2026 Nursing Culture Report: Current Realities and Future Directions 

Executive Summary 

Nursing culture continues to be one of the most critical determinants of workforce stability, engagement, and patient outcomes. Although the post-pandemic period has brought some stabilization, the challenges facing nurses and nurse leaders remain profound. National data indicate that RN turnover remained elevated at approximately 16.4% in 2024, with vacancy rates hovering around 9% to 10%. At the same time, nearly 40 percent of registered nurses report an intention to retire or leave the workforce within the next five years, driven largely by stress, burnout, and unmanageable workloads rather than retirement alone. (NCSBN, 2025)  

Nurse Burnout remains one of the most persistent retention issues and culture concerns. 

Nurse leaders consistently identify recruitment and retention, staffing stability, emotional health, and workplace violence as enduring challenges that shape the culture of care (AONL, 2025). New insights into psychological safety highlight that increased reporting of errors and concerns may not always indicate heightened risk. Instead, they can serve as a signal of a learning culture where staff feel safe to speak up (PLOS ONE, 2025). Taken together, these realities underscore the urgent need for intentional cultural investment in 2026 and beyond. As one clinical nurse put it: “When two of my closest colleagues left within six months, I questioned whether I could keep doing this too.” This reflects 𝐣𝐮𝐬𝐭 𝐜𝐮𝐥𝐭𝐮𝐫𝐞 in 𝐧𝐮𝐫𝐬𝐢𝐧𝐠 principles and strengthens the 𝐜𝐮𝐥𝐭𝐮𝐫𝐞 𝐨𝐟 𝐬𝐚𝐟𝐞𝐭𝐲 𝐢𝐧 𝐧𝐮𝐫𝐬𝐢𝐧𝐠. 

Introduction 

Nursing Culture is one of the most decisive forces shaping the stability and performance of today’s health care organizations. It influences not only retention but also the quality of patient care, the safety of the work environment, and the overall experience of both nurses and the patients they serve. Culture determines whether nurses feel valued, supported, and engaged, or, conversely, overwhelmed, isolated, and at risk of leaving the profession. 
 
Clinical nurses describe this reality vividly. One medical-surgical nurse recently shared, “I love patient care, but every shift feels like running a marathon without knowing if I’ll have enough teammates beside me to finish.” An emergency department nurse echoed a different but related concern: “The violence is what keeps me up at night. Not only the patients’ volatility, but sometimes families, too. I worry about my own safety and the safety of my colleagues.” These voices reflect the deeper truth that data alone cannot capture: culture is lived moment by moment at the bedside, and its strength, or fragility, directly shapes the nurse experience. 
 
Although there are signs of post-pandemic stabilization in some workforce indicators, two realities remain acute and deeply concerning: high levels of nurse turnover and a troubling rise in workplace violence (NSI, 2025; AONL, 2025). These challenges are not merely operational issues; they are cultural markers that reflect whether an organization is thriving or struggling. 
 
This report brings together national workforce data, research literature, and insights from CHCM consultants working directly with health care organizations. By weaving together this evidence with the lived experiences of clinical nurses, we aim to illuminate the current state of nursing culture and provide practical guidance for 2026. Our intention is to move beyond describing problems to offering actionable recommendations that strengthen engagement, restore stability, and foster cultures where nurses can thrive. 

Current State of Nursing Culture 

Engagement & Belonging 

Engagement and belonging strengthen when staffing stability and recognition practices are present (NSI, 2025). Nurses repeatedly express that being seen and appreciated matters as much as compensation or workload. One nurse reflected, “I feel invisible when no one notices the extra effort I put in. A simple thank you would mean a lot.” Recognition is not trivial; it is the foundation of a culture where nurses feel they truly belong. 

Psychological Safety 

Psychological safety is increasingly recognized as a core driver of both team learning and cohesiveness as well as patient outcomes. Research highlights that higher reporting rates of errors or near misses may actually indicate stronger learning cultures (PLOS ONE, 2025). As one nurse noted, “I used to be afraid to speak up about near misses and even actual errors. Now, in my unit, reporting is encouraged, and it feels safer for me and my patients.” Leaders must view these signals as evidence of trust rather than failure.  They must create environments that foster psychological safety and encourage nurses to speak up. This reflects 𝐣𝐮𝐬𝐭 𝐜𝐮𝐥𝐭𝐮𝐫𝐞 in 𝐧𝐮𝐫𝐬𝐢𝐧𝐠 principles and strengthens the 𝐜𝐮𝐥𝐭𝐮𝐫𝐞 𝐨𝐟 𝐬𝐚𝐟𝐞𝐭𝐲 𝐢𝐧 𝐧𝐮𝐫𝐬𝐢𝐧𝐠. 

Burnout & Well-being 

Burnout remains a defining feature of the current workforce crisis. Approximately 41% of nurses citing intent to leave the profession point to burnout and workload as primary reasons (NCSBN, 2025). These numbers come to life in clinical testimony: “I go home so exhausted I can’t even make dinner for my kids. I’m not burned out because I don’t care, I’m burned out because I care too much with too little support.” Sustainable workload models and well-being infrastructure are urgent priorities. Burnout remains one of the most persistent retention issues. 

