The Challenge

Health systems across the U.S. face an extreme shortage of nursing staff, made worse by the Covid-19 pandemic. Nurse turnover is proving costly for employers, who are forced to pay high premiums to retain experienced nurses and compete for talent.

A major U.S. hospital network partnered with us to understand the experience of nursing today – and prioritize key areas for future investment in a bid to improve retention and reduce turnover.

Our Approach

We sought to challenge core assumptions about the mental worlds and key motivations of today’s nurses – and ensure that proposed solutions would squarely address needs they faced within their daily working lives, across generations and areas of specialization.

We conducted 24 ethnographic interviews with nurses / nurse managers who had previously worked for our client’s network – an honest perspective on the employee experience typically unavailable to leaders.

Photo of a doctor or nurse. Photo by Luke Jones, Unsplash.

The Key Insight

We learned that many nurses were motivated to resign not because of money alone, but by a profound sense of moral distress: the feeling that they were unable to provide good patient care due to failures of process, lack of resources, or missing support from leaders. Responding to moral distress demands more than bonuses or payouts – it requires major investments in time, education, staffing, and mental health.

The Outcome

We produced a final report presentation that included:


A wide-angle perspective on changes in the profession of nursing today;


A comprehensive map of nursing pain points, in the voices of staff themselves;


Priority areas for further investment combined with “solution starters” to drive internal deliberations;


Four nursing personas to align the design of future solutions with lived nurse experiences.

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