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Healthcare Staffing
October 22, 2025
Bucking the Trend: Health System Makes Dramatic Gains in Nurse Retention

Bucking the Trend: Health System Makes Dramatic Gains in Nurse Retention

Sometimes a turn-around in a long-term trend is indeed possible. As improbable as it is, perennial also-rans, the Indiana Hoosiers, are currently listed at #2 in the college football rankings—their highest ranking in history. Want another example? Long relegated to the bottom of the barrel in education and ranked dead last among the 50 states in literacy rates, Mississippi has suddenly surged to number six! Calling it the “Mississippi miracle,” educators from all over the country are digging into the details of what caused this remarkable reversal in learning proficiency.

Bucking the Trend: Health System Makes Dramatic Gains in Nurse Retention

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Well, it turns out that a troublesome trend has recently been halted and reversed in the arena of healthcare staffing. Let’s take a look.

Dawn of a New Day

NYC Health + Hospitals, which is the nation’s largest municipal healthcare delivery system, consisting of 45,000 healthcare professional across the five boroughs of New York City, has recently announced major strides in the rate of nurse retention. The system announced in late August that its significant commitment to professional development and staff engagement has produced robust results for its nurse retention and recruitment initiatives, substantially strengthening its 9,600-strong nursing workforce.

According to a press release, the team’s efforts have resulted in a turnover rate of just 7.3% in 2025 to date, far below the national average of 16.4%, saving the health system more than $88 million in nurse turnover costs. As recently as 2019, the public hospital system’s staff nurse turnover rate was 46%. Furthermore, the health system hired 3,417 nurses in 2024 alone, replacing many temporary nurses who had held those positions, saving more than $150 million in recruitment costs. Now, that’s what we call a real turn-around! But how did they do it?

Successful Strategies

According to the health system’s August press release, key strategies that led to the dramatic turn-around—created and implemented by NYC Health + Hospitals—include the following program initiatives:

  • Nurse Residency Program. Launched in 2019 as a part of a consortium of New York City’s public and private hospitals, the Nurse Residency Program has enrolled more than 2,600 nurse residents to date, representing more than 35% of the citywide total. This 12-month program provides newly-hired nurses with specialized training, education, and mentoring services and is a nationally-recognized, evidence-based best practice for improving nurse satisfaction, performance and retention.
  • Professional Shared Governance. The health system implemented what it calls the Professional Shared Governance evidence-based practice model and currently has established 181 Councils. The nurse-led initiative aims to enhance nurse engagement by ensuring that frontline care providers are active participants in the system’s decision-making processes.
  • Nursing Clinical Ladder Program. Developed in partnership with the New York State Nurses Association (NYSNA), the Nursing Clinical Ladder Program is designed to promote outstanding staff nurses and support their professional growth. The program aims to foster and acknowledge nurses’ expertise and elevate their contributions to the profession, providing a unique opportunity for staff nurses, accountable care managers, head nurses, and assistant head nurses to engage in comprehensive career and professional development. The program continues to grow every year. Since 2020, applications have more than doubled, rising 228% from 1,701 applications five years ago to 3,875 applications in 2025 to date.
  • Fellowships. NYC Health + Hospitals has established several important nursing fellowship programs to promote professional development among nurses and provide career pathways for ancillary staff to become nurses.

Here’s what the health system’s CEO, Mitchell Katz, MD, had to say about their progress:

Nurses are the heart of every hospital, and over the past few years we have been investing in initiatives to show our nursing workforce how important they are to us. Today’s record-low nurse turnover rate shows that we are making NYC Health + Hospitals an exciting place for nurses to work and build their careers. I want to thank our Chief Nursing Executive Natalia Cineas, Chief Nursing Officers, and their teams for their incredible work building an array of fellowships and professional development programs that help us attract high quality nurses who provide exceptional patient care.

So, courses can be corrected and ill winds can be reversed. With the national healthcare staffing crisis causing great concern and consternation for so many facilities, it’s good to see an example of an entity that’s actually bucking the trend—and doing it in a big way. It might behoove hospitals throughout the country to take note of what NYC Health + Hospitals is doing and determine if there are strategies there that might work in their own facilities.

Positive change can happen. Just look at Indiana. Go Hoosiers!