NSG 423 Unit 7 emerging trend impact statement example

Nurses Leaving Bedside Practice After the Pandemic: Scale, Drivers Inside and Outside the Profession's Control, and What It Means for a New Graduate

Student Name

Department of Nursing, Herzing University

NSG 423: Policy, Trends, & Ethics in Nursing

Instructor Name

March 5, 2026

Nurses Leaving Bedside Practice After the Pandemic: Scale, Drivers Inside and Outside the Profession's Control, and What It Means for a New Graduate

The Trend

Since 2020, registered nurses in the United States have left direct patient care, and in some cases the profession, at rates that alarmed employers and policymakers, and many who remain report intending to leave. The trend has been running for about six years, beginning with the first pandemic surges. It concerns this writer directly: the class of 2026 will enter a workforce shaped by it.

Its Scale, With Sources and Years

Three figures describe the scale, each from a named source and year. First, analysis of national labor survey data found that the total number of registered nurses declined by more than 100,000 during 2021, a drop concentrated among younger nurses, described by its authors as the largest single-year decline in four decades (Auerbach et al., 2022). Second, the 2022 national nursing workforce survey run by the organization of state nursing boards, reported in 2023, estimated that roughly 100,000 registered nurses had stopped working in nursing over the pandemic years, and that roughly one nurse in five reported an intent to leave within five years, citing stress, burnout, and workload (Martin et al., 2023). The same survey program provides detailed data on the workforce's age, employment settings, and hours (Smiley et al., 2023). Third, a later projection, published in 2024, found that the workforce had grown again after the 2021 decline and projected continued growth, while cautioning that projections depend on whether nurses stay (Auerbach et al., 2024).

Read together, the figures say that the sharp loss of 2021 has been at least partly recovered in total numbers, but that intentions to leave remained high in 2022. A figure from 2022 describes 2022; it should not be read as the situation in 2026 without newer data.

Drivers the Profession Controls, at Least in Part

Work environment within nursing's own sphere: nurse leaders shape scheduling, break practices, recognition, and whether nurses have a voice in decisions, all elements of healthy work environment standards. Transition to practice: the design and length of residency programs for new graduates are largely within nursing's control, and structured programs have been associated with better retention in the first year. Professional culture: how experienced nurses treat new ones, including incivility, is a nursing matter. Workplace violence prevention: nurse leaders and associations can push for reporting, training, and protective policies. Self-regulation: boards of nursing, which are part of the profession's regulatory structure, decide how licensure applications ask about mental health, which affects whether nurses seek care for burnout.

Drivers Largely Outside the Profession's Control

Hospital finances and staffing budgets, set by executives and boards and constrained by payers; the demand for care, which is growing with an aging population; wages and the labor market, including competition from travel agencies and from jobs outside health care; state and federal policy on staffing, which nurses can influence but not decide; and the number of faculty and clinical placements for nursing education, which depends on funding and on hospitals as well as schools. The profession can advocate on each of these, but it does not hold the decision.

How the Trend Looks on One Unit

National figures become concrete on a single unit. On the medical-surgical unit, a composite 32-bed floor, where this writer finished a final clinical rotation, the nurse manager shared, with identifying details removed, how the unit's registered nurse staff had changed since 2019. Of 34 nurses on staff in 2019, 13 remained in 2025. Six of those who left went to travel nursing, four moved to outpatient or procedural settings with regular hours, three retired early, and eight left for other hospitals or other reasons. The unit replaced most positions, but largely with new graduates: 17 of its current 33 nurses have been licensed less than three years. On many night shifts, the most experienced nurse on the unit has fewer than five years of practice. The manager described the unit as fully staffed on paper and thin in experience in practice, a distinction the national headcount does not capture. The unit's own experience matches the pattern the national data suggest, recovery in numbers with a loss of experience, which is the change most likely to affect a new graduate's first year. It also suggests which local measure to watch: not vacancies, but the share of shifts staffed by nurses with fewer than two years of experience.

Impact on Practice

For a new graduate entering a medical-surgical unit in 2026, the trend has concrete effects. Units may have fewer experienced nurses to precept and to consult at 3 a.m., which raises the stakes of the residency program the graduate enters. Assignments may be heavier where vacancies persist, and heavier nurse workloads have been associated in large studies with worse patient outcomes. Agency and travel nurses may be a larger share of the team, changing unit culture and continuity. And the new graduate may be asked to take on charge or precepting roles earlier than previous generations did.

What the Profession, and This Writer, Can Do

At the profession level, the drivers within nursing's control suggest where effort is best spent: residency programs that extend beyond orientation, nurse leaders who fix break relief and scheduling practices, zero tolerance for incivility, and boards of nursing that ask only about current impairment rather than any history of mental health treatment. At the individual level, a new graduate can choose employers by asking about residency length, preceptor consistency, first-year turnover on the unit, and whether nurses get breaks, and can later become the experienced nurse who stays and teaches.

Where the Evidence Is Thin

The figures rely on surveys and labor data, which describe intentions and counts rather than causes. Intent to leave does not always become leaving. And data describing 2026 conditions were not available for this statement. The next update should use the most recent national workforce survey and local data from the employer the writer joins, since national trends vary widely by region and setting.

References

Auerbach, D. I., Buerhaus, P. I., Donelan, K., & Staiger, D. O. (2022, April 13). A worrisome drop in the number of young nurses. Health Affairs Forefront. https://doi.org/10.1377/forefront.20220412.311784

Auerbach, D. I., Buerhaus, P. I., Donelan, K., & Staiger, D. O. (2024). Projecting the future registered nurse workforce after the COVID-19 pandemic. JAMA Health Forum, 5(2), Article e235389. https://doi.org/10.1001/jamahealthforum.2023.5389

Martin, B., Kaminski-Ozturk, N., O'Hara, C., & Smiley, R. (2023). Examining the impact of the COVID-19 pandemic on burnout and stress among U.S. nurses. Journal of Nursing Regulation, 14(1), 4-12. https://doi.org/10.1016/S2155-8256(23)00063-7

Smiley, R. A., Allgeyer, R. L., Shobo, Y., Lyons, K. C., Letourneau, R., Zhong, E., Kaminski-Ozturk, N., & Alexander, M. (2023). The 2022 National Nursing Workforce Survey. Journal of Nursing Regulation, 14(1), S1-S90. https://doi.org/10.1016/S2155-8256(23)00047-9