Drivers of hospital nurse practitioner turnover: A national sample survey analysis

Hospital nurse practitioner (NP) turnover is costly and complex.

Provide a pre-COVID-19 pandemic baseline of hospital NP turnover.

A secondary analysis of NSSRN18 data on 6,558 (67,863 weighted) NPs employed in hospitals on 12/31/2017. We describe rates of turnover, intention to leave, and reasons for leaving or staying. Using multivariate logistic regression, we examine the association between individual and organizational characteristics and turnover. Survey weights and jackknife standard errors were applied to analyses.

Approximately 10% of NPs left their job the following year, and 53% of NPs that remained considered leaving at some point. The top reasons cited for leaving or staying were largely organizational factors. Regression analysis revealed not practicing to one's fullest scope, lower income, lack team-based care, and non-white race were associated with an increased likelihood to leave.

We find several modifiable factors associated with hospital NP turnover that can be used to tailor recruitment and retention strategies.