Survey - Nurses in 2024 A Brief Check-in

AMN Healthcare is the leader and innovator in total talent solutions for healthcare organizations across the United States. People are the heart of healthcare, and at the core of our mission is a commitment to ensure all may thrive. Through a steadfast partnership approach, we solve the most pressing workforce challenges to enable better clinical outcomes and access to care. We provide a comprehensive network of quality healthcare professionals and deliver a fully integrated and customizable suite of workforce technologies.

Nurses in 2024 A Brief Check-in

Nurses in 2024 – A Brief Check-in

About AMN Healthcare AMN Healthcare is the leader and innovator in total talent solutions for healthcare organizations across the United States. People are the heart of healthcare, and at the core of our mission is a commitment to ensure all may thrive. Through a steadfast partnership approach, we solve the most pressing workforce challenges to enable better clinical outcomes and access to care. We provide a comprehensive network of quality healthcare professionals and deliver a fully integrated and customizable suite of workforce technologies. Through our Center for Workforce Research, AMN Healthcare generates a wide range of surveys, reports, white papers, speaking presentations, podcasts, webinars and other thought leadership resources providing insight into current healthcare workforce trends and delivery models. This survey is one in a continuing series that examines the career plans, preferences and perspectives of various types of clinical healthcare professionals, including nurses, physicians and allied healthcare providers.

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Nurses in 2024 – A Brief Check-in

Introduction: Taking the Pulse Every other year, AMN Healthcare conducts a comprehensive national survey of registered nurses. In 2023, AMN Healthcare’s Survey of Registered Nurses polled over 800,000 nurses on a wide range of questions regarding their career plans, job satisfaction levels, well-being, and related topics. Data published in the survey was based on over 16,000 responses from nurses nationwide. These nurses painted a sobering picture of a profession under duress. In response to COVID-19 and myriad other challenges, only 40% of nurses surveyed said they would continue to work in their current status. Many others said they would pursue a variety of other paths, including seeking a new place of employment, working part-time, working as a travel nurse, returning to school, retiring, or leaving nursing for another field. Additional data from the survey pointed to diminished career satisfaction among nurses and concern about their personal health and well-being. AMN Healthcare’s Nurses in 2024 – A Brief Check-In provides an updated pulse reading on nurses as the new year progresses, offering insights into their outlook, work priorities, and career plans. More limited in scope than the biennial survey, it is based on five multiple choice questions and one open-ended question. The open-ended question garnered over 600 written comments from nurses regarding how they feel about the nursing profession in 2024. A representative sample of these comments are included in this report.

Methodology

The Nurses in 2024 survey was emailed to a proprietary list of over 10,000 nurses nationwide. Responses

were received from 1,155 nurses. Margin of Error (MOE) for the survey is 3% at a 95% confidence level.

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Nurses in 2024 – A Brief Check-in

The Outlook For 2024: Still Cloudy

Nurses were asked to look forward into 2024 and compare how they think the year will turn out compared to 2023.

Q1 In general, how would you rate the year 2024 for nurses compared to 2023?

13% 8%

2024 will be much better than 2023

12%

13%

2024 will be somewhat better than 2023

42%

2024 will be about the same as 2023

25%

2024 will be somewhat worse than 2023

42%

2024 will be much worse than 2023

12%

A plurality of those surveyed (42%) said they expect 2024 to be about the same for nurses as 2023. However, more nurses are pessimistic about 2024 than are optimistic. Thirty-eight percent of those surveyed indicated 2024 will be either somewhat or much worse for nurses than was 2023. By contrast, only 20% said that 2024 will be somewhat or much better for nurses than 2023. Overall, 80% of those surveyed project 2024 will be either the same for nurses as was 2023 or worse, while only 20% said it will be better. These findings suggest that the majority of nurses have not experienced or perceived significant improvements in the quality of their work environment. This is in spite of the fact that the factors leading to nurse burnout and job dissatisfaction were brought into sharp focus during the COVID-19 pandemic.

“As we move into 2024, I would like to remind people of the value of nurses: care, compassion, competence, communication and commitment.”

Many hospitals and other healthcare facilities have since initiated programs to enhance support for nurses and improve their job satisfaction levels. The survey indicates that these efforts may have resonated with a minority of nurses who project 2024 will be more favorable for them than was 2023, but have not resonated with the majority, who project either no changes this year for nurses or changes for the worse.

