The State of Nursing in 2025: Engagement Trends Signal Need for Investment and Action

New insights from nearly 500,000 nurses and clinicians highlight key factors behind rising retention and safety challenges.

Press Ganey, the leader in experience measurement, analytics, and strategic advisory services for health systems and health plans, today announced the release of its latest research report: “Nurse Experience 2025.” Drawing on data from nearly 500,000 registered nurses and clinical staff from Press Ganey’s national Nursing Excellence benchmark, the study identifies rising expectations and shifting engagement patterns that threaten the stability of the healthcare workforce. While overall turnover has shown signs of improvement, the study finds recent declines in engagement—particularly among advanced practice providers (APPs)—signaling the risk of a potential backslide.

In an industry facing both intense pressure and rapid transformation, it is critical to prioritize understanding and addressing the needs of nurses—the largest segment of the healthcare workforce and the segment with the greatest impact on patient outcomes.

“Reliably safe, high-quality care begins with investing in the people who deliver it,” said Patrick T. Ryan, Chairman and CEO of Press Ganey Forsta. “This research underscores the importance of segmenting your data to understand the diverse needs of today’s workforce. Engagement is declining—especially among Gen Z and Millennial nurses, who are calling for more flexibility. To build resilient, high-performing teams, we must listen deeply to what different groups are telling us and create environments where all nurses feel heard, supported, and empowered to speak up.”

Key findings include:

• The cost of constant change. Year-on-year turnover has improved slightly—now at 18% for all healthcare workers and 17% among nurses—but new declines in engagement suggest that progress may be short-lived. Gen Z saw the highest turnover with 24% of RNs leaving their organization last year.
• Worrisome signals from APPs. Engagement scores declined slightly across most roles, but the engagement gap between senior leadership and APPs widened the most in 2024. Only 52% of APPs believe leadership is responsive to their feedback, and just 55% feel like they have a voice in decision-making.
• Pride and teamwork fuel retention and safety. The strongest predictor of retention for clinical RNs and APPs is whether they feel pride in the organization’s mission, care quality, and reputation. Meanwhile, RNs with negative perceptions of teamwork and resources are 1.53x more likely to leave. Teamwork impacts safety, too; units that report strong teamwork show significantly better outcomes on nursing-sensitive quality indicators like falls and pressure injuries.
• Safety culture is slipping. Responses to prevention and reporting questions are down, with only 74% of employees saying mistakes are treated as learning opportunities (down from 77%)—signaling a breakdown of psychological safety.

A Path Forward

The report spotlights how leading organizations are defying national trends by strengthening social capital—the trust, connection, and collaboration that bind healthcare teams together. These organizations prioritize continuous listening, targeted action, and visible leadership engagement to rebuild resilience at every level.

“The best organizations create real change by supporting their people,” said Jeffrey N. Doucette, DNP, RN, NEA-BC, FACHE, FAAN, Chief Nursing Officer at Press Ganey. “They’re developing nurse leaders, fostering inclusive cultures, and empowering front-line clinicians to shape the work environment. This is how we rebuild trust, retain talent, and protect the future of care.”

To dive deeper into the full report and explore data-driven strategies for strengthening your nursing workforce, visit pressganey.com/nursing2025.

About Press Ganey

Press Ganey partners with healthcare providers and health plans to improve the experiences of their patients, consumers, and workforce by marrying data with unparalleled technology, analytics, and expertise. Our HX platform unites and enlivens disparate data, enabling clients to gather, analyze, visualize, and act on key insights to retain talent, improve access to care, and ensure the care journey is accessible, safe, equitable, and patient-centered. We are the trusted partner to 41,000+ healthcare provider organizations globally and 85% of health plans in the United States. Press Ganey is a Press Ganey Forsta company.

About Press Ganey Forsta

Press Ganey Forsta is a leading global provider of experience technology, data analytics, and insights that help companies better understand and serve their customers, employees, and stakeholders. Press Ganey Forsta powers the Human Experience (HX) Platform – a comprehensive experience and research technology platform that brings together CX (Customer Experience), Employee Experience (EX), Patient Experience (PX) and Market Research. It serves more than 43,000 clients globally across healthcare, financial services, hospitality, market research, professional services, retail, and technology. Press Ganey Forsta is recognized by Gartner^® as a Leader in the Magic Quadrant™ for Voice of the Customer (VoC) Platforms.

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