Nurse Turnover Rate

Nurse turnover rate is the percentage of your nursing workforce that leaves in a set period, usually a year. You calculate it by dividing nurse separations by the average number of nurses, then multiplying by 100. Tracking it apart from organization-wide turnover shows where the cost and the disruption to patient care actually sit.

Quoting one national figure is the common mistake. The number only means something once you define who counts as a nurse, which departures count, and which employment types sit in the denominator.

How do you calculate nurse turnover rate?

The formula is nurse separations in the period, divided by the average number of nurses in the period, times 100. Average the headcount at the start and end, or use monthly counts for a steadier figure. Say 20 nurses leave in a year from an average of 200. That is a 10% rate.

Internal transfers are not separations. A nurse who moves from medical-surgical to the emergency department stays in your workforce, so count that move in a separate unit-level measure instead.

What should you count in the rate?

Settle these choices before you calculate, write them down, and keep them fixed from year to year. Changing the definition mid-year makes any trend meaningless.

• Voluntary versus involuntary. Resignations and retirements are the departures HR can influence. Terminations for cause and layoffs belong in the total but should be reported separately.
• RNs versus all nursing staff. LPNs, CNAs and nurse aides leave at different rates than RNs, so a blended figure can hide a problem in one group.
• Employment status. Decide whether PRN, per diem and casual nurses are in the denominator. NSI reports that 54.0% of surveyed hospitals count every classification, while the rest count only full-time and part-time staff.

Whichever choices you make, apply them to both the separations and the headcount. Counting PRN departures but not PRN nurses inflates the rate.

Why track first-year nurse turnover separately?

First-year turnover is the share of nurses hired in a period who leave within 12 months. It reflects hiring and onboarding quality more than the experience of long-tenured nurses. Track it by hire cohort, such as everyone hired in the first quarter, and check how many are gone a year later.

NSI's 2026 report, which covers 2025 data, found that 22.7% of newly hired RNs left within a year. NSI warns that its tenure measure covers all RNs who leave by years of service and is not a measure of new graduate turnover. Record whether each hire was a new graduate or experienced before you compare cohorts.

Why is nurse turnover tracked on its own?

Replacement cost is the first reason. NSI's 2026 report puts the average cost of turnover for a bedside RN at $60,090, a hospital survey figure built on NSI's own method. Use it as a reference point and then total your own costs: recruiting, orientation, preceptor time and vacancy coverage.

Agency spend and care continuity are the others. A vacancy filled by travel or agency staff brings a premium rate and takes unit knowledge out of the team. NSI found 70.7% of surveyed hospitals wanted to rely less on travel and agency staff.

What drives nurse turnover, and what can HR influence?

NSI asked hospitals why employees resigned. Personal issues, relocation, career advancement, retirement and education led the list, followed by scheduling conflicts, salary, commute, culture and workload or staffing ratios. NSI also notes that retirement is increasingly cited by resigning RNs.

HR cannot change a relocation or a retirement date. It can change the first weeks, the support a new nurse gets and how fairly schedules are built. HR Cloud's posts on onboarding to reduce healthcare staff turnover and nurse burnout and engagement go deeper on these levers.

• Onboarding: finish compliance paperwork before day one so the first shift is about patients.
• Preceptor support: assign a trained preceptor and protect their time.
• Scheduling: publish schedules early and make shift swaps simple.
• Recognition: acknowledge good work in the first 90 days, when exits cluster.

How do you benchmark your nurse turnover rate?

Start with the NSI National Health Care Retention & RN Staffing Report, published yearly. The 2026 edition covers January through December 2025 for 527 hospitals in 40 states. It reports an average staff RN turnover rate of 17.6%, a range of 5.6% to 40.0%, and 14.6% for hospitals counting only full-time and part-time nurses.

Those figures describe acute care hospitals, not nursing homes, clinics or home care. Look for the newest edition each year, match your counting rules to the benchmark you use, and compare units against their own history as well as the national average.

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Frequently Asked Questions

Q: What is a good nurse turnover rate?

A: It depends on setting and unit. NSI treats hospitals at or below 11.5% RN turnover as the top tier, and it found the lowest turnover in pediatrics, surgical services and women's health, with the highest in behavioral health, emergency services and telemetry. Compare like with like.

Q: Should travel and agency nurses be in the rate?

A: No. They are not your employees, so they are not separations or headcount. NSI excludes temporary, agency and travel staff from its survey. Track agency hours or spend as a separate measure.

Q: How often should you calculate it?

A: Monthly, plus a rolling 12-month figure. An annual number alone hides seasonal spikes and problems that start in a single unit or hire cohort.

Q: What is the difference between turnover and retention?

A: Turnover counts the people who leave. Retention counts the people who stay, often for a specific cohort over a specific time. Both come from the same data, but they answer different questions.

Q: How do you estimate what turnover costs your organization?

A: Add the real costs of each departure: recruiting, background and credential checks, orientation and preceptor hours, vacancy overtime and agency premiums. Divide the total by the number of separations to get a cost per departure.

Q: Does a nurse moving to another unit count?

A: No. Internal transfers keep the nurse in your workforce. Track them separately, because a unit that loses many nurses to transfer has a problem even if organization-wide turnover looks fine.