Researchers at the University of Pennsylvania School of Nursing analyzed survey data from more than 4,000 registered nurses who:
- Left a bedside hospital position between 2019 and 2023, and
- Were not currently working in healthcare at the time of the survey.
The nurses in the study fell into three groups:
- 56% were retired
- 36% were unemployed
- 8% were employed outside of healthcare
Despite stepping away from the bedside, many of these nurses have not completely closed the door on returning to nursing – especially under better conditions.
Unemployed Nurses: Actively Looking to Return
Among nurses who were unemployed:
- 51% had searched for healthcare jobs in the past year
- These nurses also reported being likely to return to nursing, if the circumstances were right.
This group represents an important potential workforce that hospitals may be able to re-engage with the right incentives and support.
Nurses Working Outside Healthcare: Still Interested, But Less So
Nurses who transitioned out of healthcare were less likely to envision a return, but not by any means unreachable:
- 20% said they were very likely to return to nursing.
This suggests that although some nurses have shifted careers, a meaningful portion are still open to coming back especially if employers address the core issues that pushed them away.
The Number One Factor: Adequate Nurse Staffing Levels
When nonretired registered nurses were asked what would make them more likely to return to bedside nursing, one factor clearly rose to the top:
- 65% cited “adequate staffing” as the primary reason that would attract them back.
Following staffing, nurses identified two other top priorities, tied in importance:
- Flexible scheduling options – 59%
- Better wages or benefits – 59%
In other words, nurse staffing levels, work–life balance, and fair compensation are central to rebuilding the bedside workforce. These are also the same factors that directly affect nurse burnout, turnover, and patient outcomes.
Karen Lasater, PhD, RN, the lead author of the study and the Jessie M. Scott Term Chair in Nursing and Health Policy at Penn Nursing, summarized it bluntly:
“Unsafe staffing drives nurses away from hospital employment and adequate staffing is the key to bringing them back… High nurse turnover is a solvable crisis, because the reasons nurses leave are the same reasons they would return, if addressed.”
Retired Nurses: Many Left Earlier Than Planned
One striking finding from the study involved retired nurses:
- Nearly 40% said they retired earlier than they had planned, and
- Around 90% reported being satisfied with nursing as a career.
This discrepancy suggests that many nurses did not leave because they stopped loving the profession, but because working conditions became unsustainable.
Researchers concluded that these premature exits are largely driven by modifiable organizational factors, such as:
- Chronic understaffing
- High patient-to-nurse ratios
- Rigid scheduling
- Limited support and resources on the unit
Again, the implication is clear: improve the work environment, and many experienced nurses may consider coming back even after early retirement.
What This Means for Healthcare Employers
For hospitals and healthcare organizations, this study carries several key messages:
1. Nurse turnover is not inevitable.
Many former bedside nurses are willing to return, but only if core issues like staffing and scheduling are addressed.
2. Workplace conditions matter as much as compensation.
While pay and benefits are important, adequate staffing and flexibility strongly influence whether nurses stay or leave.
3. A sustainable workforce strategy must be multi-dimensional.
Relying solely on short-term fixes such as travel nurses or overtime may worsen burnout and fail to stabilize staffing.
4. Organizational changes can unlock a valuable, existing workforce.
By improving nurse-to-patient ratios and offering more flexible scheduling, hospitals may re-engage nurses who have left the bedside.
At the same time, healthcare leaders know that even if every willing former nurse returned, ongoing demand still exceeds domestic supply in many regions. That’s where international nurse recruitment becomes a critical part of long-term staffing strategy.
How International Nurse Recruitment Supports Safe Staffing
Many U.S. healthcare organizations are turning to internationally educated nurses to reinforce their teams and achieve stable, safe staffing levels. When done correctly, hiring foreign-trained RNs is not a quick patch but a strategic investment.
