Behavioral health nurses had the highest turnover rate among nursing specialties in 2024, according to the NSI National Health Care Retention & RN Staffing Report.
The 2025 report, released in March, includes survey findings from 450 hospitals in 37 states on registered nurse turnover, retention, vacancy rates, recruitment metrics and staffing strategies. The survey reflects hospital-reported data on 218,626 registered nurses spanning January through December 2024. Learn more about the methodology here.
The national registered nurse turnover rate in 2024 was 16.4%, marking a 2% decrease from the year prior. Behavioral health led all specialties with a turnover rate of 22.8%, followed by step-down units (20.3%) and emergency care (19.1%).
Cumulative turnover over the past five years exceeded 100% for step-down (120.8%), telemetry (117.6%) and emergency services (112.9%) — meaning these departments will turn over their entire registered nursing staff in less than four and a half years.
“When we consider the average age of nurses and the anticipated wave of retirements about to break, we need to keep in mind that some specialties will be impacted at a quicker pace,” the report said. “This is particularly true for surgical services, behavioral health and women’s health. Managing retention should be a strategic imperative, particularly given the high cost of turnover and the ongoing RN staffing crisis.”
Registered nurse turnover rates by specialty for 2024:
Behavioral health: 22.8%
Step-down: 20.3%
Emergency: 19.1%
Critical care: 18.3%
Medical/surgical: 18%
Telemetry: 17.4%
Burn center: 17%
Surgical services: 13.7 %
Women’s health: 13.3%
Pediatrics: 12.2%
