For decades, nurses have largely followed a linear career path: they got hired, moved up the clinical ladder, and stayed with the same employer – often within the same specialty – throughout the span of their careers. Since the start of the pandemic, these same nurses have begun retiring in droves as part of a wave of resignations that has seen one in five healthcare workers quit their jobs. 

As is the case with so many of the challenges facing the healthcare industry right now, the shifting expectations about what a successful career in nursing looks like predates COVID-19, but has been accelerated in the last few years. Like their counterparts in other industries, millennial nurses are seeking more flexible and diverse career experiences – which aren’t as readily available on a traditional hospital career track. In fact, according to a recent survey from my company, Trusted Health, more than one-third of nurses surveyed say their idea of a successful nursing career includes moving among hospitals, clinics, and units to gain varied experiences. 

On top of this, many nurses have turned to travel nursing for the first time recently. In fact, 48 percent of surveyed nurses who have ever taken a travel contract did so for the first time during the pandemic. And now they aren’t interested in going back to staff positions: nearly one in five of those on a travel or per diem contract said that nothing would interest them in a full-time role. 

Add to all of this to the high levels of burnout and compassion fatigue plaguing nursing, and you’ve got a full-blown crisis. Even those nurses who aren’t of retirement age and have made it to this point in the pandemic are a flight risk according to a separate Trusted study, which found that 39 percent of nurses under the age of 40 are less committed to the profession than they were pre-pandemic.

To remedy this and prevent the loss of an entire generation of nurses, the healthcare industry urgently needs to embrace new career paths and build more flexibility into the profession. Below are three ways that health systems and the industry at large can ensure that they are retaining the nurses they have while making the profession appealing to new ones. 

Rethink what a nursing career looks like. Like their counterparts in other industries, millennial nurses are far less inclined to stay at one or two organizations and work their way up the clinical ladder. In fact, 21 percent of the nurses in Trusted’s survey said that they weren’t interested in being associated with a single hospital or health system. Based on this, hospitals need to find ways to offer nurses more diversity on the job. This might include re-imagining float pools or creating structured rotational programs that enable nurses to develop their skills across specialties, care settings, and geographic locations. It also means embracing and providing mentorship for nurses who want non-traditional career paths, which is often lacking or even non-existent in most hospitals. 

Modernize shift scheduling. Traditional shift scheduling is a deterrent against sustaining a career in nursing. Although nurses want more variety on the job, they also need greater predictability and control over their time, with 73 percent reporting that they miss out on important events because they can’t get time off and 52 percent saying that the current approach to scheduling leads to lower job satisfaction. Between the burnout that has been part of the nursing landscape for years, and the overall shift towards more flexible working conditions across industries, nursing needs to modernize the scheduling process so that nurses can have more input into their schedules. 

Create better incentives for the next generation of nurse leaders. Just one in 10 nurses surveyed said that their idea of a successful career in nursing involves advancing into nurse administration and leadership roles. They see leadership as a trade-off between what drew them into nursing in the first place—patient care—and more exposure to nursing politics and the headache of staffing and scheduling. When asked why they weren’t interested in leadership roles, fully two-thirds of respondents cited “nursing politics/culture,” dwarfing all other responses. Hospitals need to root out the deeply entrenched cultural practice of bullying that has plagued nursing for decades through a multifaceted approach that includes educating all parties about what bullying looks like, offering training to new managers, building relationships between nursing departments and their HR partners, and holding employees accountable for their behavior. They also need to draw younger nurses into leadership by addressing the challenge of staffing and scheduling through technology that frees nurse leaders and managers up for more meaningful work.

Now is the time to create nursing in a new image. Things went from tenuous pre-pandemic to completely unsustainable today, and wide-ranging changes are the only solution. Younger nurses have been crying out for something different for years and this may be our last chance to listen to them before they leave the profession for good. 

About Sarah Gray 

Sarah is the Founding Clinician at Trusted Health, the leading labor marketplace for healthcare professionals. Trusted matches nurses with a range of flexible jobs that meet their preferences and career goals, offer support from a dedicated Clinical Care Team and unmatched insight into compensation and contract details. 

Sarah is a graduate of the University of Pennsylvania's Nursing School and began her nursing career at UCSF Benioff Children's Hospital. Prior to moving away from the bedside, she was a Clinical Nurse III and an Evidence Based Practice Fellow, and served on multiple hospital-wide committee boards. At Trusted, she utilizes her clinical insight and passion for innovation to change how nurses manage their careers and solve for inefficiencies within healthcare staffing.