Here’s how global nurse recruitment can complement efforts to bring domestic nurses back:
1. Stabilizing Nurse-to-Patient Ratios
Adequate staffing is the top factor that could bring former nurses back to the bedside. International hiring can help:
- Fill chronic nurse vacancies in high-need units
- Reduce reliance on overtime and mandatory extra shifts
- Support more manageable patient loads for every RN
When staffing levels improve, job satisfaction rises, burnout drops, and both domestic and international nurses benefit.
2. Reducing Overreliance on Travel Nurses
While travel nurses are sometimes necessary, they are:
- Significantly more expensive in the long term, and
- Not a sustainable foundation for core staffing.
By sponsoring permanent, full-time international nurses, hospitals can:
- Lower overall labor costs
- Reduce turnover related to constant staffing instability
- Offer patients more continuity of care
3. Supporting Flexibility and Work–Life Balance
When units are chronically understaffed, flexibility becomes difficult to offer. With a larger, more stable workforce supported by international recruitment hospitals are better positioned to:
- Offer flexible or self-scheduling
- Implement predictable shifts
- Avoid last-minute call-ins and burnout-inducing overtime
This directly aligns with what this study shows nurses are asking for.
Immigration Options for Hiring International Nurses
Bringing foreign-trained nurses to the United States requires meticulous planning and full immigration compliance. That’s where an experienced immigration law firm for nurses becomes essential.
At VisaMadeEZ, we specialize in helping healthcare organizations understand and navigate the visa and green card options available for international RNs, such as:
Employment-Based Immigrant Visas (Green Cards)
Many registered nurses qualify for employment-based immigrant visas, allowing them to become permanent residents and long-term members of your workforce. With proper planning, this route can help you:
- Build a stable, committed nursing team
- Minimize constant turnover, especially in hard-to-fill specialties
- Plan staffing with a multi-year horizon
Nonimmigrant Options (Where Available)
In some scenarios, certain temporary visa options may be appropriate for specialized roles or advanced practice nurses. However, for bedside RNs, immigrant visas are often the most practical and stable solution.
Because immigration policies can change and requirements are strict, it’s critical to partner with an immigration attorney who understands both healthcare staffing needs and the regulatory landscape.
Why Work With VisaMadeEZ?
VisaMadeEZ is an immigration law firm focused on healthcare organizations that want to hire international nurses ethically, efficiently, and in full compliance with U.S. law. We help:
- Hospitals and health systems
- Long-term care and rehabilitation facilities
- Other healthcare employers facing chronic staffing shortages
Our services include:
- Strategic planning for international nurse recruitment programs
- Guidance on PERM labor certification and immigrant petitions
- Coordination with credentialing, licensing, and NCLEX requirements
- Ongoing support as immigration regulations evolve
We understand that the goal is not just “filling positions,” but creating a safe, sustainable nurse staffing model that supports both patient care and nurse well-being.
Integrating Domestic and International Solutions
The new research from the University of Pennsylvania makes one thing very clear: the nursing workforce crisis is not purely a “supply” problem. It is also an environment and staffing problem.
A forward-looking strategy will:
1. Improve working conditions including staffing ratios, scheduling flexibility, and compensation.
2. Re-engage domestic nurses who left the bedside but are open to returning.
3. Leverage international nurse recruitment to reinforce staffing and prevent the cycle of burnout from repeating.
By combining reforms in nurse staffing practices with a carefully structured international hiring program, healthcare organizations can move from constant crisis management to long-term workforce stability.
Ready to Explore International Nurse Recruitment?
If your organization is struggling with nurse shortages and considering international recruitment, VisaMadeEZ can help you:
- Understand your immigration options for hiring foreign-trained nurses
- Design a compliant, sustainable international nurse staffing program
- Align immigration strategy with your broader HR and workforce goals
To learn more about how international nurses can support your staffing needs and how to get started with the U.S. immigration process contact VisaMadeEZ today.
We’ll help you turn today’s staffing challenges into a long-term, strategic solution for your patients, your nurses, and your organization’s future.
