Healthcare organizations are seeing signs of improvement in employee engagement, but new workforce data shows that hospitals and health systems still face serious retention challenges. For healthcare leaders already struggling with nursing shortages, provider burnout, and rising labor costs, the message is clear: engagement matters but it cannot solve the staffing crisis alone.
According to a recent Press Ganey report analyzing feedback from more than 2.6 million healthcare employees and physicians surveyed in 2025, hospitals in the top quartile for employee engagement are 4.2 times more likely to achieve top patient experience scores. In other words, engaged healthcare workers are not only more likely to stay they also play a direct role in improving patient satisfaction, care quality, and organizational performance.
For hospitals, skilled nursing facilities, long-term care organizations, and health systems, this data reinforces a critical reality: building a reliable healthcare workforce requires both retention strategies and long-term recruitment solutions, including the hiring of qualified international nurses.
Healthcare Employee Engagement Is Improving But the Recovery Is Fragile
The Press Ganey report found that overall healthcare employee engagement increased from 3.97 to 4.01 over the past year, marking the largest gain in eight years. Physician engagement also improved, rising from 3.96 to 4.01.
These gains are encouraging, especially after years of pandemic-related stress, workforce shortages, and rising burnout across the healthcare industry. However, the report also warns that the recovery remains fragile.
A major concern is confidence in leadership. According to the report:
- 35% of healthcare employees lack confidence in senior leadership
- 37% of providers lack confidence in senior leadership
For healthcare employers, this points to a deeper workforce issue. Employees want more than competitive pay. They want transparent communication, meaningful support, career development, role clarity, and confidence that leadership understands the pressures of frontline care.
When those needs are not met, hospitals and care facilities may face higher turnover, lower morale, increased staffing costs, and declining patient experience scores.
Disengagement Is Expensive for Healthcare Organizations
Employee disengagement has a measurable financial impact. The report found that disengaged caregivers are 2.6 times more likely to leave their organization.
For an average health system with approximately 3,000 employees, turnover can cost more than $16 million annually. That figure includes expenses related to recruiting, onboarding, temporary staffing, overtime, training, productivity loss, and disruption to patient care.
The difference between low-engagement and high-engagement organizations is significant:
- Low-engagement healthcare organizations experience turnover rates around 24%
- High-engagement healthcare organizations experience turnover rates closer to 15%
For healthcare executives and HR leaders, these numbers highlight a costly gap. Even a modest reduction in turnover can save millions of dollars each year. But with continued shortages of registered nurses, licensed practical nurses, advanced practice providers, and other clinical professionals, retention alone may not be enough.
This is where strategic healthcare immigration planning becomes an important part of workforce stability.
Early Warning Signs: Nonresponse May Predict Turnover
One of the most important findings in the report is that many healthcare organizations may be overlooking early signs of attrition.
Among employees who plan to leave within three years, 34% leave within just one year. Even more telling, 26% of survey nonrespondents leave within a year, compared with 15% of employees who respond to engagement surveys.
This suggests that silence itself may be a warning sign.
When healthcare employees stop participating in surveys, skip feedback opportunities, or disengage from internal communications, it may indicate that they are already emotionally disconnected from the organization. For hospitals and healthcare facilities, tracking survey nonresponse can be just as important as analyzing survey scores.
Organizations that want to reduce nurse turnover and improve healthcare staff retention should consider monitoring:
- Employee engagement survey response rates
- Department-level turnover trends
- Exit interview themes
- Absenteeism and overtime patterns
- Internal transfer requests
- First-year resignation rates
- Burnout indicators among nurses and providers
These insights can help healthcare leaders respond earlier before workforce gaps become urgent staffing emergencies.
Turnover Pressure Is Highest at Both Ends of the Workforce
The Press Ganey report also shows that turnover pressure is not limited to one generation.
Generation Z healthcare employees have the highest turnover rate at 35%. Many younger workers are entering the healthcare field with different expectations around flexibility, work-life balance, mental health support, career growth, and organizational culture.
At the same time, baby boomer turnover is also rising, increasing from 19% to 21%. As older nurses and healthcare professionals retire or reduce their hours, hospitals face the loss of experienced clinical talent, institutional knowledge, and mentorship capacity.
This creates a dual challenge:
1. Younger healthcare workers may be more likely to leave early in their careers.
2. Experienced healthcare workers are increasingly exiting the workforce.
For healthcare organizations, this means the domestic labor pipeline may not be sufficient to meet long-term staffing needs. Many employers are now looking at international nurse recruitment and healthcare immigration as part of a broader workforce strategy.
Advanced Practice Providers Remain a Concern
The report also identified advanced practice providers as one of the least engaged workforce groups. Press Ganey cited concerns around role clarity and involvement in decision-making.
This is especially important because nurse practitioners, physician assistants, certified registered nurse anesthetists, and other advanced practice providers often play a central role in expanding patient access and supporting physicians.
