Open positions and recruitment, though improved over last year, remain a concern.
Editor’s note: We collected survey responses (n=1,228) from September 23 to December 20, 2024. Respondents included subscribers to American Nurse Journal and visitors to our website. We asked all respondents to answer some questions, and we targeted nurse managers (426) or clinical nurses (802) to answer others. For the purposes of this survey, we define nurse managers as leaders, supervisors, and executives; clinical nurses include all other nurses. Because of rounding, some survey results may not add up to 100%.
The number of open nursing positions grew more slowly in 2024 and recruiting to fill them was slightly easier than in recent years, according to nurses responding to American Nurse Journal’s eighth annual Trends and Salary Survey.
Although 41% of nurse managers said they saw an increase in open positions in the previous 12 months, that was down from 57% who noted more openings in last year’s survey. Nearly a third (32%) of 2024 respondents said they experienced little staffing change over the previous year, compared to 19% in the 2023 survey.
2023 nursing trends and salary survey results
Trends and Salaries Interactive Results
Turnover also eased slightly, with 48% of respondents reporting increased turnover compared to 54% in 2023. However, an easing in turnover and open positions hasn’t translated into dramatically easier recruitment of RNs. More than half of nurse manager respondents (56%) said they found it more difficult to fill open positions in 2024 than previously.
Although that figure represents a 10% reduction from last year, we found little change in those saying they found recruitment easier (19% vs 18%). The silver lining is that a greater proportion (25% vs 16%) said the recruiting climate had not worsened in 2024.
None of these findings suggest that staffing shortages have disappeared across the country. Many nurses continued to cite concerns about adequate staffing, now and in the future, as one of their chief concerns when asked, “What about the future workforce and/or workplace keeps you awake at night?”
“We are now concerned with the mandated numbers for staffing, and the associated fines, that we have now entered into a warm body syndrome,” said one nurse. “This means that people are hired and the current management methods of precepting and actually managing these folks appropriately has taken a back seat. The basics are going down the toilet. Managers are required to manage without the authority to reprimand or dismiss ineffective staff members. That brings a whole new set of patient issues.”
Several other respondents expressed concern about the ability to provide adequate staffing for an aging population as nurses retire or leave the profession and organizations have fewer new nurses to replace them. One nurse wondered, “Will demand for care outstrip supply as the proportion of elderly patients increases?”
Other key findings from the 1,228 nurses who responded to this year’s survey include the following changes from 2023:
- More nurses sit at the bottom and top of the salary scale among this year’s respondents.
- Overall, nurse managers reported higher job satisfaction in every category, including in their relationships with coworkers.
- Clinical nurses also expressed generally increased satisfaction, although more expressed frustration with their ability to advance and drive change in their organizations.
- The percentage of nurses who described themselves as “very emotionally healthy” nearly doubled from the previous survey.
- Nurses continued to report workplace safety as a concern; however, the percentage of nurses who experienced bullying or physical assault in the previous 2 years fell.
- Among those who were victims of workplace violence and reported it, fewer said they felt satisfied with how the matter was handled.
What keeps you up at night?
We asked nurses, “What about the future workforce and/or workplace keeps you awake at night?” Here’s a sampling of what they told us.
Will the hospital be open next week, month, year?
There’s no longevity. We will be lacking seasoned mentors. Also, educators need pay increases to attract more to that workforce.
Understaffing and stress can lead to an increased risk of medical errors.
The recruitment of nurses in remote areas is difficult, which affects the distribution of medical resources across the country.
The unpredictable environment of politics is taking a toll on healthcare. Nonclinicians are weighing in on issues that are going to have serious consequences on the lives of patients that will come from misinformation and abuse of social media.
The rapid pace of medical technology changes can make it difficult for nurses to keep up. Continuous high-intensity work may lead to burnout of nurses and affect their physical and mental health.
The proportion of young nurses leaving the profession because of stress or pay issues is rising.
