Attracting and Recruiting Nursing Talent in a Competitive Market | Compendium 2.0

Chapter Table of Contents

1. Introduction: Rethinking How to Attract and Support Nursing Talent

2. Strengthening Talent Acquisition Partnerships

3. Standardizing the Recruitment Process

4. What Nurse Leaders Need Most from Talent Acquisition Teams

5. Understanding All Phases of Talent Acquisition 

6. Building a Sustainable Talent Pipeline

7. Meeting Needs Across Generations 

8. Using Technology and Metrics to Support Better Hiring

9. Designing Roles to Attract and Retain Nurses

10. Building Internal Resource Pools

11. Final Takeaways: What Nurse Leaders Can Do Now

12. References

13. Committee Members

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1. Introduction: Rethinking How to Attract and Support Nursing Talent

Recruiting and retaining qualified, competent nurses and nursing support staff is a top priority for health care organizations and nurse leaders. The nurse vacancy rate remains high at 9.6%, with more than 40% of hospitals reporting rates above 10%. With organizations needing an average of 83 days to hire an experienced nurse, health care leaders need new strategies to compete for talent in a tight labor market (NSI Nursing Solutions, Inc., 2025). 
 

2. Strengthening Talent Acquisition Partnerships

Talent acquisition (TA) teams and nurse leaders achieve better results when they work closely together, delivering consistent messaging throughout the recruitment process while speaking authentically to what matters most to candidates. 

For example, one health system reduced its vacancy rate from 20.9% in July 2021 to 8% in September 2022 after nursing leaders and recruitment teams partnered to develop a candidate-centric hiring recruitment and process, among other initiatives (Tellson et al., 2023).

At a more granular level, TA teams benefit from a direct connection to a nurse or unit liaison who can explain the open role’s day-to-day realities, clarify expectations and answer questions. Pairing recruiters with a “buddy” nurse, for example, gives them a reliable point of contact for questions about unit culture and role expectations. Activities such as cross-functional huddles, informal meet-and-greets and team-building exercises often help these groups build trust and coordinate efforts. 

Once partnerships are in place, teams must align on process.
 

3. Standardizing the Recruitment Process

In successful partnerships, TA teams typically lead the recruitment process, while nurse leaders play an active role in shaping messaging, vetting candidates and setting expectations. 

Still, TA teams benefit from a standardized process that maps the candidate journey from application to start date.

Teams should clearly delineate who handles initial screening, interviews and final decisions. This reduces confusion during handoffs, particularly the important transition period from offer acceptance to preboarding, where candidates may feel forgotten and rescind acceptance of the job. One doctoral study of long-term care recruiters found that without proactive follow-up, candidates often disengaged — especially if there were delays in communication or hiring decisions (Chester, 2019). Establishing a clear escalation process, such as having the hiring manager directly contact top candidates within 24 hours of an offer, helps close priority hires quickly.

Communication tools such as scripting guides or reference cards can also support recruiters in their candidate interactions. Studies in clinical research recruitment demonstrate that tools such as hiring workflows, checklists and standardized guidelines can reduce bias, improve candidate matching and shorten time to engagement (Mokhtech et al., 2022).

Understanding what nursing candidates are looking for within the role — especially when it comes to work-life balance — helps teams create roles that reduce drop-off and support retention.
 

4. What Nurse Leaders Need Most from TA Teams

Hiring processes grounded in the realities of the role help ensure new staff arrive with realistic expectations.

Set scheduling expectations early

Work-life balance is a top priority for today’s nurses and a powerful tool to attract candidates, so much so that Wolters Kluwer (2024) listed it as its top way to attract nurses. Offering staff flexible scheduling options or allowing nurses to select their own shifts can directly improve that balance.

For this reason, organizations have created flexible roles and staggered shifts, especially in hard-to-staff units. For example, Cleveland Clinic created a Nursing Workforce Flexibility Taskforce to help leaders assess unit needs and select appropriate scheduling options. Flexibility initiatives included staggered shifts, shorter or split shifts, team-based scheduling and split registered nurse positions that allow nurses to work across units (Cleveland Clinic, 2023). 

