Nurse retention strategies: The importance of flexibility

A mother and daughter engage in an activity

McKinsey report finds that nurses of all tenures want more flexibility 

A McKinsey survey completed in late 2023 examined how 5,772 nurses across four generations and all tenures felt about their careers — and working with one another. The resulting report, published in March 2024 as part of an ongoing collaboration with the American Nurses Foundation, provides insight into how organizations can support nurses of all generations and tenures and explains why doing so is critical in a time marked by worsening workforce shortages.

Nurses across all tenures have considered leaving their careers

Thirty percent of all nurses surveyed and 45% of early-tenure nurses (those with less than five years of experience) indicated they might leave their posts within the next six months. ShiftKey’s “Solutions to Healthcare Burnout Report,” which surveyed 1,000 nurses and healthcare workers across the nation, found that 49% had considered leaving, although respondents did not disclose a time frame for doing so.

Nurses of all tenures value schedule flexibility

Preferences vary by tenure, but all nurses value flexible scheduling. About one-third of nurses report that their facilities do not offer any schedule flexibility, and when flexibility is offered, they don’t feel positive about what is offered. Rather, 30% of early-tenure nurses and 25% of mid- and most-tenured nurses are neutral to dissatisfied with the flexibility options offered.

Nurses’ flexible scheduling preferences by tenure

Early-tenure nurses

Early-tenure nurses have a strong preference for self-scheduling: 46% said that it was No. 1 choice of flexible work. However, 67% of early-tenure nurses want flexible, variable shifts: 36% would like to be able to select the length of their shifts and 31% want to be able to select shift-start times. The least favored options for early-tenure nurses were set schedules (21%), followed by hybrid work options and partial self-scheduling (17% each).

Mid-tenure nurses

For mid-tenure nurses, the most important forms of schedule flexibility were flexible, variable shift lengths (32%), self-scheduling (28%), hybrid work options (26%), flexible shift-start times (25%), set schedules (17%), and partial self-scheduling (13%).

Most-tenured nurses

Most-tenured nurses’ desire for flexible shift lengths (25%) barely exceeded their desire for hybrid-work options (22%), self-scheduling (21%), and variable shift-start times (21%). Least favored among most-tenured nurses were set schedules and partial self-scheduling (11% each).

Facilities can create flexibility for their teams by using technology to support flexible scheduling practices or by enabling internal employees to pick up open shifts with more flexible start and end times.

Schedule flexibility can help bring experienced nurses back to the workforce

It's long been understood that mentorship is a necessary part of training and retaining nurses, but what has yet to be explored in as much depth is the role flexibility can play in bringing experienced nurses back to healthcare. Of 1,640 McKinsey survey respondents who were eligible to retire, 46% indicated that they would reconsider if provided with schedule flexibility. Among previously or currently retired nurses, 46% said that having flexibility would cause them to consider resuming their careers.

McKinsey’s findings on the importance of flexible scheduling in healthcare align with our “Empowered Workforce Report.” Although we didn’t break responses down by tenure, nearly half (49%) of those respondents who use the ShiftKey app have 10+ years of experience in the healthcare field, 71% have personal caregiving responsibilities, and 53% said it was possible to resume their career because they could be “their own boss.”

The role mentorship programs play in nurse retention

McKinsey found that mid- and most-tenured nurses want to provide mentorship to early-tenure nurses, with 72% reporting that teaching and coaching early-tenure nurses made them feel “energized and fulfilled.” Among early-tenure nurses, 18% rank mentorship programs as “a top initiative to support a positive work environment.”

The McKinsey report also added further evidence supporting the assertion that mentorship programs help retain more nurses and bring retired nurses back into the workforce: A total of 65% of nurses eligible for retirement said that the opportunity to serve as an educator (34%) or mentor nurses (31%) would make them consider returning to clinical nursing. A positive work environment, of which mentorship is a part, was also indicated.

When we compared intent to leave with the sentiments each nurse shared, there was a positive correlation between those who reported more negative sentiments and those who reported a greater intent to leave.


A strong nurse retention strategy should include mentorship programs, flexible scheduling options, and a robust listening program to ensure a positive work environment.

Offering flexible scheduling is critical for increasing nurse retention rates

By providing nurses of all tenures with the flexibility they desire, facilities can leverage the expertise of their most-tenured nurses, support junior nurses and build robust teams that span generations and tenures. Ultimately, this bolsters nurses’ well-being and satisfaction with work while benefiting residents and patients.

Technology like SAMI, which seamlessly integrates OnShift’s next-generation healthcare software with ShiftKey’s independent professional marketplace, can help. With SAMI, Schedule Automation Marketplace Integration, facilities can build a complete schedule proactively and cost-effectively while keeping nurses engaged and offering them more of the flexibility they want. Facilities using SAMI are even increasing revenue by $1.2 million* per building. See what SAMI can do for your organization.

*Based on facility-reported data. This is not intended to represent or guarantee that current or future users will achieve the same or similar results.