The limited hands-on clinical exposure for RN students.
Nurses are being asked to do so much from a task and documentation aspect that I worry that they are losing the critical thinking skills.
Top issues
We asked nurses, “Other than staffing, which is widely seen as a top issue, what are the one or two most important issues for the nursing profession?” Here’s some of what they said.
Mutual respect, civility, and courtesy are important in the workplace environment. A toxic workplace should not be allowed to continue.
We aren’t centered on prevention. We throw more time and resources into fixing problems than taking the necessary steps to avoid them.
We are not focusing enough on telehealth and the needs of the rural patient.
Unquantified nursing care services. Nursing should be billable and not part of room and board charges.
To solve the problem of inadequate nursing resources in rural areas. Enhance the ability to care for patients with different cultural backgrounds.
Strengthen communication training between nurses and patients and between nurses. Nurses need more support in complex ethical decisions.
Set up a nursing ethics committee to deal with complex ethical issues. Promote diversity and inclusion policies in nursing.
EHR driving nursing care rather than the nursing process driving nursing care. Persistence and support of new nurses to keep them in nursing.
We need time to network and support each other. We need time to get ongoing education without feeling like we are leaving our clinical work unattended or other staff having to carry the burden.
Nurses who completed their clinical training during COVID were unable to have adequate opportunity to learn the intricacies of bedside nursing and thus are more likely to make errors of consequence, and to require significant amounts of support and guidance from more experienced staff. (While I genuinely love educating my colleagues, sometimes it takes more time than I actually have available with my workload.)
Salaries: More nurses at the bottom and top
Although a larger percentage of respondents to this year’s survey earned $69,000 or less (29% vs 25% in 2023), the portion of nurses earning $130,000 or above increased from 13% to 15%. Those in the middle ranges fell from 62% to 55%. Some of the growth at the top of the salary scale may be driven by a larger proportion of respondents in the current survey with more than 25 years of experience.
That higher proportion of more senior nurses also could explain the jump in respondents who said they plan to retire within the next 2 years (17% vs 10%) or 5 years (19% vs 15%). These percentages were accompanied by a drop in those planning to work beyond the next 5 years—from 55% to 38% in the most recent survey.
A smaller percentage reported that their salaries had increased in the previous 12 months compared to last year (53% vs 61%), and more reported that their salaries decreased (12% vs 11%) or remain unchanged (35% vs 28%).
Many respondents, in their open-ended answers, cited salary as a barrier to getting and keeping nurses, especially as responsibilities increase when staffing doesn’t. “Despite the increase in workload, there has been no commensurate increase in pay, leading to dissatisfaction,” said one respondent. “How to find a balance between intense work and family life?”
Others specifically cited academia as an area that requires salary improvement. One nurse noted the “lack of support for adequate compensation for nurses in academia, which affects recruitment/retention, and thus the number of nursing students who can be enrolled.”
Most nurses say they plan to stay with their current employer for at least the next 5 years,
although this year, slightly more (17% vs 14%) say they plan to leave within the year.
Among all nurses (whether seeking a new job or not), most say (as they have in past surveys) that a higher salary would be enough for them to consider a change. For those who already plan to leave, money remains a primary factor. Another important factor was dissatisfaction with the work environment (38% vs. 37% in 2023; respondents could choose more than one answer).
Words of wisdom
Everyone needs advice, whether as a new nurse or a seasoned professional, so we asked survey respondents, “What is the best piece of nursing advice you’ve ever received?” Here are some of the words of wisdom they shared:
Your patients will never care what you know until they know how much you care (about them).
Take your time, slowing down by 30 seconds can save you from a mistake.
You have accountability responsibility and the authority over the nursing care you deliver.
We are seeing people at the lowest points many times, don’t take it personally.
You will make mistakes so instead of dwelling on them, take in the information and learn from it so you do not do it again.