Voice in Decision-Making 

A growing body of evidence connects shared/ professional governance with engagement and retention (AONL, 2025). When nurses participate in shaping decisions, their sense of ownership strengthens. One clinical nurse observed, “Being asked my opinion on scheduling was the first time I felt like my voice mattered. It changed the way I viewed my workplace.” Embedding governance within culture ensures that decision-making is inclusive, transparent, and aligned with clinical realities. These are clear 𝐧𝐮𝐫𝐬𝐢𝐧𝐠 𝐜𝐮𝐥𝐭𝐮𝐫𝐞 𝐞𝐱𝐚𝐦𝐩𝐥𝐞𝐬 that support sustainable 𝐫𝐞𝐭𝐞𝐧𝐭𝐢𝐨𝐧 𝐬𝐭𝐫𝐚𝐭𝐞𝐠𝐢𝐞𝐬. 

Trends & Insights 

Turnover is showing signs of easing, yet it continues to be a material concern for health care organizations across the country (NSI, 2025). Even small fluctuations in turnover rates have outsized impacts on staffing stability, patient continuity, and financial performance. Nurse leaders emphasize that although some progress has been made, nursing 𝐫𝐞𝐭𝐞𝐧𝐭𝐢𝐨𝐧 challenges remain one of the most pressing threats to workforce resilience. As one CNO reflected, “We can no longer celebrate small dips in turnover if we don’t also address the root causes of why nurses are leaving in the first place.” 

Alongside turnover, nurse leaders consistently rank stability, nursing retention, and safety as enduring cultural challenges (AONL, 2025). Safety concerns encompass both the physical threats of workplace violence and the psychological threats of burnout and lack of belonging. These stressors reinforce each other, creating environments where intent-to-leave remains persistently elevated despite efforts to improve staffing and well-being (NCSBN, 2025). A clinical nurse summed up the sentiment: “It’s not just the workload that wears me down. It’s the feeling that nothing is truly changing.” Burnout remains one of the most persistent nurse retention issues.  

One encouraging development is the increasing maturity of measurement practices. More organizations are broadening their cultural metrics to include not only traditional engagement surveys but also measures of psychological safety, belonging, and governance voice (PLOS ONE, 2025). These tools help leaders capture more nuanced signals of organizational health and provide richer insights into the lived realities of staff. However, measurement without meaningful follow-up can erode trust rather than build it. As one nurse leader candidly explained, “We’re finally measuring what matters but measurement has to lead to action, or nurses won’t believe change is real.” These are clear 𝐧𝐮𝐫𝐬𝐢𝐧𝐠 𝐜𝐮𝐥𝐭𝐮𝐫𝐞 𝐞𝐱𝐚𝐦𝐩𝐥𝐞𝐬 that support sustainable 𝐫𝐞𝐭𝐞𝐧𝐭𝐢𝐨𝐧 𝐬𝐭𝐫𝐚𝐭𝐞𝐠𝐢𝐞𝐬. 

The trend is clear…while the data now tell a more complete story of culture in nursing, leaders must match measurement with visible, sustained interventions. Without this bridge between insight and action, culture assessments risk becoming just another survey, rather than a catalyst for genuine transformation. 

Moving forward, organizations must shift from reactive interventions to proactive strategies that build sustainable culture and nursing of excellence. Psychological safety should not only be valued but also made measurable and teachable, allowing teams to embed it into daily practice (PLOS ONE, 2025). Stabilizing the staffing experience is equally critical, requiring not just an awareness of vacancy rates but an intentional focus on reducing schedule volatility and creating predictability in nurses’ work lives (NSI, 2025). 
 
Recognition must evolve beyond episodic gestures into robust practices that strengthen belonging across units and organizations (AONL, 2025). Professional governance should be re-energized, ensuring that nurses have meaningful decision-making influence, and that responsibility, authority, and accountability are clearly defined. As one nurse explained, “When I was asked to help write our council charter, it was the first time I felt I had a true stake in the direction of my hospital.” Building nurse manager capability in coaching and feedback will further strengthen the relational fabric of nursing teams, while aligning safety and civility protocols with executive-level backing will help establish consistency and trust. Collectively, these strategies create a blueprint for healthier, more resilient culture in nursing. This reflects just nursing culture principles and strengthens the culture of safety in nursing. These are clear nursing culture examples that support sustainable retention strategies. 

Future Direction for Nursing Culture: Recommendations for 2026 and Beyond 

As the profession looks ahead, several emerging priorities will shape the trajectory of culture in nursing. Belonging must move from episodic recognition events to embedded rituals and system-wide practices that create lasting inclusion. Governance should no longer be viewed as a separate structure but as an inseparable component of nursing culture, with responsibility, authority, and accountability serving as cornerstones. 
 
Well-being, too often relegated to optional programs, must be reframed as strategic infrastructure, influencing staffing models, civility standards, and the creation of organizational well-being divisions. Technology and artificial intelligence present new opportunities to relieve administrative burden, monitor cultural signals in real time, and amplify the nurse’s voice at both the unit and organizational levels. Finally, equity must become a defining characteristic of governance and culture, ensuring that diversity of role, specialty, background, and career stage is represented and valued. 
 