By addressing flexible scheduling early in the TA process — clarifying shift structures, discussing weekend and holiday rotations and outlining any options for part-time, self-scheduling or reduced hours — both sides enter the relationship with shared expectations. 

When candidates have a clear picture of what’s possible, they’re better able to assess fit. At the same time, nurse leaders can avoid situations where new hires feel surprised or misaligned after joining the team.  

Clarify expectations around accountability

While flexibility is important, nurse leaders remain responsible for maintaining team reliability. Attendance, timeliness and equitable distribution of responsibilities all affect morale and patient care. Leaders are concerned about how to hold team members, especially new hires, accountable — without creating friction or turnover risk. 

Setting expectations upfront helps. Candidates should understand the team’s norms around shift coverage, call-ins and performance standards. Clear communication during recruitment makes it easier to hold staff accountable later because the groundwork has already been laid. 

Acknowledge the effort behind each hire

TA teams undergo considerable effort to bring one strong candidate through the door. Recruiters and managers may screen dozens of applications, conduct multiple interviews and coordinate internal reviews just to get to one hire. This effort is often invisible, but it affects capacity, timelines and staffing. 

Reduce ghosting through better communication

Nurse leaders report increasing instances where candidates accept an offer, and then stop responding, fail to show up on their start date or cut off communication without explanation. Ghosting can happen for many reasons. Some candidates receive competing offers, while. others may feel overwhelmed or anxious about the role and back out rather than face an awkward conversation. A lack of timely communication from the employer can also contribute, leaving candidates uncertain or disengaged.

This behavior has consequences. Ghosting disrupts onboarding, wastes time and delays care coverage. It also undermines trust. 

To reduce ghosting and improve retention, hiring teams should set clear timelines, provide regular updates and build rapport with candidates throughout the hiring journey. Open communication, realistic timelines and mutual respect can prevent last-minute drop-offs and lay the foundation for stronger, more stable hires. 

These concerns highlight the need to rethink how roles are designed, especially as nurses’ expectations shift.
 

5. Understanding All Phases of Talent Acquisition 

Recruitment metrics provide a window into how well the process is working. The following indicators help teams assess the health of their hiring strategy (Lay, 2020).

• Time to fill tracks how long a position remains open, from first contact to signed offer.
• Offer acceptance rate reflects how many candidates accept offers and may signal whether compensation, communication or timelines need adjustment.
• Qualified candidates per opening reveals how many applicants are a strong fit after initial screening and can help forecast the volume needed to make one hire.
• Cost per hire captures total internal and external expenses involved in recruitment.

Key Takeaways:

• Shared data helps leaders understand what’s working, identify gaps and adjust their efforts to improve hiring outcomes.
• Long gaps between interviews, slow follow-up after interviews or offers and unclear timelines during onboarding can cause candidates to disengage or accept other offers. TA teams can avoid this by communicating quickly and frequently with all parties throughout the process.
• Personalized offers show that the organization is listening to candidates. When hiring teams customize each offer based on what the candidate values — such as schedule flexibility, role growth or team culture — they can increase the likelihood of acceptance and help candidates envision a long-term fit.
• Authentic employee voices help attract candidates who are more likely to connect with the organization’s culture.
• Organizations can amplify those voices by building a strong social media presence and encouraging staff to share their own experiences.
• When TA teams understand the clinical area, team culture and patient population of the units they support, they are able to communicate more clearly and answer questions more accurately to potential candidates, ultimately helping to reduce the risk of mismatched expectations that can lead to early turnover.
   

6. Building a Sustainable Talent Pipeline

Nurse leaders and TA teams need a clear view of the local talent pipeline. Staying connected to nursing schools and communities helps them reach candidates early.

Starting early: pre-nursing school programs

Pre-nursing school pipeline programs introduce the nursing profession to prospective candidates early in their educational journeys. Partnerships with educational institutions, community outreach efforts, mentorship opportunities and hands-on clinical learning programs can positively influence the volume and preparedness of students entering nursing education.

For example, a Georgia-based health system partnered with a local school system to create a five-day summer camp that introduces high school students to health care careers. Surveys showed that 40% of the 150 participants now want to pursue nursing careers and 33% are interested in becoming physicians, while 60 students from the first group in 2022 have already been hired into paid care assistant roles after graduation. The entire program costs less than $15,000 to execute and allows the health system to build relationships with future nurses while gaining immediate staffing support from enthusiastic young employees who are already familiar with the organization.