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Nurses in 2024 – A Brief Check-in

What Nurses Want in The Workplace in 2024

The survey suggests what could be done to improve the outlook of nurses by identifying what is most important to them in their own workplaces.

Q2 How important are each of the following at your workplace in 2024?

Extremely important

Moderately important

Somewhat important

Slightly important

Not at all important

Better pay rates for nurses at my workplace

75% 11%

More nurses per patient at my workplace

68% 12%

Better schedules/hours for nurses at my workplace

58% 17% 10%

More recognition for nurses at my workplace

47% 23% 16%

More wellness programs for nurses workplace

42% 23% 16%

11%

More diversity among nurses at my workplace

26% 20% 21%

24%

The survey indicates that there are several work-related factors that are extremely important to nurses, with better pay rates primary among them. Three quarters of nurses (75%) rated “better pay rates for nurses” as “extremely important” at their workplace, while 86% rated better pay as either “extremely important” or “somewhat important.” Only 10% rated better pay rates as “slightly important” or “not at all important.” Many healthcare facilities have recently reevaluated nurse compensation and adjusted pay rates. Nevertheless, the survey indicates that enhanced compensation remains a matter of key importance to nurses as they consider their work environment.

“Better pay is always a better option than coffee, mugs, gifts, etc.”

Nurses also consider staffing levels at their workplace to be extremely important, second only to increased pay. Sixty-eight percent of those surveyed rated “more nurses per patient” as “extremely important,” while 80% rated more nurses as either “extremely important” or “somewhat important.” Only 13% said more nurses was either “slightly important” or “not at all important.”

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Nurses in 2024 – A Brief Check-in

An ongoing concern for many nurses is the insufficient time they have available for direct patient care. In understaffed facilities, nurses can be physically taxed by the pace at which they must work, and morally injured if they believe they are unable to provide adequate care to patients. In fully staffed facilities, the physical demands of the job may be more evenly distributed and nurses may be more likely to enjoy the emotional rewards gained by maintaining high standards of care. The majority of nurses (58%) said that “better schedules/hours” are extremely important to them at their workplace, while only 14% said “better schedules/hours” are either “slightly important” or “not at all important.” COVID-19 caused workers of all types to reassess where, when and how they work. This is particularly true of nurses, who were at ground zero of the pandemic. For many, the old paradigm of fixed hours/shifts is no longer tenable. Schedule flexibility and the ability to have more control over when and where they work are of increasing importance to nurses and other healthcare workers. Flexible work options may include part-time work, telemedicine or hybrid positions, travel nursing (either through an outside agency or through an internal agency managed by their employer), per diem work or others. Today, offering schedule flexibility can be key for healthcare facilities seeking to be nurse “employers of choice” -- of equal or near equal importance to pay rates and adequate staffing. RECOGNITION, WELLNESS AND DIVERSITY Other workplace related factors considered extremely important to nurses are workplace recognition, wellness programs and workplace diversity. However, none of these factors was rated as “extremely important” by the majority of nurses surveyed. Close to one half (47%) rated “more recognition for nurses” at their workplace as “extremely important,” while 70% rated more recognition as either “extremely important” or “somewhat important.” Only 15% rated such programs as “slightly important” or “not at all important.” Forty-two percent of those surveyed rated “more wellness programs for nurses” at their workplace as extremely important, while 65% rated such programs as either “extremely important” or “somewhat important.” Only 18% said they are either “slightly important” or “not at all important.” Just over one quarter (26%) rated “more diversity among nurses” at their workplace as “extremely important,” while 46% rated diversity as either “extremely important” or “somewhat important”, while 34% said slightly to not at all. The survey indicates that while recognition, wellness and diversity are important to nurses, they may be less important than more tangible rewards such as enhanced pay, more nurses per patient, and better schedules.

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Nurses in 2024 – A Brief Check-in

High Turnover Rates, More Personal Focus

Nurses were asked if they plan to take various steps in 2024 that involve workplace or personal choices.

Q3 How likely are you to do the following in 2024?

Extremely likely

Somewhat likely

Neither likely nor unlikely

Somewhat unlikely

Extremely unlikely

Focus more on my own health and well-being, e.g., diet, exercise, etc.

56% 32% 10%

Work more on my personal relationships

46% 33% 16%

Enrich my mental/cultural life, e.g., read more, watch more movies, learn a new language, etc.

