Nurse turnover continues to challenge hospitals, long-term care facilities, rehabilitation centers, home health agencies, and other healthcare organizations across the United States. As healthcare employers work to stabilize staffing levels, a recent study published in Health Affairs Scholar offers important insight into which registered nurses are most likely to leave their roles and why organizations may need to rethink their long-term nurse recruitment strategies.
For healthcare leaders, the message is clear: relying only on the domestic nursing workforce may not be enough. With burnout, job dissatisfaction, academic advancement, and career mobility driving turnover, many healthcare organizations are turning to international nurse recruitment and foreign nurse visa sponsorship as a more sustainable way to build a reliable nursing workforce.
At VisaMadeEZ, we help healthcare organizations navigate the immigration process for hiring qualified international nurses, including EB-3 visas for nurses, green card sponsorship for registered nurses, and other employment-based immigration solutions.
Nurse Turnover Remains a Major Workforce Challenge
The study analyzed data from the latest National Sample Survey of Registered Nurses, focusing on 8,953 front-line registered nurses. Researchers examined both actual nurse turnover and self-reported intentions to leave.
One of the most significant findings was the national nurse turnover rate: 28.7%.
That means more than one in four front-line registered nurses left their roles during the period studied. For healthcare employers already struggling with nurse shortages, this level of turnover can create serious operational and financial pressure.
High nurse turnover can lead to:
- Increased overtime expenses
- Heavier reliance on staffing agencies and travel nurses
- Lower staff morale
- Disrupted continuity of patient care
- Higher recruitment and onboarding costs
- Greater risk of burnout among remaining nurses
- Reduced patient satisfaction and quality outcomes
For hospitals and healthcare facilities, the cost of losing experienced nurses is not only financial it directly affects patient care and workforce stability.
Job Dissatisfaction Is a Key Driver of Nurse Turnover
According to the study, nurses who reported being dissatisfied with their jobs were more than 2.5 times more likely to leave their roles.
This finding reinforces what many healthcare administrators already know: retention depends on more than compensation alone. Workplace culture, scheduling flexibility, leadership support, staffing ratios, career development, and burnout prevention all play a role in whether nurses stay or leave.
However, even healthcare organizations that invest heavily in nurse retention may still face staffing gaps due to broader national workforce shortages. That is why many employers are expanding their recruitment strategy to include internationally educated nurses.
Hiring foreign-trained nurses can help healthcare organizations create a more stable workforce pipeline, especially when domestic recruitment alone is not meeting demand.
Graduate-Educated Nurses Are More Likely to Leave Bedside Roles
Another notable finding from the study involved nurses with advanced degrees. Nurses holding an MSN, DNP, or PhD had 55% higher odds of turnover compared with nurses whose highest degree was a BSN.
Among nurses who left their roles, 8.7% held graduate degrees.
This trend may reflect the fact that graduate-educated nurses often have more career mobility. Nurses with advanced degrees may transition into leadership, education, advanced practice, consulting, research, or non-bedside roles. While these career paths are valuable to the healthcare system, they can intensify shortages in front-line nursing positions.
For employers trying to maintain bedside staffing, this presents a difficult reality: some of the most highly educated nurses may also be among the most likely to move out of front-line roles.
This is one reason healthcare organizations increasingly consider international nurse hiring as part of a long-term staffing model. Many qualified foreign-educated nurses are eager to work in U.S. healthcare settings and may provide employers with a more stable recruitment pipeline when supported through the right immigration process.
Nurses Enrolled in Degree Programs Are More Likely to Turn Over
The study also found that nurses enrolled in a degree program were 84% more likely to leave their roles.
Researchers suggested that this may be due to several factors, including the difficulty of balancing rigid work schedules with academic demands and the increased career mobility that comes with earning a higher degree.
For employers, this finding is important. Supporting nurse education is valuable and often necessary, but organizations should also prepare for the possibility that nurses pursuing additional credentials may eventually transition to different roles, departments, or employers.
A balanced healthcare workforce strategy should account for this reality. Retention programs are essential, but so is building a consistent recruitment pipeline. For many facilities, that pipeline includes foreign registered nurses, international nursing graduates, and employment-based nurse immigration.
Labor Union Participation Was Linked to Lower Turnover
The study found that nurses involved in a labor union or collective bargaining arrangement were less likely to leave their jobs.
This may reflect the influence of negotiated wages, benefits, working conditions, and job protections. While union participation varies by state and healthcare setting, the broader takeaway is that nurses are more likely to stay when they feel supported, protected, and heard.
Employers that want to reduce nurse turnover should consider both retention-focused workplace improvements and proactive recruitment planning. Even strong retention programs may not fully offset the national nursing shortage, especially in high-demand specialties or underserved areas.