Key takeaways:

• Early engagement through affordable educational camps significantly increases student interest and recruitment into health care roles.
• Low-cost, high-impact initiatives can yield measurable outcomes including immediate workforce contributions and clear pathways into health care careers.
• Direct partnerships with local education systems strengthen the local talent pipeline.

Supporting nursing students: pre-licensure programs

Pre-licensure programs help transition nursing students from academia into professional practice and can help organizations increase retention and reduce onboarding burden.

For example, after conducting a community needs assessment to understand local workforce gaps and student interest, a Pennsylvania-based health system partnered with a local college to create a training pipeline for high school students — many of whom are the first in their families to attend college. The assessment revealed demand for entry-level clinical roles and interest among students in health care careers, helping the health system design a relevant program.

Beginning in their sophomore year, students complete 1,000 hours of classroom and hands-on training to become patient care technicians (PCTs), medical assistants (MAs) or surgical technicians. In their senior year, they shadow clinical staff, attend a skills boot camp and complete job readiness sessions. Upon graduation, eligible students are hired into paid roles at the health system and enroll in a local clinical training program, working full-time while attending college at night. The health system reports immediate benefits from filling high-need support roles, while students gain career pathways and income. 

Key takeaways:

• Conducting a community needs assessment helps tailor pipeline programs to local workforce gaps and student interests.
• Structured, early employment opportunities, such as PCT or MA roles, build clinical readiness and reduce onboarding time.
• Targeted programs expand the future nursing workforce.
   

7. Meeting Needs Across Generations 

Professional motivations, expectations, and communication preferences often reflect both generational influences and life stage. For example, Millennials and Generation Z tend to value workplace flexibility, mission alignment, and opportunities for growth, while Generation X often emphasizes work–life balance and autonomy. Baby Boomers, though gradually exiting the workforce, are known for their commitment, optimism, and desire to leave a legacy (Mellum, 2024). 

With this in mind, a health system in Georgia is building flexible, multigenerational talent pipelines that align with a range of career goals and learning preferences. A key component of this strategy is cross-training, or upskilling existing nurses in a second preferred specialty to create more adaptable roles. For instance, an emergency department nurse may be trained to work in the ICU.

To further strengthen the pipeline, the health system is partnering with a local nursing school to launch a clinical instructor program. By embedding seasoned clinical instructors in care settings as mentors and preceptors, the initiative helps early-career nurses develop and clinical instructors stay connected to hands-on nursing at the bedside, rather than moving into non-clinical or purely administrative roles.

By offering flexible roles, meaningful work and professional development opportunities to Millennial and Generation Z nurses, the health system's pipeline speaks directly to the priorities of younger generations. These strategies create a more adaptable workforce while building pathways for the next generation of nurses.

Key takeaways:

• Cross-training nurses in more than one specialty helps both the system and the staff. It gives leaders more staffing flexibility and gives nurses new skills and career options.
• Experienced nurses can play a powerful role in supporting the next generation. Placing clinical instructors at the bedside helps new nurses learn on the job and keeps veteran staff engaged.
• Stronger ties between schools and hospitals help students move into practice more smoothly. Bringing education into real care settings may ease the transition and strengthen early-career support.
   

8. Using Technology and Metrics to Support Better Hiring

TA teams can use hiring metrics — such as how many candidates complete applications, how long it takes to fill roles and which job platforms generate the most applicants — to improve their processes and attract more qualified applicants.

Optimize job postings for search and fit

Today, most nurse candidates search for jobs through digital platforms such as Indeed, LinkedIn or employer career sites. The quality of that experience depends on how easily candidates can filter for roles that match their needs. Job postings must feature clear, searchable details that include the clinical area, shift, hours, education requirements and experience factors that directly affect a nurse’s ability to assess fit and readiness for the role. 

TA teams should regularly review and update job postings to align with common search filters. This approach increases their chances of reaching qualified candidates and helps them focus on applicants who are a strong match. 

Employers should also make sure their career sites include filtering tools, such as dropdown menus, checkboxes and side-panel filters, which let candidates sort openings by job type, location, schedule, department or experience level. 

