Nurses report wage, staffing dissatisfaction but most say they'll stick around until retirement, report finds

Despite challenges with compensation, staffing shortages, safety and more, most nurses want to remain in the field until retirement, a new report found.

The State of U.S. Nursing Report, in its fifth iteration, was published by healthcare career marketplace Incredible Health. The report included the platform’s proprietary data from 1 million nurses users and the findings of a survey that reached more than 3,300 nurses working in the hospital setting.

It found that nearly a quarter of nurses say they are very likely to leave their role this year. Though nurses are slightly less dissatisfied with current staffing levels compared to 2023, 88% believe that patient care is being negatively impacted by staffing shortages. More than half of nurses (63%) are assigned to care for too many patients at a time. Nearly a quarter reported they were required to perform tasks outside of their job description due to staffing shortages. 

“The U.S. population is aging and that is putting more and more strain on the healthcare system,” Iman Abuzeid, M.D, cofounder and CEO of Incredible Health, told Fierce Healthcare. “We have not done a great job of increasing the number of healthcare workers to meet that growing demand.” 

Being understaffed impacts how much care can be delivered and the quality of that care, she explained. For nurses doing things outside their job description, that might look like a highly specialized cardiac care nurse having to do some work of a medical-surgical nurse, Abuzeid said. 

Only 11% of nurses have used AI in their roles. Most (70%) don’t see AI impacting their roles in the next year, though 64% believe AI will negatively impact their employment overall. And 65% think the technology will impact the industry negatively overall. 

Some do recognize the positive impacts of AI, like supporting technological education and making processes more efficient. Those who have used AI have done so for recommendations on patient care, during the patient intake process, care summary creation and for job searching.

At the same time, the report outlined nurses' concerns of greater trust in AI than trust in staff and of a resulting imbalance between younger and older generations of nurses. 

“At the end of the day, getting the technology live and out there and being used by people is probably going to be the number one thing that overcomes some of the perceptions,” Abuzeid noted, adding that for many, “it’s just not real yet.”

The report revealed a generational divide in how nurses perceive AI: 69% of nurses 55 years and older think AI will negatively impact the industry, compared to 44% of 18- to 24-year-olds. Most nurses don’t feel hopeful about the next generation of nurses. Right now, there are several generations in the workforce, per Abuzeid. With some aging out, there is a concern that there are not as many experienced nurses left to mentor the incoming cohort. 

At the same time, younger nurses have different expectations than those who are older, Abuzeid said. They want to specialize faster and to get salary hikes quicker.

“The market is enabling them to do that because of the shortage,” Abuzeid said. “This creates a particularly tough challenge for hospital executives because you have to hire, engage and retain a workforce spanning five generations.” 

Half of nurses have been verbally or physically assaulted by a patient or the patient’s family within the past year, with over a quarter noting they’re likely to leave their current role because of this incident. As with flexible schedules, most executives recognize nurse safety is a concern but very few are currently doing something about it, per Abuzeid. 

Though the average salary for a nurse nationwide has been increasing, currently at $90,000, nurses still struggle, Abuzeid noted. Per the report, 78% described being able to meet their basic needs with little to nothing left over. Factors like burnout, inadequate staffing and dissatisfaction with compensation contribute to sentiment over compensation, with 64% feeling not fairly compensated. 

“The sentiment around not having much disposable income is honestly quite similar to that of other Americans,” Abuzeid said. “It is becoming increasingly hard to have a lot of disposable income in the U.S.” 

In the face of these challenges, health systems are increasingly implementing tools to fight burnout and build a sense of community. “There is a pretty concerted effort to tackle challenges of this workforce,” Abuzeid said. Those strategies include a focus on career advancement, such as by expanding training programs, and offering more flexible schedules, though that can be difficult to accomplish from a logistics standpoint.

Overall, the mental health of nurses improved in this year’s report, up 6% from 2023. More than three-quarters of nurses want to remain in the field until retirement, roughly level with 2023 figures and up from 55% in 2022. 

Incredible Health’s platform aims to help nurses manage their careers and get hired. It also offers free continuing education, peer support and a salary estimator. It is free to use for every U.S. nurse.