Healthcare staffing is having a sustainability crisis. After years of applying short-term fixes to systemic problems, hospitals across the United States are awakening to the difficult truth that they can’t recruit their way out of workforce instability.
Burnout and turnover are rampant. The revolving door of clinicians has become normalized, with hospitals reporting turnover rates as high as 30%. Healthcare organizations facing soaring costs have become overreliant on travel clinicians and still struggle to stay adequately staffed.
At its core, the root issue is that the systems have been designed for volume over viability. When health systems prioritize initial recruitment over alignment and retention, they overspend on short-term fixes while simultaneously hurting their long-term workforce stability. Not only that, they incur major losses.
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According to the 2025 NSI National Health Care Retention & RN Staffing Report, the average cost of turnover for a staff RN is $61,110. This results in the average hospital losing between $3.9 million and $5.7 million annually due to turnover.
Clinicians drop off early in the pipeline because they receive little context and minimal support. The only way to solve this problem is to create a system that drives long-term retention and workforce stability by supporting clinician well-being.
Why the volume model fails
A high-volume approach creates churn that affects all parties:
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- Clinicians face onboarding delays and little support
- Staffing agencies risk their clients’ trust over unviable placements
- Internal talent acquisition teams waste time and money
- Healthcare facilities struggle with low productivity and poor patient care
Ironically, in an attempt to stem their turnover with quick placements, healthcare organizations are causing the same problem they’re trying to solve.
Too often, the recruiting process is seen as “complete” once a contract is signed. That’s the fundamental mistake; onboarding is the starting point, never the finish line.
Even clinicians who are a good cultural fit may drop out due to a lack of support. Clinicians are expected to arrive ready to care for patients, only to find they can’t navigate the hospital or find the equipment they need.
A failed placement stalls productivity, wastes weeks of search and onboarding, and leaves the same spot open. This is exhausting for clinical teams and financially untenable for health systems.
What a better model looks like
To increase the long-term success of placements, the focus has to shift from volume to viability. This means emphasizing fit, onboarding and readiness.
Fit goes beyond credentials. It allows for communication alignment with the team, safety expectations and comfort in a facility. Rushing placement without considering these variables leads to poor patient outcomes and quick turnover.
Onboarding needs to be a strategic investment. Too many hospitals treat this as an afterthought or a checkbox. The key is defining expectations and performance standards clearly before the contract starts. Clinicians should be familiar with their new work environment before arriving.
When geographical restrictions make physical walk-throughs challenging, virtual simulations can reduce day-one confusion. Knowing what to expect from their unit will accelerate their confidence and speed to the bedside.
Clinicians seek meaningful human connection at every stage of the process and hospitals need their input. If hospitals want to boost retention and strengthen patient care, they must strengthen their clinician onboarding process.
Meeting rural and mid-size systems where they are
The workforce crisis is even more acute for rural and mid-sized hospitals, which often rely heavily on travel clinicians and international recruitment, yet struggle to convert these temporary solutions into lasting workforce stability.
These facilities lack the name recognition, geographic appeal, or resources to compete against large health systems. While many clinicians choose careers based on purpose, the pull of higher bill rates in coastal markets is undeniable.
Knowing they rarely win on compensation or location, smaller hospitals must tell a different story. This is where culture, career growth and work-life balance become serious factors.
Data helps smaller systems compete by understanding clinicians’ behavior by generation, region and specialty. Sometimes, that means highlighting issues on which larger systems sometimes falter, such as safety ratios and mission-driven work.
Building trust with at-cost-plus-margin models
Data is crucial to identify gaps in the staffing funnel. Most healthcare systems rely on their own data to pinpoint whether dropout occurs during screening, onboarding, or early placement.
Health systems need a broader lens to understand their talent funnel. Workforce partners can provide market insights on competitors, supply shifts and rate trends.
A combination of internal analytics, third-party platforms and direct clinician feedback provides the clear data organizations need to understand the life cycle of their staffing funnel, from initial interest to onboarding and retention.
Data-driven transparency ought to also extend to pricing models. The industry-norm max bill rate structure obscures true placement costs. An at-cost-plus-margin model would create accountability and help systems make informed spending decisions.
The path forward
Filling roles quickly eases the short-term pressures of healthcare staffing, but it doesn’t solve the underlying crisis. If a stable, dependable care team is the priority, then it’s time to rethink the staffing funnel.
Stop treating onboarding as the endpoint and focus on transparency and value-based care. Don’t measure success by shifts filled, and instead, measure clinician experience and retention. The ultimate goal is to build stronger teams and environments that support patients and caregivers alike.
Photo: illustration, Getty Images
Buffy Stultz White is CEO of PHHI, a healthcare staffing firm dedicated to transforming how hospitals and clinicians work together. She assumed leadership to challenge outdated models that prioritize profit over people and treat clinicians as interchangeable. At PHHI, Buffy focuses on building lasting partnerships with hospitals while ensuring clinicians are supported, respected, and set up for success. She champions sustainable staffing strategies that value both clinician well‑being and hospital performance.
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