Nurse turnover is straining hospitals nationwide, not because nurses are abandoning the profession itself, but because operational friction and system inefficiencies are driving them away. Healthcare leaders may be overlooking these fixable drivers of burnout, which steal time from patient care.
According to NSI Nursing Solutions’ 2025 Retention & RN Staffing Report, staff RN turnover remains at 16.4%, while the average cost to replace a bedside RN has climbed to $61,110. Press Ganey’s Nurse Experience 2025 report also found that 17% of nurses left their roles last year, including 24% of Gen Z RNs in 2024.
Susan Grant, DNP, RN, NEA-BC, FAAN, chief clinical officer at symplr, believes many nurses are not leaving healthcare itself. They are leaving systems that make nursing increasingly difficult to sustain.
Nurse burnout is increasingly tied to workflow friction, administrative overload, and unstable scheduling rather than bedside care itself, according to Susan Grant, DNP, RN, NEA-BC, FAAN, chief clinical officer at symplr. To address this, Grant says healthcare systems can improve retention by reducing duplicate documentation, stabilizing staffing processes, involving nurses in technology decisions, and protecting time for patient care.
“Nurses do hard things every day,” Grant said. “What wears people down is the unnecessarily hard things, and that is the friction that leadership can actually remove.”
Expanding on the source of burnout, Grant said nurses are increasingly exhausted not by patient care, but by fragmented workflows and operational inefficiencies that accumulate throughout a shift.
“When you’re losing close to 90 minutes a day to non-care work, it can be demoralizing (and exhausting),” she said. “Nurses want to leave a shift feeling like they had the time to actually attend to the person in the bed, not just complete the tasks around them.”
Workflow Friction Is Eroding Nursing Sustainability
This normalization of operational burdens, Grant continued, is particularly evident inside healthcare systems, especially among experienced nurses who have adapted to inefficient processes over time.
“At the bedside, reducing friction is very specific,” she said. “It’s the number of times a nurse has to stop mid-thought, leave the patient, track down information, log into another system, or enter the same thing twice because the tools don’t connect.”
When healthcare organizations tackle highly visible workflow challenges like staffing requests, scheduling communication, and disconnected systems, Grant said nurses can quickly feel the impact of meaningful operational improvements.
“It should translate into more time to be present with patients, because nursing is all about human connection,” Grant said.
Burnout Cannot Be Solved With Resilience Alone
Despite these growing issues, Grant said healthcare organizations still miss the mark when burnout is treated as an individual problem instead of a systems issue.
“We have to get out of the mindset that adding ‘more’ automatically makes things better,” she said.
Grant said nurses experience an exhausting accumulation of alerts, documentation requirements, and digital tools that ultimately increase cognitive burden.
“Nurses don’t experience those things one at a time,” Grant said. “They experience the pileup, and the pileup is what becomes exhausting.”
According to Grant, many nurses are frustrated that healthcare environments are increasingly making it harder to provide the patient-centered care they were trained to deliver.
“Nurses are telling me that they’re walking away because the environment keeps making it harder to practice the way they were taught and the way they believe patients deserve,” she said.
AI’s Biggest Opportunity May Be Giving Nurses Time Back
As healthcare systems rapidly adopt artificial intelligence tools, Grant believes the most valuable applications will be those that quietly reduce operational burden rather than add complexity.
“The biggest opportunities are in taking work off nurses’ plates that does not require a nurse’s judgment,” she said.
That includes streamlining scheduling, reducing duplicate data entry, improving interoperability between systems, and automating routine communication tasks.
Grant also highlighted the potential for AI-supported documentation tools to better capture the full scope of nursing care without interrupting patient interactions.
In one example, she described ambient listening technology documenting a moment when a nurse paused to pray with a patient before an unexpected return trip to the operating room.
“AI did not create the compassion,” Grant said. “It simply got out of the way so the nurse could be fully present, and it helped ensure the full scope of nursing care was recognized.”
Nurses Want Guardrails and a Voice in AI Decisions
While AI adoption continues to accelerate, Grant said healthcare organizations risk losing clinician trust if nurses are excluded from implementation decisions.
“First, nurses have to be involved from the beginning, not invited in after decisions are already made,” she said.
Grant said many nurses remain skeptical because they have experienced technology rollouts with limited training, poor communication, and alert fatigue.
“If we want nurses to trust AI, we have to lead with responsibility,” Grant said. “Nurses shouldn’t have to guess who owns a tool, what it’s being used for, or what happens when they get something wrong. Spell it out up front.”
She also emphasized the importance of rapid feedback loops when frontline nurses identify problems with new systems.
“The fastest way to build confidence is to show that concerns are heard and adjustments happen,” she said.
Scheduling Stability May Be One of Healthcare’s Fastest Retention Fixes
Reflecting on potential solutions, Grant said scheduling and staffing stability remain among the most immediate operational opportunities to improve nurse retention.
“When the schedule comes out late, when someone gets floated with little notice, when the plan changes mid-shift and the unit is constantly trying to plug holes, nurses spend their energy just trying to hold it together instead of focusing on the patient in front of them,” she said.
Grant noted that instability affects nurses long after a shift ends.
“If you can’t count on what next week looks like, it’s hard to recover, it’s hard to plan your life, and eventually it’s hard to say yes again,” she said.
Rather than relying solely on turnover data, Grant said healthcare leaders should monitor earlier signs of workforce strain, including schedule stability, short staffing frequency, floating practices, and how often nurses are contacted on days off.
“Turnover is a rearview mirror metric,” Grant said. “It tells you who you lost, after you’ve already lost them.”
Leadership Visibility Still Matters
Grant said rebuilding trust starts with visible leadership presence and follow-through.
“I would urge nurse leaders to be present and listen,” she said. “Listening is not a soft skill. It is a safety practice, and it is also how you rebuild trust with your teams.”
She encouraged leaders to identify one operational barrier stealing time from patient care, fix it, and communicate those improvements directly back to staff.
“Nurses do not need perfection,” Grant said. “They need consistent leadership that acts, listens, and delivers real change that gives time back for patient care.”
