UNC School of Nursing report identifies six priorities for nursing workforce retention

A report from researchers at the University of North Carolina at Chapel Hill School of Nursing, North Carolina Area Health Education Centers, and the Kenan-Flagler Business School’s Center for the Business of Health outlines six priorities to help health care leaders address nursing turnover and strengthen retention across the state.

“Retaining North Carolina’s Nursing Workforce: A Guide for Healthcare Leaders” draws on responses from 11,214 nursing personnel surveyed through the RETAIN study. The findings identify workplace conditions that influence nurses’ decisions to stay in or leave their jobs and organizations.

Cheryl B. Jones, PhD, RN, FAAN, the Sarah Frances Russell Distinguished Professor and director of the Hillman Scholars Program in Nursing Innovation at the UNC School of Nursing, served as principal investigator and lead author. Co-investigators and report co-authors are Drs. Sinhye Kim (Yonsei University, South Korea, former SON PhD student and post-doctoral scholar), Joshua Barrett (Kenan-Flagler, former SON PhD student and current SON adjunct faculty), and Jill Forcina (AHEC, SON alumnus and SON adjunct faculty). The project received support from the School of Nursing and NC AHEC.

The study, conducted in late 2023 through early 2024, gathered responses from 8,808 registered nurses, 1,644 licensed practical nurses and 762 certified nursing assistants (CNA IIs) with credentials through the North Carolina Board of Nursing. Participants answered questions about turnover, well-being, work environments and strategies that would help retain them in their jobs, including compensation, scheduling, workload, and organizational and clinical relationships.

Among respondents, 61% of registered nurses, 55% of licensed practical nurses and 62% of certified nursing assistants planned to leave their current nursing position within five years. About 40% of registered nurses and licensed practical nurses and 43% of certified nursing assistants planned to leave within two years. These responses reflect intentions to leave a position, which may include changing jobs within an organization or moving to another employer.

Better pay ranked as the leading reason respondents planned to leave their current positions. Workplace stress was the leading reason for leaving an employer among respondents who had changed employers in the previous year. Relationships with patients, nursing colleagues, staff and managers were among the leading reasons respondents stayed.

The report emphasizes that no single strategy will retain nursing personnel on its own. Instead, a combination of approaches may be needed to adapt recommendations to meet organizational and staff needs.

The findings come as North Carolina faces projected nursing workforce shortages. The report cites NC Nursecast projections of a shortfall of nearly 12,500 registered nurses and more than 5,000 licensed practical nurses by 2033, with shortages concentrated in hospitals and long-term care settings. Those projections were developed using pre-pandemic licensure trends.

The report is available through the Carolina Digital Repository, where it was published Oct. 7, 2026.

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