Streamline applications with the right ATS features

An applicant tracking system (ATS) is a central hub that helps TA teams work smarter and faster. By automating routine tasks, tracking performance metrics and integrating with the Human Resources Information System (HRIS), the ATS simplifies workflows across departments and reduces administrative burden.

To support both recruiters and candidates, a modern ATS should include the ability to upload a resume with auto-fill, candidate referral tools, automated offer letters, timestamp tracking and storage for documents such as credentialing records. The ATS should also give current employees a way to explore internal job openings, which helps organizations retain talent.

Reduce drop-off with a frictionless candidate experience

Reducing friction in the application process is key. Employers can lower candidate drop-off rates by requesting only essential information upfront, then collecting detailed data later during background checks and credentialing. In a competitive hiring market, small improvements like these can make a big difference in securing top talent.

Use data to identify bottlenecks and improve strategy

TA teams need real-time data to improve hiring outcomes. When HR and IT teams configure the ATS and HRIS to track key metrics automatically, they eliminate manual data entry and make reporting more accurate and efficient. These systems can surface valuable information, such as which departments have the highest vacancy or turnover rates or where credential requirements are causing delays.

Metrics such as time to fill, offer acceptance rates and interview-to-hire timelines reveal where slowdowns occur and whether candidates remain engaged. Tracking how many candidates move through each stage, from referral to hire, shows whether outreach efforts are effective or need adjustment. Candidate details such as clinical rotations, referral status, rehire eligibility or contingent experience help identify which talent pools are most successful and highlight where to focus future recruiting efforts.

Workforce trends such as retirement projections, seasonal hiring needs and changing demographics provide important context for setting hiring targets and planning recruitment cycles.
 

9. Designing Roles to Attract and Retain Nurses

Flexible roles help health systems attract and retain nurses by offering options that fit different life and career stages without compromising shift coverage or staffing stability. This section outlines practical ways to build flexibility into the workforce.

Engaging students 

As noted earlier in the chapter, health care organizations often partner with local colleges and universities to hire nursing students into aide or intern roles. These positions help students gain familiarity with clinical environments, build relationships with unit staff and ease the transition to full-time nursing roles. Offering flexible scheduling options that accommodate school demands, early placement for high-performing interns and scholarships tied to hard-to-fill roles can strengthen the pipeline and improve retention after licensure.

Supporting internal mobility

Early-career nurses increasingly seek career growth and new challenges. Without clear advancement opportunities, they may leave for other units or organizations. Creating internal pathways such as clinical ladders, residency programs and succession planning initiatives signal long-term investment to potential hires and help retain motivated staff. For example, research shows that organizations with a clinical ladder program have high rates of job satisfaction and retention among participating nurses (Hansen, 2023).

Converting temporary staff to permanent hires

Organizations that treat temporary staff as part of the team increase the likelihood of hiring them permanently. Some managers send welcoming letters to travel nurses or per diem agency clinicians, assign them to “buddies” and encourage them to participate in team events. 

Reengaging retired nurses

As experienced staff exit the workforce, many organizations are reengaging retired nurses. Flexible options such as shorter shifts, job sharing or four-hour coverage during peak times allow these clinicians to contribute without returning to full-time practice. Retired nurses can also help onboard new hires and help them develop through precepting. In some cases, they serve in paid, as-needed roles; in others, they return as volunteers. 

Beyond individual role design, many systems are scaling flexibility through internal resource pools.
 

10. Building Internal Resource Pools

Health care organizations are using internal resource pools, including float teams, internal travelers and seasonal surge staff, to reduce dependence on agencies while offering nurses more flexibility. These pools allow leaders to scale staffing based on demand and pilot new models, such as contract-to-perm conversion or internal mobility.

