A nurse holds hands with a senior nursing home resident
Credit: Terry Vine/Getty Images Plus

Nearly a third of U.S. registered nurses are considering leaving their current patient-care role, according to the latest survey on healthcare worker attitudes from research firm McKinsey. 

The 32%  “likely” to leave represents an increase of 10 percentage points since McKinsey’s last poll about 10 months ago.

And it’s not just RNs ready to walk away. 

The firm’s survey of 866 frontline nurses and other healthcare professionals providing direct patient care in a variety of settings also showed 28% of licensed practical nurses and 27% of certified nurse aides are likely to leave.

Among those who said they were likely to leave their current positions, a whopping 71% said they would leave direct care or their healthcare career altogether. 

“The strongest drivers of intent to leave included insufficient staffing levels, seeking higher pay, not feeling listened to or supported at work, and the emotional toll of the job,” noted study authors Gretchen Berlin, RN, McKinsey’s senior partner in Washington, D.C., and partners Meredith Lapointe and Mhoire Murphy.

The numbers of those likely to leave ticked up over the course of 2021, even as wages did. And nowhere was that scenario worse than in skilled nursing settings.

A study published in JAMA Health Forum Friday found that skilled nursing had the largest 2020 employment declines among all healthcare sectors except dentists’ offices. Nursing homes lost 8.4% of their workforce, according to a RAND Corp. analysis of data from the  Bureau of Labor Statistics.

In early 2021, SNFs saw an even steeper decline of 13.6% compared to 2019 levels, despite having the largest wage increases at 9.5% in 2020 and 6.3% in 2021.

The McKinsey respondents, which included about 3% working in long-term care settings, reinforced that many nurses need more than higher pay to stay. Though skilled nursing responses weren’t broken out, 30 of 94 home care nurses said they were likely to leave.

Job satisfaction slipped noticeably in 2021, according to McKnight’s own 2022 Outlook survey. At the time, staffing experts called those declines dangerous territory for nurse managers and staff in other top-level positions, where shortages were intensifying. That survey was conducted around the same time period as the latest McKinsey findings.

In the McKinsey analysis, nurses with less than 10 years of experience cited higher pay as a more influential factor, but retirement and the physical toll of the job were bigger factors for registered nurses with more experience.

Just over 60% of those likely to leave said an “unmanageable workload” was a reason to leave; with 57.9% citing a need for work-life balance. Among those likely to stay in direct patient care, 66% said they were “doing meaningful work” and 65.2% said haveing “caring and trusting teammates” were critical factors.

The McKinsey analysts noted that high-level public policies may be needed to address such factors as workload, especially amid historic staffing challenges. But there is hope for change that can influence worker attitudes.

“While broader solutions — and collaboration across the public and private sector, for example, to increase nurse educator capacity and elevate the role of nursing — are critical in the long term, healthcare organizations can consider a number of medium and longer-term strategies to support their workforces,” they wrote. “Examples include doubling down on retaining critical talent grounded in the specific needs and preferences of the front line; minimizing workload strains where possible through advanced analytics (planning, deployment) and workflow redesign; and innovating around new ways to grow the talent pipeline (including with partners).”