45% 33% 13%

Change jobs

35% 20% 14% 12% 19%

Change my hours/schedule

35% 23% 19%

14%

Work as a traveler

16% 13% 15% 14% 42%

Over one-third of nurses surveyed (35%) said it is “very likely” they will change jobs in 2024, while the majority (55%) said it is “very likely” or “somewhat likely” they will do so. A smaller number (32%) said it is “somewhat unlikely” or “very unlikely” they will change jobs this year. These findings clearly suggest that job dissatisfaction among nurses remains prevalent and that high levels of nurse turnover can be expected throughout 2024. While it is unlikely that the majority of nurses will change jobs this year, the survey indicates that many have a strong inclination to find a different employment setting.

“I love being a nurse but I find it very difficult to stay in the profession. We are understaffed and overworked.”

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Nurses in 2024 – A Brief Check-in

Similarly, 35% of nurses surveyed said it is “extremely likely” or “somewhat likely” they will change their hours and/or schedules this year, while the majority (58%) said it is “extremely likely” or “somewhat likely” they will do so. Less than one quarter (24%) said it is “extremely unlikely” or “somewhat unlikely” that they will change their hours/schedules this year. As was referenced above, “better hours/schedules” are extremely important to the majority of nurses. The survey indicates that many nurses are dissatisfied with their current hours/schedules and plan to modify them in some way, reiterating the importance of schedule flexibility as a retention tool. SELF-HEALING AND PERSONAL ENRICHMENT The majority of nurses surveyed (56%) said that they are “extremely likely” to focus more on their health and well-being in 2024, while 88% said they are “extremely likely” or “somewhat likely” to do so. Only 2% said they are “extremely unlikely” or “somewhat unlikely” to focus on their health and well-being this year. These findings suggest that the majority of nurses are embracing self-healing measures such diet, exercise and other health- promoting activities to cope with the physical rigors and mental stress of their jobs. As healthcare professionals, they clearly understand the importance of these activities to overall health and appear committed to pursuing the type of activities that clinicians commonly recommend to their patients.

“Better work/life balance is needed as is self-scheduling.”

Forty-five percent of nurses said they are “extremely likely” to enrich their mental and cultural lives in 2024 by reading more, watching more movies, learning a language and related activities, while 78% said they are “very likely” or “somewhat likely” to do so. Only 9% said they are “extremely unlikely” or “somewhat unlikely” to pursue these activities. These findings further underscore the need many nurses feel to balance their work and professional lives and to maintain their physical, mental and emotional well-being. Forty-six percent of nurses said it is “extremely likely” that they will work on their personal relationships in 2024, while 79% said it is “extremely likely” or “somewhat likely” they will do so. Only 5% said it is “extremely unlikely” or “somewhat unlikely” that they will work on their personal relationships this year. The survey suggests that many nurses are committed to enhancing the personal aspects of their lives, and plan to commit the time required to do so. By offering nurses a better work/life balance, employers can promote both nurse well-being and job satisfaction, while positioning themselves as “employers of choice.”

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Nurses in 2024 – A Brief Check-in

Impact on Patients

Nurses and other healthcare professionals typically derive job satisfaction from the positive impact they have on patients. Nurses were asked what impact they have had on patients in 2024.

Q4 How would you rate your impact on the health and well-being of patients in 2024?

37% EXTREMELY POSITIVE

37% MODERATELY POSITIVE

17% SOMEWHAT POSITIVE

6% SLIGHTLY POSITIVE

3% NOT AT ALL POSITIVE

The great majority of nurses (91%) said they have had an “extremely positive,” “moderately positive,” or “somewhat positive” impact on the health and well-being of patients this year, while only 9% said they had a “slightly positive” or “not at all positive” impact. There are times when the impact nurses have on the health and well-being of patients may be diminished by circumstances outside their control, such as limited resources, insufficient staffing or the conditions and attitudes of patients themselves. While over one-third of nurses surveyed (37%) said they have had an “extremely positive” impact on patients in 2023, that number might be higher given the wider availability of the resources and support nurses need to provide quality patient care.

“As my career advances, I find nurses to be more subject to paperwork/computer work and less involved in patient care.”

Ideally, the majority of nurses should consider the impact they have on patients to be “extremely positive.” Were this the case, the number of nurses who plan to seek new jobs might be lower and nurse retention rates higher.