• Facility-based float teams allow nurses to work within one hospital across different units in their specialty. Nurses have a consistent "home base" location but experience varied work environments. This appeals to experienced nurses who want routine combined with variety, often with a small financial incentive.
• Multifacility float teams enable specialized nurses to work across multiple locations within a health system based on patient volume and staffing needs. This model works particularly well for critical care, post-anesthesia care and emergency departments. Nurses maintain their specialization while gaining schedule flexibility and varied environments.
• Seasonal and surge pools help organizations respond to predictable volume fluctuations. For example, a nurse might work 36 hours per week during high-volume winter months and 12 hours per week during slower summer periods. This arrangement addresses peak staffing needs while allowing nurses time for family commitments.
• Internal travel pools offer nurses the scheduling autonomy and variety of travel nursing while staying within one health system. These roles attract nurses seeking flexibility without the disruption of relocating, helping organizations retain talent that might otherwise leave for travel positions.

These models work best when built on solid infrastructure and informed by data.
 

11. Final Takeaways: What Nurse Leaders Can Do Now

Focus on one or two strategies at a time to sustain your momentum in attracting and retaining nursing talent. 

Nurse leaders can strengthen recruitment and retention by focusing on a few high-impact strategies. Start by partnering strategically with TA teams to set clear expectations during the recruitment process. Build your talent pipeline early through local partnerships and create roles that match the priorities of today's workforce. Use data to track time to fill  and offer acceptance rates and optimize job postings with searchable details. Finally, focus on one or two strategies at a time to sustain your momentum in attracting and retaining nursing talent. 

12. References

AAG/H Nurse Recruitment in 2025: 6 Must-Follow Best Practices https://www.aag.health/post/best-practices-nurse-recruitment

Chester, J. M. (2019). Strategies HR recruiters use to recruit long-term care nurses (Doctoral dissertation, Walden University). Walden Dissertations and Doctoral Studies. https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=8822&context=dissertations 

Cleveland Clinic. (2023, February 21). Flexible scheduling helps attract and retain nurses Consult QD. https://consultqd.clevelandclinic.org/flexible-scheduling-helps-attract-and-retain-nurses

Hansen, V. (2023). Evaluation of a revised clinical ladder program in addressing clinical competence and performance, accountability, professional growth, rewards and benefits, job satisfaction and engagement, and autonomy and decision making (Doctor of Nursing Practice project, The George Washington University). Health Sciences Research Commons. https://hsrc.himmelfarb.gwu.edu/cgi/viewcontent.cgi?article=1136&context=son_dnp

Lay, A. (2020, January 1). Calculate nurse recruiting metrics that matter with these formulas. Nurse.com. https://www.nurse.com/solutions/blog/calculate-nurse-recruiting-metrics-that-matter-with-these-formulas

Scholz Mellum, J., (May 10, 2024) Generational Harmony in Nursing OJIN: The Online Journal of Issues in Nursing Vol. 29, No. 2. https://doi.org/10.3912/OJIN.Vol29No02PPT30

Mokhtech, M., Jagsi, R., Mailhot Vega, R., Brown, D. W., Golden, D. W., Juang, T., Mattes, M. D., Pinnix, C. C., & Evans, S. B. (2022). Mitigating bias in recruitment: Attracting a diverse, dynamic workforce to sustain the future of radiation oncology. Advances in Radiation Oncology, 7(5), 100961. https://pmc.ncbi.nlm.nih.gov/articles/PMC9436705/

NSI Nursing Solutions, Inc. (2025). 2025 National health care retention & RN staffing report https://www.nsinursingsolutions.com/documents/library/nsi_national_health_care_retention_report.pdf

Tellson, Alaina et. al Closing the Workforce Staffing Chasm by Breaking Boundaries: Innovative Partnerships and Strategies Between Recruitment and Nursing Nursing Administration Quarterly, 2023 https://www.nursingcenter.com/journalarticle?Article_ID=6690984&Journal_ID=54011&Issue_ID=6690879

Wolters Kluwer. (2024). Ten recruiting strategies to attract nurses https://www.wolterskluwer.com/en/expert-insights/ten-recruiting-strategies-to-attract-nurses

13. Committee Members

Committee Chair: 

• Meredith Foxx, MSN, NEA-BC, senior vice president and chief nursing officer, Cleveland Clinic

Committee Members:

• Patricia Artley, DNP, NEA-BC, chief clinical officer and CNO, Medical Solutions
• Carol Bradley, MSN, RN, senior vice president and chief nursing officer, Legacy Health System
• Amanda Wheeler, MBA, RN, vice president, insourcing and workforce optimization strategy, Healthcare Workforce Logistics