Don’t be afraid to ask for help from colleagues or management when you’re in trouble.
Pay attention to alarms; take a look and save a life.
Participating in clinical research can increase your knowledge and career value. Being open to feedback from colleagues and patients helps you grow.
Job satisfaction remains high among nurse managers
A larger percentage of nurse managers reported high satisfaction with their jobs compared to the previous year (70% vs 63% in 2023). This finding held true for every category—salary, benefits, time worked, level of authority, and ability to advance and drive change. However, we saw a slight drop in those who said they felt neutral on these issues and an increase in those who now express some level of dissatisfaction.
Nurse managers also reported more satisfaction with their coworkers, including peers, supervisors, and management. Although, again, we saw increases in some unsatisfied ratings, particularly when it came to physician colleagues, supervisors, and management.
In their open-ended responses, many nurse managers reported alarm with what they see as the lack of preparedness among new nurses. Others noted the lack of support from and dedication of senior nurses to help train younger staff.
“Clinical experience for RN students is quite limited,” one respondent noted. “That puts a burden on hospitals for orientation. It may contribute to new graduates leaving the bedside as they had limited knowledge of the actual environment, expectations, and workload.”
One nurse’s comment captured both ends of the spectrum: “Older nurses eating their young and younger nurses disrespecting nurses with many years of experience.”
Compared to last year, the current survey included a higher percentage of charge nurses (24% vs 15%) and fewer nurse executives, service line leaders, and unit/department managers.
A larger percentage reported working as nurse managers for less than a year or more than 16 years; a smaller portion represented the middle years.
DEI in the workplace
We asked nurses, “What is your facility doing to improve diversity, equity, inclusion, belonging, and accessibility?” Here’s a sampling of the feedback we received.
A work in progress.
Actively recruiting diverse faculty. We have two male faculty, three Native American, and two Black faculty. We have faculty who are in their 20s and 65-plus.
Allocate a portion of the budget to diversity and inclusion initiatives and projects. Engage outside experts to provide advice and evaluation to ensure the effectiveness of the diversity strategy.
Always looking for best talent and supportive of those who want to grow in the organization. I’m proud to have a diverse team and work for an organization who believes and supports inclusion, diversity, belonging through education and training and are supportive.
A lot of talk, not much change.
Clinical nurses’ job satisfaction higher too
Clinical nurses also reported overall higher job satisfaction (74% in 2024 vs. 70% in 2023), although most of the increases in individual categories were seen in the “Very satisfied” ratings, while the “Somewhat satisfied” percentages declined in several areas. We also saw an increase in dissatisfaction with clinical nurses’ ability to advance and drive change in their organizations.
One respondent reflected that perspective when asked what keeps them up at night: “Limited career advancement opportunities: In some cases, there may be limited opportunities for career growth and promotion, which can be demotivating.”
Although nurses can progress by getting advanced degrees and entering specialty areas, that depletes the supply of bedside nurses, some commenters noted. “The art of nursing is dying,” said one. “Young nurses are no longer interested in the holistic care of the patient. They want to graduate, work in the ICU for a year, and then be a CRNA.”
As with nurse managers, we found increases across the board among clinical nurses pleased with their relationships with colleagues, from peers and supervisors to physicians and management. We also noted a slight uptick in nurses who felt that staffing assignments at their workplace were appropriate most of the time (56% in 2023 to 59% in 2024).
However, nurses who responded with comments about the top issues facing nursing frequently cited staffing as a continuing area of stress. “Understaffing in hospitals can affect the quality and efficiency of care,” wrote one.
The survey indicated a significant jump in the percentage of all nurses (managers and clinical nurses) who described themselves as “Very emotionally healthy” in this survey, up to 18% from 9% in the prior survey. And those who reported themselves as “Not emotionally healthy” dropped to 13% from 17%.
However, the open-ended comments reflected the reality that many nurses still feel concerned about the impact of stress on their mental health: “Faced with frequent experiences of serious illness and death, nurses’ psychological trauma has not received sufficient attention.”
