Over One-Third of Nurses Considering Career Change in 2024 Amid Staffing Mandate Challenges

Over one-third of nurses are considering changing careers this year, signaling a potential job churn for the industry – which may prove especially concerning for operators in the wake of the final minimum staffing mandate.

This is according to a recent study conducted by AMN Healthcare, which surveyed 1,155 nurses regarding their career outlook for 2024.

About 80% of survey respondents said they believe that 2024 will either offer no workplace improvement or could potentially be worse than 2023. Roughly 20% expressed optimism about a better year ahead, signaling widespread apprehension among nursing professionals.


This sentiment, coupled with stricter staffing standards, could be problematic for operators.

Katie Smith Sloan, president and CEO of LeadingAge, criticized the staffing mandate – which mandates a minimum of 3.48 hours per resident per day (HPRD) of total staffing, with specific allocations for registered nurses (RN) and nurse aides – for not including any support for recruitment and training for staff.

“How can providers hire more RNs when they do not exist?” she said in a statement. “Nurse aides, who are the backbone of aging services, are also in short supply – yet again, the rule does not include support to recruit, train and hire more of these critical workers. By the Centers for Medicare and Medicaid Services’ (CMS) estimate, the rule will add to providers’ financial burden – by $43 billion, over 10 years.”


Indeed, the financial burden might be too much for operators to sustain with difficult labor conditions.

“Nurses weathered the storm of COVID-19, but many still see clouds ahead for the profession,” Robin Johnson, group president of nursing solutions with AMN Healthcare, said in a press release. “Clearly, continued focus on nurse wellness, job satisfaction and retention must be a priority for the healthcare industry.”

A substantial portion of the nurses surveyed by AMN Healthcare said they are considering job changes in 2024, with 35% indicating an extreme likelihood of seeking new employment this year.

Additionally, 35% of nurses highlighted the possibility of altering their working hours or schedules, with 58% indicating openness to such adjustments.

“Turnover and volatility in the nursing workforce have been endemic over the last several years,” Johnson said. “That trend is likely to continue until nurse concerns are addressed.”

When asked about their priorities in the workplace for 2024, nurses identified several key areas. Foremost among these was compensation, with 75% of respondents emphasizing the importance of better pay.

Also, 68% nurses expressed a desire for improved nurse-to-patient ratios, and 58% said they wanted better schedules. Recognition for nurses and wellness programs also ranked prominently but were secondary to core concerns such as compensation and working conditions.

“While recognition and wellness are important to nurses, what is most important are the conditions under which they work and the compensation they receive for their skills, effort, and dedication,” Johnson said. “More nurses on the floor and more flexible schedules are the keys to enhanced nurse job satisfaction, along with fair compensation.”

Yet some rural nursing homes, which are set to be the most impacted by the mandate, are finding ways to stay afloat and continue serving their residents amidst these challenges.

For example, Burwell Community Memorial Health Center in Nebraska, which had been burdened with debt and labor challenges, turned around its operations by focusing on strong management, local services, and a renewed focus on staff well-being and benefits.“I think it goes back to the idea of that not-for-profit model,” Administrator Tim Groshans told Nebraska Public Media. “We kept our vision on three things: salaries, benefits and physical plant. And so if we’re top-notch in all three of those areas, from a not-for-profit definition, I think we’re doing the right thing.”

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