Michigan Nurses Study 2023 shows improved conditions, but burnout and abuse persist

Nurses in Michigan reported improved conditions compared to 2022 in the 2023 Michigan Nurses Study, but burnout and staff shortages remain high and nearly half reported workplace abuse in the last year.

Last year, about a third of nurses surveyed planned to leave their jobs (32%), compared to 39% in 2022. New questions in 2023 explored reasons for leaving the job and future plans and found that 13% of those leaving the profession planned to leave the nursing profession entirely, excluding retirements. After accounting for retirements, the number of those leaving the profession rose to 36%.

Christopher Friese, a professor of nursing at Elizabeth Tone Hosmer University and lead researcher on the study, said the 13% group is particularly concerning because it includes younger working nurses.

This group may have many years left in their nursing careers, but they are choosing to pursue other opportunities. This should be a concern for health care leaders and policymakers.

These nurses are leaving the profession that Americans have trusted most for two decades. This is a group we should listen to very carefully. And they are leaving the profession because health care leaders are ignoring their legitimate concerns about their jobs and chronic understaffing.”

Christopher Friese, Elizabeth Tone Hosmer Professor of Nursing

In 2023, 18% of nurses surveyed plan to reduce their hours and 7% plan to work as travel nurses, compared to 28% and 18%, respectively, in 2022.

Further findings:

• Of the 32% who planned to leave their job within a year, 42% planned to leave their current employer but stay in the industry, 22% planned to retire or quit their careers, 13% planned to change jobs within their company, and 6% planned to go back to school.
• The main reasons for leaving their current position were workload, management and leadership, and salary and benefits.
• Fewer nurses reported exhaustion, an unfavorable work environment, workplace abuse, mandatory overtime and staff shortages.
• Those who planned to leave the nursing profession were more likely to report abuse and emotional exhaustion.
• COVID-19 was not a common reason for departure.

Friese said an underestimated but concerning number is the fact that so many nurses are planning to reduce their hours in the clinical setting.

“Healthcare facilities rely on a mix of full-time and part-time physicians to meet daily staffing needs. If nurses plan to reduce their clinical hours, that means facilities will have to hire more staff to meet basic needs,” he said.

According to Friese, there could be several reasons for the lower dissatisfaction rates last year compared to 2022. There were fewer cases and less severity of COVID, improved access to health care, and more attention from health leaders to staff retention.

“The most important policy change we observed was that in 2023 fewer hospitals will be requiring mandatory overtime to maintain staffing levels,” Friese said. “This was seen as a welcome sign by many registered nurses.”

At the county and state level, there are enough people with nursing licenses to fill open positions — if health systems focus on retaining nurses, Friese says. One problem is that unlike doctors, who can bill insurers directly for their services, the cost of care is rolled into room and board costs. This model creates incentives for health systems to cut nursing positions to save costs.

Health economist Olga Yakusheva, a professor of nursing and public health at UM, recently published an article in Health Affairs journal proposing a new funding model that she says would incentivize hospitals to fill nursing vacancies. She discusses her research in a Michigan News Q&A.

The results of the Michigan Nurses Study will appear in JAMA Network Open on July 18.