Fewer assaults, more dissatisfaction with outcomes
The percentage of nurses reporting being physically assaulted by a patient, family member, or visitor in the prior 2 years fell from 22% in 2023 to 16% in the latest survey. (The percentage reporting being verbally assaulted or bullied decreased slightly as well, from 52% to 48%.) But among those who were assaulted and reported the incident, a smaller percentage (48%) said they were satisfied with the outcome, a 10% drop from the previous survey.
Similarly, although fewer nurses reported being verbally assaulted by a fellow employee or healthcare worker, the percentage of those who felt satisfied with the handling of the situation dropped from 45% to 33%. However, 29% didn’t report the incident at all; 38% said they didn’t report because they felt nothing would be done to address the situation.
“No one understands that if you report certain people that there is some type of reprisal from that person to you,” said a respondent. “Is it fair? No, but it happens, and I have seen it over and over again. There are times I have seen it and the person reported only for them to continue with the bullying but more aggressively.”
The pattern of fewer reports, but less satisfaction with the outcome of reported incidents, held true in other categories as well:
- The percentage of nurses reporting being physically assaulted by a fellow employee or healthcare worker was cut in half (8% to 4%), but those who reported the incident were less likely to be satisfied with how it was handled (down from 78% to 45%).
- Although we found a slight drop in the percentage of those reporting being bullied by their manager, those who reported the incident were much less satisfied (falling to 28% from 49% in the prior survey). In addition, 53% didn’t report the incident at all; more than half because they feared reprisals and a third because they didn’t think anything would be done about it.
- Those reporting being physically assaulted by their manager fell to just 2%, compared to 6% previously. But only 71% of those who reported a manager’s physical assault were satisfied with how the matter was handled compared to 85% in 2023.
- Reports of sexual harassment also fell, down to 11% from 14%, but dissatisfaction with the outcome rose to 47% vs 31%.
Nurses speak out: Workplace violence
Although the percentage of nurses who said they’ve experienced violence in the workplace in the past 2 years fell in most categories, the threat of abuse remains widely felt in nursing, based on this sampling of responses to the question: “What thoughts would you like to share about nurses as the victims of workplace violence?”
Action to stop workplace violence starts with putting in metal detectors and having security present at all times in the ED. Patients are becoming more violent, and there are no safety measures in place. It does not feel safe at work.
Actions speak louder than words. Telling us you care while doing nothing about what has occurred or even fully recognizing it tells us you care about politics more than people.
Always have someone with you while de-escalating situations. Ask for help before it becomes out of control.
It happens too often and is frequently seen as ‘part of the job,’ especially if you work in high-stress areas like the intensive care unit.
Always pay attention to body language of patients. Mood swings can happen suddenly. We don’t always think about our own safety as we are usually more concerned with patients’ safety.
I think hospitals do a lot of talking about being tough about workplace violence, but they are generally not supportive of staff who are the victims of workplace violence. How many times do we hear, ‘What could you have done to prevent this?’
Be prepared. Call for help before the escalation begins. Always keep safety of yourself first. Leave the situation if you need to.
Most still glad they chose nursing
Despite all the challenges, three-quarters of nurses taking this year’s survey say that, if they had to do it over again, they would still become a nurse (down 3% from 2023).
One nurse summed up her decision this way: “I’ve never wanted to do anything else but nursing. I have a teaching degree but nursing is what I love.”
David J. Gilmartin is a digital content editor at HealthCom Media in Doylestown, Pennsylvania. Cynthia Saver is a medical writer in Columbia, Maryland, and editor of Anatomy of Writing for Publication for Nurses, 5th ed. Her blog, The Writing Mind, is available at myamericannurse.com/category/the-writing-mind.
American Nurse Journal. 2025; 20(2). Doi: 10.51256/ANJ022522
