Ann Arbor Times

Nurses in Michigan reported modest improvements in working conditions in the 2023 Michigan Nurses Study compared to 2022. However, issues such as burnout and understaffing remain significant, with nearly half of the respondents reporting abuse in the workplace over the past year.

In 2023, approximately a third of surveyed nurses (32%) planned to leave their jobs, down from 39% in 2022. The study introduced new questions exploring reasons for leaving and future plans, revealing that 13% of those planning to leave intended to exit the nursing profession entirely, excluding retirements. Including retirements, this figure rose to 36%.

Christopher Friese, Elizabeth Tone Hosmer Professor of Nursing and the study’s principal investigator, expressed concern about this trend. "This group potentially has years left in their nursing careers, yet they are choosing to pursue other opportunities," Friese said. "That should be concerning for health care executives and health policy leaders."

Friese emphasized that these younger nurses are departing from a profession Americans have trusted for two decades due to unaddressed concerns about workplace conditions and chronic understaffing.

In addition to job departures, the survey found that 18% of nurses planned to reduce their hours and 7% intended to pursue travel nursing roles in 2023. These figures were down from 28% and 18%, respectively, in 2022.

Friese highlighted an underappreciated but significant issue: many nurses planning to reduce clinical hours. "Health care institutions rely on a mix of full- and part-time clinicians to meet daily staffing needs. If nurses plan to reduce their clinical hours, that means facilities will need to recruit more personnel to meet basic needs," he said.

Friese suggested several factors might explain lower dissatisfaction rates last year compared to 2022. These include fewer COVID-19 cases and less severity of illness, improved access to healthcare services, and increased attention from healthcare leaders on staff retention.

"The one key policy change we observed was fewer hospitals using mandatory overtime to maintain staffing levels in 2023," Friese noted. "So that was seen as a welcome sign from many registered nurses."

According to Friese, there are enough individuals with RN licenses statewide who could fill nursing vacancies if healthcare systems focused on nurse retention. He pointed out a systemic issue where nursing care is bundled into room and board expenses rather than billed directly like physician services. This model incentivizes cutting nursing positions as a cost-saving measure.

U-M health economist Olga Yakusheva recently proposed a new funding model aimed at incentivizing hospitals to fill nursing vacancies. Her research was published in Health Affairs and discussed further in a Michigan News Q&A.

The findings of the Michigan Nurses Study were published on July 18 in JAMA Network Open.

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