A systematic review of registered nurse turnover and retention in the United States

Background The pandemic has highlighted the struggles of nurses and risks of workforce shortages. Analysis of nurses' job decisions is necessary to mitigate these risks. Purpose The purpose of this systematic review was to understand factors associated with registered nurse (RN) work outcomes in the United States, and to examine the inclusion of equity and wellness concepts in this body of literature. Methods This review utilized the Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol. Studies from PubMed and CINAHL were included if they focused on RNs in the United States in the past 10 years. A total of 34 studies are included in the review. Findings RN work outcomes are impacted by individual, unit level, and organizational factors. Few studies address equity, and many only address RN health in terms of burnout. Discussion Future work needs to draw samples from broader practice settings, focus on interventions that promote positive outcomes, and focus on equity and the wellbeing of RNs.