In 2026, registered nurse satisfaction has fallen again, turnover has risen, and more than half of nurses report experiencing workplace violence. However, demand to enter nursing remains strong, and many universities are turning away qualified candidates due to space constraints. Experiences nurses are also willing to return to the bedside and new data also linked nursing investment to stronger hospital operating margins.
Here is what to know about the state of nursing in 2026.
The nursing workforce at a glance
The U.S. is facing an estimated deficit of more than 250,000 registered nurses by 2028, a shortage that has loomed over the industry for years without much projected change.
In 2025, 324,090 acute care registered nurses exited their positions, and hospitals hired 377,650 RNs — a 2.9% add rate, down sharply from 5.6% the previous year and reflecting a slower pace of hiring, according to the 2026 NSI National Health Care Retention & RN Staffing Report.
After a three-year improvement in job satisfaction, nurses are again reporting lower satisfaction. In the 2026 Nurses.org survey, 47% of nurses said they were satisfied with work, representing a decrease from the 55% who said the same in 2025. In addition, 23% of nurses said they are at least somewhat likely to leave nursing within the next year.
Turnover rates for staff registered nurses rose in 2025, resulting in a national average of 17.6%. The top reasons for exiting were personal issues, relocation, career advancement, retirement and education. Across health systems, nursing turnover costs an average of $60,090, a slight decrease from $61,110 in 2025. Each RN turnover causes the average hospital to see between $4.2 million and $6.2 million in annual losses.
Despite rising turnover, RN vacancy rates declined by 1%, now sitting at 8.6% nationally. The average hospital still has 43 registered nurse FTEs unfilled, with 33.1% of hospitals reporting a vacancy rate of 10% or higher.
Turnover rates and declining satisfaction abound despite more than half of nurses saying their compensation increased between 2025 and 2026, according to the Nurse.org survey. More than one-third (37%) said financial strain has prompted them to work extra shifts or overtime, 15% said they have taken a second job and 8% said financial stress has prompted considerations to leave bedside nursing. However, about 2 in 5 respondents said they stayed at the bedside due to financial necessity. Other reasons they chose to stay — despite wanting to leave — were schedule convenience (32%), commitment to patient care (28%) and workplace relationships (24%).
Workplace violence continues to make the job difficult for many. More than half of nurses said they have experienced verbal threats or aggressive language in the past year, 27% reported physical assault and 10% reported sexual harassment.
However, a recent survey found that adjusting minimum wages for competitive compensation, as well as investments in safety, well-being, recruitment and retention, had a strong positive association with a hospital’s operating margin.
Recruiting and retaining nurses
Recruiting an experienced nurse takes an average of 78 days — five days faster than last year, according to the NSI report.
Many systems are turning to financial incentives to attract new and experienced nurses. Among new nurses, the most effective incentives are loan repayment; for midcareer or more experienced nurses, sign-on bonuses are the most desirable.
Systems are also making cultural and management style shifts. Gen Z is now the second-largest cohort of nurses in hospitals, and leaders reported that Gen Z nurses require about 2.5 times more meaningful interactions with front-line leaders each month to achieve similar engagement and retention outcomes as older generations. This often takes the form of personalizing professional development, reducing administrative friction, modernizing communication channels, offering greater scheduling flexibility and strengthening mental health support.
Among Gen Z nurses, retention is strongest in the first two years of employment, typically while they are supported by residency programs and structured onboarding. After about 30 months, turnover rises above that of other generations.
Bringing nurses back to the bedside is still a top strategy for many systems. In 2022, some systems implemented a “boomerang” recruitment strategy to bring nurses back to the bedside. Hospitals reported many benefits to bringing back nurses who left for other positions. These nurses return with more experience, are able to easily reintegrate into the culture and are less expensive to reorient, and are often more engaged than external hires.
A Philadelphia-based University of Pennsylvania survey found the majority of nurses who left bedside roles in recent years are willing to return, and adequate staffing levels are the factor that would reattract them.
Nursing education
As of April 1, the National Council Licensure Examination for registered nurses now includes more competencies in care management and basic care and comfort, while most of the exam structure, scoring and content distribution are unchanged. The new competencies include providing unbiased care and dignity through a patient’s lifespan. These changes are considered less significant than those of the last overhaul in April 2023.
The NCLEX-RN pass rate among first-time, U.S.-educated individuals since has fluctuated, from 88.6% in 2023 to 91.2% in 2024 to 86.7% in 2025.
Across the country, universities and health systems are opening and expanding their nursing programs to meet the demand of students wanting to enter the profession. However, the American Association of Colleges of Nursing found that more than 65,000 qualified applicants were turned away from nursing programs in the most recent academic year. The issue: not enough nursing faculty to teach them. The national nursing faculty vacancy rate hovers near 7% — with nearly 1,700 positions unfilled — and more than one-third of current nursing faculty are older than 60.
Some systems are trying to close this gap by offering split nursing bedside and faculty roles. States such as Kansas are also cutting some faculty position requirements. On April 6, Kansas legislators passed a law prohibiting the state’s board of nursing from requiring college instructors to have credentials at least one level higher than the degree awarded in the program they teach.
The post The current state of nursing | 2026 appeared first on Becker's Hospital Review | Healthcare News & Analysis.
