Millennial Nurses to Advanced Practice Nurses: How it affects our nursing retention and shortage

Disclaimer: this is not a sponsored post by Advisory Board or AMNHealthcare. I do get reimbursed for google ads. Please see disclosure policy.

Millennial Nurses

Millennial nurses already advancing? Seems scary to some, but all angles would have to be considered before we instill fear in the nursing workforce.

Advancement is never a bad thing! But how does it affect our first year turn over rate and our nursing shortage? Will our traditional retention strategies to keep nurses engaged work?

Well… research says otherwise. Keep reading…

The role of an advanced registered nurse transformed through a series of reasonable changes due to variances in demand. With the support of various nursing associations such as the National Council of State Boards of Nursing (NCSBN) APRN Advisory Committee and the APRN Consensus Work Group, it is also evident that the role has been revolutionized overtime to optimize their scope of practice and patient outcomes. An advancement in nursing practice was profoundly researched and concluded with inspiring results.

The roles considered as APRN began as positions to satisfy demands for specialized care. Clinical nurse specialists (CNS), for instance, was developed to care for complex cases within psych populations (Denisco & Barker, 2016). The CNS role expanded shortly after the first CNS program at Rurgers University, where nursing educators started to incorporate other specialties that included oncology, medical-surgical, pediatric, and critical care nursing (Denisco & Barker, 2016). The nurse practitioner (NP) role is another example of how advancement has progressed overtime. In the 1970s, nurse practitioners were developed to meet the shortage of primary care physicians and to care for the underserved populations. Institute of Medicine (IOM) identified the need for nurses to be optimized at the forefront of patient care due to the increasing demand for their role. As the role gained recognition, it was encouraged for nurses to be allowed to practice to their full scope of practice as advanced nurses. As of today, there are now more than 321 institutions that offer a masters-level NP program and there are roughly 192,000 of NPs in the United States (Denisco & Barker, 2016).

In this day in age, the culture of nursing has emphasized the importance of advancement. With the changes in our patient population, there will be a significant need for more advanced nurses due to the anticipated increase of health care demand for our aging baby boomers. As expected, the increase in NPs have evolved into primarily taking care of specialized populations with optimized patient outcomes. Research has shown that NPs provide similar care as primary care physicians from a cost, quality, and patient outcomes perspective. It is inviting to see that more than 30% of NPs are working with vulnerable populations and other specialties.

With the increasing need for healthcare in the near future, our front-line nurses (especially our millennial nurses) are encouraged into pursuing educational advancement. We are now entering a nursing workforce that is multi-generationally sensitive. With that in mind, this concept does have pros and cons to the emerging needs of more nurses in the workforce. Though we are meeting the demands of the physician shortage through roles such as nurse practitioners and physician assistants, the nurses turnover rate continues to be a problem for organizations. As more nurses return back to school to get advanced, the nursing shortage becomes harder to manage.

Advisory Board (2016). PDF Snapshot. Retrieved from:

Advisory Board (2016). PDF Snapshot. Retrieved from:

According to a research report by the Advisory Board (2016) called Win Millennials’ Loyalty, the national RN turnover rate is trending steadily upward. Our nursing workforce is currently made up of one-third of millennials (under the age of 35) and one-quarter of nurses over the age of 55. As our baby boomer nurses start thinking about retirement, more millennial nurses enter the workforce with the mindset of furthering their education and clinical advancement. A survey performed by AMNHealthcare (2018) on millennials in nursing reports that more than 1 in 4 of millennials stated that they would pursue a Nurse Practitioner’s degree in the next three years.

In addition to that concept, it is evident that our traditional retention strategies will have to be re-evaluated as more millennials enter the workforce. Speaking on behalf of millennials, we are one of the most engaged groups… but unfortunately, we are not loyal. That may seem harsh, but the minute that an opportunity arises that accommodates our personal endeavors and/or professional development plan, we will take it. Some may think that both factors, loyalty and engagement, go hand-in-hand but may differ depending on age groups. In some cases they do align… you would think that if a nurse is engaged, they would be loyal to an organization for the next 3 years, but not according to latest surveys.

Advisory Board (2016). PDF Snapshot. Retrieved from:

Advisory Board (2016). PDF Snapshot. Retrieved from:

According to the Advisory Board (2016), gaps between engagement and loyalty scores have shown that nurses older than 55 with more than 15 years of experience are more engaged than loyal. As I mentioned earlier, this is quite expected because majority of them are thinking about retirement. But then results show the same for nurses under the age of 35! Millennials are also engaged but not loyal. Why is that?

I was able to correlate AMNhealthcare’s results to the Advisory Board’s data and should not be surprising to most. Millennial nurses are going back to school to further advance so it’ll be harder to commit. With that in mind, re-inventing your retention strategies to be focused on loyalty is important. Focusing on engagement is just not enough to keep millennials loyal to their role long enough before they start looking for a new one.

Though it is important to respect their own pursuits in their professional development, there are endless opportunities for millennials now more than ever before, therefore, keeping them engaged/loyal in their current role will be key.

For further insight on how to win millennial’s loyalty, please refer to the references below! It’s a great read! Sign up to be a member at


Denisco, S. M. & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession. Burlington, MA: Jones & Bartlett Learning.

AMNHealthcare (2018). Survey of millennial nurses: A dynamic influence on the profession[PDF file]. Retrieved from

Advisory Board (2016). Win millennials’ loyalty: Best practices for retaining young, early tenure nurses[PDF file]. Retrieved from