When these professionals feel excluded from decisions or unclear about their responsibilities, engagement can decline quickly. Healthcare organizations should ensure that advanced practice providers have:
- Clear role expectations
- Strong onboarding and integration
- A voice in clinical operations
- Leadership development opportunities
- Support from physicians and administrators
- Pathways for professional growth
Improving engagement among advanced practice providers can strengthen care delivery, reduce turnover, and improve patient outcomes.
Why Healthcare Staffing Needs a Long-Term Solution
The latest engagement data confirms what many healthcare employers already know: improving workplace culture is essential, but staffing shortages remain a structural challenge.
Hospitals and care facilities cannot rely only on short-term fixes such as overtime, travel nurses, or temporary staffing agencies. These options may fill immediate gaps, but they often come with high costs and limited continuity.
A more sustainable healthcare staffing strategy may include:
- Improving employee engagement and leadership trust
- Strengthening nurse retention programs
- Investing in career development and mentorship
- Reducing burnout and administrative burden
- Expanding domestic recruitment efforts
- Hiring qualified international nurses through employment-based immigration
International nurse hiring can help healthcare organizations build a stable, committed workforce while reducing dependence on temporary staffing. Many internationally educated nurses bring years of clinical experience, strong patient care skills, and a long-term interest in U.S. employment opportunities.
How International Nurse Recruitment Supports Healthcare Workforce Stability
For many healthcare organizations, hiring international nurses is no longer just an emergency response it is a strategic workforce planning tool.
Through the proper immigration process, U.S. healthcare employers may be able to sponsor qualified foreign nurses for permanent employment. This can help hospitals, nursing homes, rehabilitation centers, home health agencies, and long-term care facilities address ongoing nurse shortages while building a more predictable staffing pipeline.
Benefits of international nurse recruitment may include:
- Reduced long-term staffing vacancies
- Lower reliance on costly temporary labor
- Improved workforce continuity
- Greater staffing stability across high-need units
- Access to experienced registered nurses
- Support for rural and underserved healthcare facilities
- Stronger long-term workforce planning
However, the immigration process for healthcare workers can be complex. Employers must navigate credentialing, licensing, visa requirements, labor certification considerations, consular processing, documentation, timelines, and compliance obligations.
That is why working with an immigration law firm experienced in healthcare staffing is essential.
Healthcare Employers Need Both Engagement and Immigration Strategy
The Press Ganey report makes one thing clear: engaged employees improve patient experience, reduce turnover, and strengthen organizational performance. But even highly engaged healthcare organizations may still struggle to fill nursing vacancies due to national workforce shortages.
The strongest healthcare workforce strategies combine internal retention with external recruitment.
For example, a hospital may improve engagement by investing in leadership training, nurse recognition programs, shared governance, and better scheduling practices. At the same time, the organization can develop an international nurse hiring program to fill critical long-term staffing gaps.
This balanced approach helps healthcare employers move from reactive staffing to proactive workforce planning.
Instead of constantly filling vacancies after employees leave, organizations can build a steady pipeline of qualified nurses who are ready to support patient care for years to come.
Immigration Planning Is a Competitive Advantage for Healthcare Organizations
Healthcare organizations that begin the immigration process early are often better positioned to manage staffing shortages. Because international nurse immigration can take time, employers benefit from planning ahead rather than waiting until vacancies become severe.
A proactive immigration strategy can help healthcare employers:
- Identify which roles are eligible for sponsorship
- Understand visa options for nurses and healthcare workers
- Prepare documentation correctly
- Avoid unnecessary processing delays
- Coordinate hiring timelines with licensing requirements
- Maintain compliance with immigration regulations
- Build a repeatable process for future international hiring
In a competitive healthcare labor market, organizations that understand how to recruit and sponsor international nurses may gain a meaningful advantage.
The Bottom Line
Rising employee engagement is a positive sign for the healthcare industry, but turnover risks remain significant. Disengaged caregivers are more likely to leave, younger workers are turning over at high rates, experienced professionals are retiring, and many organizations continue to face persistent nursing shortages.
Healthcare leaders must focus on both retention and recruitment. Improving employee engagement can reduce turnover and improve patient experience, but long-term workforce stability may also require a strong international nurse hiring strategy.
For hospitals and healthcare organizations looking to reduce staffing gaps, control labor costs, and improve continuity of care, international healthcare recruitment may be a critical part of the solution.
Ready to Build a Stronger Healthcare Workforce?
At VisaMadeEZ, we help healthcare organizations navigate the immigration process for hiring qualified international nurses and healthcare professionals. Our team understands the unique staffing pressures facing hospitals, long-term care facilities, rehabilitation centers, home health agencies, and other healthcare employers.
Whether your organization is exploring international nurse sponsorship for the first time or looking to improve an existing immigration hiring program, VisaMadeEZ can help you move forward with confidence.
- Sponsor qualified international nurses
- Understand healthcare immigration requirements
- Reduce delays in the visa process
- Build a reliable nurse recruitment pipeline
- Support long-term healthcare workforce planning
- Stay compliant throughout the immigration process
Your patients need dependable care. Your workforce strategy should be just as dependable.
Contact VisaMadeEZ today to learn how international nurse hiring can help your healthcare organization reduce staffing shortages and build a more stable clinical team.
