Creative Strategies Hospitals Use to Attract Nursing Talent

In a fiercely competitive healthcare landscape, hospitals are pulling out all the stops to lure top nursing talent through their doors. From offering eye-popping sign-on bonuses to implementing flexible work schedules, today’s hospitals are transforming the nurse hiring process into a high-stakes game where only the most innovative strategies win.

As the nursing shortage intensifies, the creative recruitment approach isn’t just about the perks — it’s becoming an essential tool in the race to build a skilled nursing workforce.

Nursing vacancies are as high as 17% — more than double pre-pandemic levels — and hospitals scrambling to fill them need to do more than raise salaries and bolster benefits packages to entice nurses.

“I am very thankful when I hear of creative ideas that nurse administrators come up with to try to get their ultimate goal, which is enough qualified nurses to take care of patients,” said Linda Plank, dean of the Louise Herrington School of Nursing at Baylor University in Dallas.

Signing Bonuses, Tuition Reimbursement, and Self-Scheduling, Please

Signing bonuses were among the top perks offered to healthcare workers, with almost 18% of job openings advertising the incentive for new nurse hires; the average signing bonus for registered nurses (RNs) topped $11,000. In 2023, California-based Palomar Health made headlines when it offered eligible RNs a $100,000 signing bonus paid over a 3-year period.

“We are seeing a variety of incentives, like sign-on bonuses, that can be effective at getting the attention of potential new hires,” said Deborah Trautman, PhD, RN, FAAN, president, and CEO of the American Association of Colleges of Nursing. “With the growing competition for registered nurses, especially those prepared in baccalaureate programs, employers should consider what’s most important to nurses entering the field.”

Hospitals have also invested in benefits ranging from tuition reimbursement, student loan forgiveness, and professional development opportunities to expanded parental leave and onsite childcare. Flexible scheduling is a sought-after perk that benefits both new and experienced RNs and could also help with recruitment.

“In the past, [hospitals said], ‘Our shift starts at 7 and ends at 7’,” Plank said. “Now, hospitals are a little bit more flexible…and being open to flexible shifts has merit. If we’re willing to look at things differently, it could get more people involved in patient care.”

An American Nurses Foundation report found that nurses preferred variable and flexible shift lengths, flexible start times, and self-scheduling options over set schedules. In fact, 45% of nurses who left clinical practice would consider returning to work if hospitals switched to a self-scheduling model.

The Cleveland Clinic, Cleveland, introduced staggered shifts that start at nontraditional times, including 11 AM to 11 PM, flexible shift lengths, and split RN positions that allow clinical care nurses to divide their time between different departments. Last year, Hackensack Meridian Health in New Jersey also piloted a self-scheduling program for its nursing staff.

Hiring Outside the United States

Despite the prevalence of signing bonuses and premium perks, some hospitals still struggled to fill open positions with nurses recruited from outside the United States. Data from The Kaiser Family Foundation show that 32% of hospitals hired foreign-educated RNs in 2022 — more than double the number hired in 2010.

Jennifer Mensik Kennedy, PhD, MBA, RN, NEA-BC, FAAN, president of the American Nurses Association (ANA), is concerned about that trend. The ANA supports the International Council of Nurses and their call for “stronger codes for ethical recruitment of nurses” because international nurse recruitment practices can negatively affect the quality of healthcare in countries that are depleted of nurses.

“Recruiting international nurses as a key strategy for building core staffing is not sustainable in the long term,” Kennedy told Medscape Medical News. “We need to redirect our focus on how to retain staff through fostering healthy work environments and addressing antiquated payment models.”

Reinforcing Retention

Recruiting nurses is just one element of addressing the nursing shortage. Prioritizing job satisfaction is essential to retaining nursing staff. Currently, 33% of nurses who enter the profession quit within the first 2 years.

A growing number of hospitals have implemented programs focused on increasing retention. Lifepoint Health, a national network of 60-plus acute care hospitals, launched a Nurse Residency Program in 2023. The 12-month program, which offers training and mentorship to help recent nursing school graduates, has recruited 750 new nurses and helped them transition to clinical practice.

The Nurse Residency Program has been so successful that the hospital system plans to introduce a 2-year fellowship program this fall that supports the professional development of nurses who want to specialize in areas like acute care, obstetrics, or the intensive care unit.

“We are more focused than ever on increasing partnerships and alignment with our local nursing programs, expanding clinical education opportunities for nursing students, owning and driving a nursing culture, and creating an environment where employees want to work,” said Michelle Watson, MSN, RN, CENP, chief nurse executive and senior vice president of clinical operations at Lifepoint Health.

Watson also credits their facilities’ chief nursing officers as being “highly engaged and visible leaders” who spend time with RNs to learn about their career aspirations and help them understand how the organization can support their desires for ongoing professional development.

The 2022 Nurse Staffing Task Force, a collaborative initiative by the ANA and other prominent national nursing and healthcare organizations, has developed and widely disseminated a set of recommendations for hospitals focusing on investing in nurse staffing, safe and supportive work environments, and competitive wages.

In addition, the Reimagining Nursing Initiative, started by the American Nurses Foundation, is striving to help nurses feel valued and compensated by creating pilot programs that can help modernize nurses’ reimbursement structure so that they can direct bill.

In the end, attracting and retaining top nursing talent is about more than filling positions — it’s about building a healthcare system where nurses thrive. “In the United States and abroad, we owe it to nurses and the communities they serve to have sustainable and appropriate solutions to staffing and work environment challenges,” said Kennedy.

Jodi Helmer is a freelance journalist who writes about health and wellness for Fortune, AARP, WebMD, Fitbit, and GE HealthCare.