Top Predictors of Nurse Turnover
The study identified several major predictors of nurse turnover, including:
- Job dissatisfaction
- Holding a secondary position
- Enrollment in a degree program
- Holding a graduate degree
- Burnout
These factors reveal a complex staffing environment. Nurses are not leaving for one reason alone. Turnover is often tied to professional advancement, economic pressure, burnout, scheduling challenges, and changing career goals.
For healthcare organizations, the solution must also be multifaceted. Competitive pay, better scheduling, improved staffing ratios, leadership support, and career development are all important. But employers should also look beyond local labor markets.
A strong workforce plan may include international nurse visa sponsorship, EB-3 green cards for nurses, and partnerships with immigration professionals who understand the healthcare industry.
Why International Nurse Recruitment Matters More Than Ever
The U.S. healthcare system continues to face a significant nursing shortage. As domestic nurse turnover remains high, international nurse recruitment offers healthcare employers an opportunity to build a more dependable workforce.
International nurses can help fill critical staffing gaps in:
- Hospitals
- Skilled nursing facilities
- Long-term care facilities
- Rehabilitation centers
- Home health agencies
- Community health organizations
- Rural and underserved healthcare facilities
For many employers, hiring international nurses is not simply a short-term solution. It is a long-term investment in workforce stability.
Through employment-based immigration, qualified foreign nurses may be eligible to work permanently in the United States. The EB-3 visa for registered nurses is one of the most common pathways for healthcare employers seeking to sponsor international nurses for permanent positions.
How VisaMadeEZ Helps Healthcare Employers Hire International Nurses
Hiring foreign-trained nurses requires more than identifying qualified candidates. Employers must comply with U.S. immigration requirements, licensing standards, credentialing rules, and visa procedures.
That is where VisaMadeEZ can help.
As an immigration law firm focused on healthcare workforce solutions, VisaMadeEZ helps healthcare organizations sponsor international nurses through a streamlined, compliant immigration process.
Our services may include assistance with:
- EB-3 visa sponsorship for registered nurses
- Green card petitions for foreign nurses
- Healthcare employer immigration strategy
- PERM-related guidance where applicable
- I-140 immigrant petitions
- Consular processing support
- Adjustment of status guidance
- Immigration compliance for healthcare employers
- Coordination with recruiters and HR teams
- Long-term nurse staffing immigration planning
We understand that healthcare organizations cannot afford unnecessary delays when patient care is on the line. Our goal is to make the immigration process clearer, faster, and easier for employers seeking to hire qualified international nursing talent.
International Nurse Sponsorship Can Strengthen Long-Term Retention
One of the advantages of international nurse hiring is that employment-based immigration often supports longer-term workforce planning. While every case is different, nurses sponsored through permanent immigration pathways may be seeking stable, long-term employment opportunities in the United States.
For healthcare organizations facing repeated turnover, this can be a valuable part of a broader staffing strategy.
International nurse sponsorship may help employers:
- Reduce dependency on temporary staffing agencies
- Lower long-term recruitment costs
- Improve continuity of care
- Fill hard-to-staff roles
- Support rural or underserved facilities
- Build a more diverse nursing workforce
- Create a predictable talent pipeline
Of course, international recruitment should not replace efforts to improve working conditions for existing nurses. The strongest healthcare organizations do both: they invest in retention while also building reliable domestic and international recruitment channels.
A Smarter Approach to Nurse Staffing
The findings from the Health Affairs Scholar study show that nurse turnover is influenced by multiple factors, including dissatisfaction, burnout, graduate education, and degree enrollment. These trends are unlikely to disappear overnight.
Healthcare employers that want to remain competitive must plan ahead.
A modern nurse staffing strategy should include:
- Strong retention initiatives
- Competitive compensation and benefits
- Flexible scheduling where possible
- Burnout prevention programs
- Leadership development
- Domestic nurse recruitment
- International nurse recruitment
- Immigration planning for long-term workforce needs
By incorporating international registered nurse sponsorship into their workforce strategy, healthcare organizations can reduce staffing uncertainty and better prepare for future demand.
Partner With VisaMadeEZ to Hire International Nurses
Nurse turnover is a serious challenge, but healthcare employers do not have to face it alone. With the right immigration strategy, your organization can access a global pool of qualified nursing professionals ready to contribute to patient care in the United States.
VisaMadeEZ helps healthcare organizations simplify the process of sponsoring international nurses, from immigration planning to petition preparation and case management.
Ready to Build a More Stable Nursing Workforce?
If your healthcare organization is struggling with nurse turnover, staffing shortages, or long-term recruitment challenges, VisaMadeEZ can help you explore immigration-based hiring solutions.
Schedule a consultation with VisaMadeEZ today to learn how your organization can sponsor qualified international nurses through EB-3 green card pathways and other employment-based immigration options.
Let us help you make international nurse hiring easier, faster, and more compliant so your team can focus on what matters most: delivering quality patient care.