A younger nurse offered this perspective: “I want to stay in nursing. I just need to know that the system will change to make it sustainable for me.” Her voice reflects the hopes of a new generation that will inherit the culture decisions being made today. These are clear nursing culture examples that support sustainable retention strategies. 

Call to Action 

The Creative Health Care Management (CHCM) 2026 Nursing Culture Report is more than a summary. It is a reflection of what nurses are experiencing every day; the strains of turnover, burnout, and safety concerns, but also the resilience, compassion, and commitment that continue to define the profession. This dual reality is the story of nursing today: enormous pressure, paired with extraordinary strength. Burnout remains one of the most persistent retention issues. 

The findings are clear: engagement, psychological safety, and well-being are no longer optional priorities. They are essential to retaining nurses, protecting quality, and ensuring the future of care delivery. Without them, the profession risks losing not only its workforce but also the spirit of nursing itself. This reflects just culture in nursing principles and strengthens the culture of safety in nursing. 

The profession cannot afford to delay. Delay now carries measurable risk to workforce stability, quality, and trust. Leaders at every level must act by measuring culture with intention, listening deeply to frontline voices, and creating environments where nurses feel safe, valued, and empowered to influence decisions. This is not abstract work; it is the daily practice of leadership, presence, and accountability. 

The call is simple: step forward, take ownership, and build a nursing culture where nurses can thrive.  

The future of nursing depends on the choices we make today. Clinical testimony underscores this urgency: “If leaders don’t act soon, many of us won’t be here to see the changes.” 

Afterword 

At Creative Health Care Management (CHCM), our role is to stand alongside organizations answering this call. Over decades, we have developed practical supports that align directly with the needs illuminated in this report. We offer these resources not as an endpoint but as a starting point for organizations ready to take the insights from the 2026 Nursing Culture Report and translate them into sustained change. 

We believe that culture repair is not only possible but achievable when leaders commit to deliberate action. Our 90-Day Culture Repair Kickstarter equips organizations with the resources to diagnose distress, disrupt harmful patterns, and design new cultural practices that strengthen trust, belonging, and accountability. Rather than offering quick fixes, this toolkit provides leaders with structured conversations, data-driven assessments, and practical tools to move from insight to sustainable improvement. 

Our decades of work in shared governance and professional governance have demonstrated that embedding nurse voice into decision-making is the key to long-term cultural strength. Building on this legacy, CHCM has developed the Governance Maturity Framework, a structured pathway that helps organizations assess their current level of governance development and chart their progress toward fully integrated governance cultures. The Governance Maturity Framework is not only a way to assess where an organization stands in embedding governance into culture, it is also a structured pathway supported by CHCM’s proven solutions.  

At every level of governance maturity, CHCM brings tools, coaching, and practices that help organizations move forward with confidence. This framework ensures that responsibility, authority, and accountability are not abstract concepts but everyday realities, creating organizations where governance is lived, not laminated. These are clear 𝐧𝐮𝐫𝐬𝐢𝐧𝐠 𝐜𝐮𝐥𝐭𝐮𝐫𝐞 𝐞𝐱𝐚𝐦𝐩𝐥𝐞𝐬 that support sustainable 𝐫𝐞𝐭𝐞𝐧𝐭𝐢𝐨𝐧 𝐬𝐭𝐫𝐚𝐭𝐞𝐠𝐢𝐞𝐬. 

Equally essential is CHCM’s Well-Being work, which focuses on restoring meaning, connection, and civility to the nursing profession. Through our tried-and-true solutions, Reigniting the Spirit of Caring (RSC), See Me as a Person (SMAAP), and the Interprofessional Relational Model™ (IRM), we help organizations reconnect caregivers to purpose, strengthen relationships across disciplines, and foster environments of compassion and respect. 

In addition, CHCM’s Leading an Empowered Organization (LEO) is designed to strengthen leadership capacity at every level of the organization. Through this work, leaders are equipped to lead with presence, integrity, and courage, so they can build organizations that are both resilient and compassionate. 

CHCM partners with organizations to build leadership and empowerment practices that create safe and respectful workplaces, where nurses feel supported rather than depleted. Together, these approaches address the emotional and relational foundations of well-being in nursing. 

The call is clear: begin the work now. 

Download the Culture Survey for Workplace Leaders, or schedule a consultation, or invite us to present these findings to your leadership team. Together, we can create cultures where nurses thrive, and in doing so, safeguard the future of our profession. 

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References 

• NSI Nursing Solutions. (2025). National Health Care Retention & RN Staffing Report (CY2024 results). 

• NCSBN & National Forum of State Nursing Workforce Centers. (2025). 2024 National Nursing Workforce Survey. 

• American Organization for Nursing Leadership (AONL). (2025). Nursing Leadership Insight Study. 

• PLOS ONE. (2025). Systematic/narrative review on psychological safety and patient safety outcomes.