."

Guste believes it is a big mistake for nurse leaders not to go be with patients, as well as with nurses. She said hearing patient stories helps her remember her goals as a nurse and a leader.

"Being out on the units, not just with the patients, not just with the nurses, but with all the staff has really enabled me to realign my vision every day [and] give me purpose," Guste said, "and align me back to why I became a nurse in the first place."

Her advice to CNOs is to be authentic and listen to staff, and to lead with empathy.

"Don't every forget why we became nurses," Guste said, "so inspire collaboration and push towards transformation and everyday excellence."

G Hatfield is the nursing editor for HealthLeaders.


Thirty-one percent of nurse leaders say they plan to change positions in the next year, according to AMN Healthcare’s new report.

Workforce shortages and burnout are two major contributing factors to nurse leader dissatisfaction.

CNOs should make efforts to engage with both patients and nurses to reinvigorate their purpose for becoming a nurse leader.

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