Healthcare workers are essential workers. Yet, we continue to see the churn-and-burn cycle despite added investments in professional development and retention programs.
Here’s a preview of the list.
- Not feeling valued or appreciated.
- Pay/wages not keeping up.
- Lack of benefits.
- Schedules.
- Education/professional development
- Communication
- Safety
- Integrity
Let’s dive into the details about each reason why healthcare workers quit, and what you can do about it.
Not feeling valued or appreciated.
During the pandemic, there was an awakening, a renewed appreciation for the healthcare workers. People had “A healthcare hero lives here” signs indicating their pride and enthusiasm for working in this industry and for helping people.
A recent study from The Harris Poll found that less than a third of healthcare workers feel very valued or loyal to their company.
With the scarcity of available workers during that time, each worker that did show up was more highly valued. Many healthcare workers had to leave the industry (altogether or at least temporarily) to care for a loved one. This is what’s referred to as double-duty caregiving, and sometimes triple-duty caregiving, when these workers also complete most of the housekeeping/household duties.
Caregiver and clinician programs often sit at the surface level: monthly raffles, pizza parties, and, on rare occasions, include a day off. These programs can be effective, but the common denominator is that they either reward everyone equally or at random.
Caregivers want to feel valued and appreciated for their unique contributions to the workplace. Effective retention programs reward team members on the spot or immediately after they do or say something that is noteworthy. This can be as simple as passing on a kind word that a patient shared about care quality, or telling someone one-on-one, in private, that they’re doing a good job and that you appreciated that they picked up an extra shift.
As you think about your caregiver recruitment and retention strategy, think about how you can hone in on what it means to find and keep a healthcare hero at your company.
Pay or wages not keeping up.
One of the most common complaints that healthcare workers have about the workforce is pay. For CNAs/caregivers, the average wage (nationally) is $37,180. For nurses/therapists, the average salary (nationally) is $83,090, according to the Bureau of Labor Statistics (BLS).
There are many factors and variables that go into an individual’s wage/pay; however, by and large, healthcare workers remain underpaid. This isn’t unique to the healthcare industry, and we’ve witnessed it firsthand.
In fact, this is one of the reasons that earned wage access (or EWA)—as an industry—exists in the first place. This systemic problem can’t and won’t be solved overnight; however, there are simple steps that employers can take today to lessen the burden on your workers.
One way to combat the wage dynamic is allowing employees to access wages before their next paycheck. It’s a commonly requested benefit, and more payroll platforms are integrating with these programs too. Workers see the immediate benefit of being able to withdraw earned funds before payday and taking control of their money.
This helps them to maintain authority, autonomy, and control, despite economic and industry turbulence. If you’re thinking about improving your recruiting and retention strategy, try to think outside of the box to make sure that your workers’ financial needs are met.
Addressing retention—in a financial way—doesn’t just mean offering earned wage access. It could also mean encouraging workers to open savings accounts, to become financially literate, and to use available professional development opportunities to advance in their careers (so they can continue to earn more).
Lack of benefits.
Benefits are an essential element of an employer’s recruiting stack. Think of benefits as the cherry on top of the ice cream. It’s not the reason they say “yes,” but it’s essential to the experience.
Healthcare workers want what every other industry has, but here are a few essentials:
- Healthcare coverage (medical, dental, vision, short/long term disability)
- Financial stability (adequate pay, 401K)
- Professional development and educational opportunity
- Work-life balance (not having to choose between either)
We know what you’re thinking: I can’t afford to offer all of this. Our response to that is: You can offer it; it might just look a little bit different than what you’re picturing in your head.
For healthcare coverage, there are many innovative and cost-effective models that work with your budget and your employees’ wallets. Individual Coverage Health Reimbursement Arrangement (ICHRA) and Minimum Essential Coverage (MEC) plans are two key models that can help you remain compliant while meeting your team’s needs.
Offering voluntary benefits can give your employees flexibility and choice, without you having to own the sticker price. Try to find a few core benefits that you can cover (or mostly cover) and offer a few voluntary benefits that they can pick and choose from.
What’s more important than offering benefits, though, is making sure that your employees know what’s available to them and how to enroll. When sharing information, include real, practical scenarios instead of examples shared in Explanation of Benefits (EOB) documents.
Schedules.
Scheduling is one of the toughest functions in healthcare. And often underappreciated.
Rather than thinking of schedules as a one-and-done part of the employee onboarding process, treat it as an ongoing and evolving conversation. Just as your employees’ schedules may fluctuate over time, your patient census and care needs change, too.
Make sure that you communicate and reiterate your organization’s process for sharing schedule changes. And more importantly, be sure to adhere to them.
If policies or procedures aren’t enforced—or unevenly enforced—employees take notice. Set an example for your team to follow and make sure that they understand how valued they are.
When your workers feel that their work is disposable or easily replaceable, this can contribute to the “I’ll just quit” mentality.
Education & Professional Development
Your employees want to progress and move up within the field. Professional development is an important consideration when caregivers weigh leaving for another job.
How do we know that this is happening? CareAcademy research found that 7 in 10 caregivers were interested in pursuing higher education (beyond their current level). The top two reasons were to make an impact on their community and to improve their job opportunity, respectively.
Fostering this healthy, long-term dynamic with your team members starts with onboarding. Nearly 80% of caregiver turnover happens within the first 90 days of employment. Some turnover is good because it can help weed out people who weren’t a good fit for the role, industry, or specific clients.
