Generation Z nurses have one of the strongest retention rates in their first two years, but after roughly 30 months, turnover rises above that of other generations, a report from Laudio and the American Organization for Nursing Leadership found. However, nurse leaders at two health systems are seeing a more varied picture.
Gen Z, born between 1997 and 2012, now represents the second-largest cohort of nurses in health systems, and is the only generation increasing its share as older cohorts retire or exit.
Hospitals and health systems have spent years building Gen Z retention programs, but a Press Ganey report found 1 in 5 early-career nurses are leaving their jobs. The national nursing turnover rate of 17% has held steady for the past few years and the average U.S. hospital lost $5.19 million from registered nurse turnover in 2025. Gen Z and baby boomers had the highest turnover rates at 22%, followed by millennials at 21% and Gen X at 14%.
Although nationally, Gen Z nurses are more likely to turn over after 30 months, hospitals and health systems are reporting varying trends in turnover timetables.
At Renton, Wash.-based Providence, Gen Z nurses are more likely to be retained than other generations in the first year, but at about three to 3.5 years of tenure, exit rates among Gen Z are almost twice that of other generations, Sylvain Trepanier, DNP, RN, chief nurse executive at Providence, told Becker’s.
The pattern isn’t consistent across Providence’s markets. Its California hospitals are not seeing the same exits. Meanwhile, in its Alaska, Eastern Washington, Montana, Oregon, Puget Sound and Texas areas, hospitals report higher turnover at three to five years for Gen Z, but strong retention in the first three years.
Leaders at West Des Moines, Iowa-based UnityPoint Health have not concluded that 30 months is a “single or universal tipping point for Gen Z nurses,” Sarah Brown, MSN, RN, senior vice president and chief nursing officer at the system, told Becker’s. Nurse retention patterns vary by market, care setting, role and individual circumstances.
“What the 30-month discussion does reinforce is the importance of staying closely connected with nurses after the initial transition-to-practice period,” Ms. Brown said.
Dr. Trepanier and Ms. Brown said nurses are most likely to stay until they gain sufficient experience to compete for different roles.
What’s behind Gen Z departures?
No single factor drives early-career nurse exits, but leaders noted a few trends in common reasons nurses leave.
At Providence, relocation and other personal reasons are the most common drivers of nurse departures, Dr. Trepanier said.
“We know that retention risks have always been high for those between the ages of 20 and 30,” he said. “Beyond the standard earlier-in-career reasons for movement, like pay, we must also begin considering other community and social impacts: seeking better cost-of-living locations, deciding where to settle down and begin families, or moving to take care of aging family.”
Many nurses also leave to pursue an advanced degree, move into a specialty, find a different schedule or care setting, or land a role that better fits with their personal needs, Ms. Brown said.
Although many Gen Z nurses leave their positions, they appear to be moving within healthcare, Dr. Trepanier said.
Retention programs can address some of these needs, but clear and realistic expectations, psychological safety, belonging, recognition and consistent leadership can also help retain nurses also matter, Ms. Brown said.
Systems should also consider current societal and economic conditions that can influence turnover, Dr. Trepanier said.
“Traditionally, root-setting moments like starting a family or buying a house reduced the mobility of a worker and, consequently, retention rates rose,” Dr. Trepanier said. “We must consider the influence of the current society and economy: marriage rates are lower and homebuying, while still desirable, is now forcing Gen Z to either become more aggressive in seeking higher wages or relocating intentionally to a lower cost-of-buying area.”
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