A systematic review of registered nurse turnover and retention in the United States

  • Author Footnotes
    # The authors have no conflicts of interests to declare.
    Kyla F. Woodward
    Corresponding author: Kyla F. Woodward, School of Nursing, University of Washington, Box 357260, Seattle, WA 98195.
    # The authors have no conflicts of interests to declare.
    Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, WA
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  • Author Footnotes
    # The authors have no conflicts of interests to declare.
    Mayumi Willgerodt
    # The authors have no conflicts of interests to declare.
    Department of Child, Family, and Population Health Nursing, University of Washington School of Nursing, Seattle, WA
    Search for articles by this author
  • Author Footnotes
    # The authors have no conflicts of interests to declare.


      • Registered nurse (RN) turnover research lacking data about equity and wellness in workforce.
      • Minimal robust data available on interventions that improve retention of RNs.
      • Community-based and ambulatory care RNs missing in most turnover research.
      • RN turnover research needs to move beyond descriptive survey studies.



      The pandemic has highlighted the struggles of nurses and risks of workforce shortages. Analysis of nurses’ job decisions is necessary to mitigate these risks.


      The purpose of this systematic review was to understand factors associated with registered nurse (RN) work outcomes in the United States, and to examine the inclusion of equity and wellness concepts in this body of literature.


      This review utilized the Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol. Studies from PubMed and CINAHL were included if they focused on RNs in the United States in the past 10 years. A total of 34 studies are included in the review.


      RN work outcomes are impacted by individual, unit level, and organizational factors. Few studies address equity, and many only address RN health in terms of burnout.


      Future work needs to draw samples from broader practice settings, focus on interventions that promote positive outcomes, and focus on equity and the wellbeing of RNs.


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