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Nurses In 2024 – A Brief Check-In

A Matter of Pride

Pride of profession can be an important factor affecting the satisfaction levels of nurses and many other types of workers. The survey asked nurses about their current level of professional pride.

Q5 How proud are you to be a nurse in 2024?

EXTREMELY PROUD MODERATELY PROUD SOMEWHAT PROUD

37%

24%

20%

SLIGHTLY PROUD

10%

NOT AT ALL PROUD

While the great majority of nurses (91%) indicated some level of professional pride, only 37% said they are “extremely proud” to be a nurse. As was referenced above, nurses and other healthcare professionals typically derive job satisfaction from the quality of care they deliver, and the same may be said of professional pride. Their professional pride may be diminished if they are unable to deliver the quality of care they believe should be provided. Given the vital and often heroic role nurses play as front-line caregivers, the majority should be extremely proud to be a member of their profession. The fact so few are is cause for reflection and concern. IN THEIR OWN WORDS Nurses were asked what comments they would like to share with the public and colleagues regarding how they feel about the nursing profession as we move into 2024. The question was optional, and over 600 nurses chose to provide written comments. Below is a representative sample. » “Better pay is always a better option than coffee, mugs, gifts, etc.”

» “We need more than a pizza in the lunchroom to indicate support from management.”

» “We have gone from hero to zero time and again.”

» “Allow more flexibility in schedules!”

» “As my career advances, I find nurses to be more subject to paperwork/computer work and less involved in patient care.”

» “You have to change jobs just to move up in pay.”

» “We are constantly expected to increase productivity and workloads.”

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Nurses In 2024 – A Brief Check-In

» “Better work/life balance is needed as is self-scheduling.”

» “Better nurse-to-patient ratios, better hours and better shifts are a must!”

» “The best thing I ever did was become a nurse.”

» “Becoming a nurse was the worst decision I ever made.”

» “Burnout is taking a toll on every aspect of nursing.”

» “Can we stop treating nurses like they are machines?”

» “Even with the pandemic behind us, the long-term effects from that time are still with us. Burnout is the number one sign of hard times in nursing.” » “Nurses are worthy and prepared to change the status of healthcare in our facilities, our communities, the nation and globally.”

» “I don’t feel safe working as a nurse. I don’t feel supported.”

» “I work as an Emergency Department nurse. As a team, we save lives. I may not get a bathroom break, let alone a lunch break. How is it that my hairdresser is working better hours and making more money?”

» “I am still proud to be a nurse after 36 years. I love new babies and supporting families.”

» “I believe nursing is in a critical state. Given nurse shortages, whether driven by retirement or burnout, something has to be done.” » “I love being a nurse but I find it very difficult to stay in the profession. We are understaffed and overworked.” » “I love being a nurse, however, I will be retiring. I find there is much more violence against nurses and it is in every aspect of nursing, not just the ER.”

» “When nursing staff is minimal, patient care suffers.”

» “I would really like to see nurse-to-patient ratios improve.”

» “I was so proud to be a nurse during a pandemic that no one saw coming, as we donned our trash bags and homemade masks and went to nursing homes to care for our patients. How about rewarding that by giving us better working conditions?” » “We are human beings first, nurses second. We need to be paid adequately, have better nurse/patient ratios and have the resources to provide the best patient care we can.”

» “As we move into 2024, I would like to remind people of the value of nurses: care, compassion, competence, communication and commitment.”

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Conclusion AMN Healthcare’s Nurses in 2024 survey is intended as a window into the career plans and perspectives of nurses moving into the current year. While limited in scope and distribution, it strongly suggests continued volatility in the nursing workforce and continued challenges for nurse employers. Looking forward to the remainder of 2024, more nurses (38%) are pessimistic about what the year holds for them than are optimistic (20%). More than one-third of nurses (35%) said it is extremely likely they will change jobs in 2024, while 35% said it is extremely likely they will change their schedules/hours. Only 37% of nurses said their impact on the health and well-being of their patients in 2024 has been extremely positive, while only 37% said they are extremely proud to be a nurse.

The survey further indicates that the three factors of most importance to nurses in their workplaces are better compensation, more nurses per patient, and better hours/schedules. Employers who are able to offer work environments that provide what nurses find of most importance may be able to enhance nurse job satisfaction and retention and position themselves as nurse employers of choice.

For additional information about AMN Healthcare’s services or thought leadership resources, visit: AMNHealthcare.com

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