The majority of it, though, is controllable with a thorough, comprehensive initial training and onboarding program. This experience sets the tone for any further training and education.
Start the process by surveying your caregivers to see what topics they would like to learn more about, whether it’s dementia, transferring clients, or basic cooking skills. You might be surprised by what they share.
Then, layer these courses on top of state-mandated or required training to help balance compliance with their personal interests. Share with your team that you’re required to administer these courses, but you’re trying to incorporate their learning and preferences too. This will help them to understand things better, build trust and rapport with you, and help them see that you’re looking out for their interests.
Communication
Communication is one of the most challenging aspects of leadership. It’s not just about knowing what to communicate, but also about how.
During the first year of the pandemic, home care providers saw turnover rates dip compared to previous years. It fell to 64% in 2020, after hitting an all-time high of 82% in 2018. This was not an accident. It was directly attributable to an unprecedented level of communication that likely hadn’t been done before.
Providers had to give additional personal protective equipment (PPE), update caregivers on client conditions (if they had symptoms or not), and be regimented about sharing scheduling changes or updates. There was an overarching narrative that positioned anyone who worked in healthcare as a healthcare hero.
This helped to build morale in a way that caregivers and clinicians haven’t felt in a long time. We have an opportunity to learn from this era and incorporate these best practices into the day-to-day.
Some takeaways:
- It doesn’t hurt to overcommunicate about your team’s schedules. Text them reminders or confirmations, and make sure they know when they’re working—and with whom.
- Invite, rather than prescribe. When building or adding shifts to schedules, invite the worker to participate in those conversations. They might have insights on client health that you don’t know. If you’re going to add a shift to someone’s schedule, confirm it with them first.
- Set realistic expectations. When your team members are first starting to work with patients or clients—regardless of care setting—help them get a realistic picture of who they’re working with. Care plans only share so much about how it really works. Let them know that John likes a cup of coffee before he takes a bath, or how to best engage or redirect Beth when her sundowning starts. Every person is different and deserves continuity of care, even if it means seeing different caregivers.
Safety
Worker safety is the top priority of any healthcare organization. A recent Harris Poll study found that “[a]lmost half of healthcare workers consider leaving their jobs due to workplace safety concerns.”
You’ve seen the headlines. Your workers have seen the headlines. Healthcare, in general, is one of the most violent fields. Despite these known risks, your team members are dedicated to ensuring your patients’ and clients’ health and safety.
Make sure that you have workplace safety protocols in place designed to prevent and mitigate issues. Some of the most common hazards are:
- Physical injury: Falls, trips, and slips
- Exposure: chemicals, infectious agents, and pathogens
- Work stress: long hours (burnout), physical demands, and exposure to suffering
More importantly, make sure that your workers are aware of the risks and who to contact in the event of an emergency or medical event.
Integrity
One of the most essential parts of keeping workers is keeping your word. Flipped on its head, you have the power to control turnover by enforcing rules and implementing proper order.
As a leader or manager, you have the power to change the lives of your team members. From putting one shift on their schedule, this can add peace of mind, help them pay a bill, and restore/build trust.
Think about it this way: applicants are often asked questions during the interview process that assess their integrity. Whether it’s clients leaving jewelry on a dresser or witnessing another worker tamper with things, you want to get a feel for how they would respond in a situation.
Workers continually reassess and negotiate their understanding of you as an employer. Lead by example in your approach with them. One common example we’ve noticed in post-acute care is resident accusations against workers. A client will file a complaint that a worker stole something, and immediately punish the worker without conducting any investigation or probing. A fairer approach would be to talk to both parties and relevant witnesses. And then use that information to determine appropriate next steps.
This balanced will help your workers trust you as a person and leader.
Retention Isn’t a Perk—It’s a Leadership Practice
Healthcare turnover isn’t a mystery. It’s the predictable outcome of how people experience their work every single day.
When any one of those factors reaks down consistently, people leave. When several break down at once, they leave faster.
What’s important to recognize is that most of the reasons healthcare workers quit aren’t driven by flashy perks or massive budget increases. They’re driven by operational discipline, communication habits, leadership behavior, and how intentionally you design the employee experience.
Retention doesn’t live in a single program or initiative. It shows up in:
- How supervisors recognize great work in real time.
- How transparent and consistent scheduling practices are.
- Whether benefits are accessible and clearly explained.
- How seriously safety protocols are enforced.
- Whether training pathways feel like real career momentum or just compliance.
- How leaders respond when something goes wrong.
Small decisions compound. So does trust.
One of the fastest ways organizations can reduce unnecessary stress for frontline workers is by improving financial flexibility and predictability. Tools like earned wage access—including platforms such as Keeper—give workers more control over when they access the money they’ve already earned, helping them navigate short-term financial pressures without resorting to high-cost alternatives. While this alone won’t solve systemic wage challenges, it can meaningfully improve day-to-day stability and peace of mind.
Healthcare workers stay when they feel respected as professionals and supported as people. They stay when their employer keeps its word, invites them into conversations that affect their lives, and invests in their long-term growth (not just their next shift).
The organizations that win the next decade of healthcare staffing won’t simply compete on wages or job postings. They’ll compete on leadership quality, operational integrity, and the everyday experience of work.
If you want to reduce turnover, start by auditing your organization through the same lens your caregivers and clinicians use. Where are you building trust, and where are you unintentionally eroding it?
Because retention isn’t something you “roll out.” It’s something you practice every day.
