Missouri hospitals have spent the past few years digging out of the staffing hole the pandemic left behind. In some ways it’s working. Across the whole hospital workforce, vacancies are way down from their worst point. Zoom in on registered nurses, though, and the picture’s messier. Nurses are still leaving faster than hospitals would like. Hiring isn’t really the fight anymore. Keeping people is.
What do the newest numbers say?
In June, ABC17 News reported on the Missouri Hospital Association’s latest workforce report. RN turnover hit 18.9 percent in 2025. The year before, it was 16.1 percent, and the MHA had already called that uncomfortably high. RN vacancies crept up too, from 10.1 percent to 10.9 percent.
Where you are in the state makes a big difference. Central Missouri had the worst RN turnover, 28.8 percent. West Central came in at 22.1 percent. The northeast region, 21.1 percent.
Widen the lens to every hospital job, not just nursing, and turnover was 23.7 percent in 2025, up from 22.2 percent in 2024. There is some good news. KRPS reported that the overall vacancy rate has dropped from 17 percent in 2021 to 10.1 percent in 2025. So hospitals are filling jobs. Holding on to the people in them? That’s the hard part.
“No longer temporary”
Jill Williams, MHA’s vice president of workforce development, put it plainly. Workforce challenges, she said, aren’t a temporary disruption anymore. They’re a bigger strategic issue that needs long-term investment and people working on solutions together.
That’s a real shift. During COVID, plenty of hospitals got by on travel nurses and a lot of overtime. Those were Band-Aids. Now the goal is a workforce that actually stays put.
And it’s not only nurses. The MHA figures Missouri needs about 1,000 more physicians, including around 600 in primary care and 160 psychiatrists. Some support jobs churn even faster than nursing. Environmental services turnover was 42.5 percent in 2025. Think about what that means on a busy floor. When the people around you keep changing, the nurses who stay end up carrying more.
Why does turnover matter so much?
Because it’s not just an HR problem. Every time a nurse leaves, somebody covers those shifts, usually coworkers who are already stretched thin. New hires need time to find their feet. And it’s pricey. The 2026 NSI National Health Care Retention and RN Staffing Report, which tracks hospitals nationwide, estimates each bedside RN who leaves costs a hospital $60,090 on average. Same report: 22.7 percent of newly hired RNs nationally left within their first year.
That first-year number is a big deal for Missouri. If new grads keep walking out after a few months, hospitals are basically running in place.
There’s a patient side to this too. A unit that’s always short, or always training someone new, has less slack when things get busy. Nurses feel it. Families notice. Teams that stick together know each other’s habits and the unit’s quirks, and they’re quicker to spot when something’s off with a patient.
So what are hospitals trying?
There’s no magic fix. A few ideas keep popping up, though.
One is growing their own. Some hospitals now start building their pipeline before nurses even graduate. Poplar Bluff, for instance, launched a Nurse Extern Program in 2024 that brings nursing students into the hospital early. Does that kind of thing work? Look at the south central region, which includes Poplar Bluff and West Plains. Nursing turnover there dropped from 40.9 percent in 2021 to 17.1 percent in 2025. That’s now below the state average.
Another is rethinking care teams. Who does what on a unit? If nurses can hand off tasks other staff could handle, they get more time for actual nursing.
Tech plays a part too. By 2024, 71 percent of Missouri hospitals had predictive AI built into their electronic health records, according to the MHA. The hope is that smarter tools take a bit of weight off busy staff.
Underneath all of it is what nurses have been asking for forever. Workloads they can manage. Flexible schedules. Fair pay. Managers who actually listen.
Job hunting as a nurse in Missouri? Ask about this stuff in the interview. Is there a nurse residency or a structured orientation for new grads? Will you get a dedicated preceptor, and for how long? How do schedules get made? How often will you be floated to other units? The answers say a lot about whether a hospital is serious about keeping people.
Missouri still needs more nurses
Retention comes first, sure. But Missouri also needs new nurses coming in. Retirements alone keep pulling experienced people out, and rural areas usually feel the pinch first.
One path that’s grown a lot is the accelerated nursing degree for people who already have a bachelor’s in another field. Career changers can become RNs in a little over a year instead of starting over from scratch. Rockhurst University’s accelerated BSN is one hybrid online nursing program in Missouri. Coursework is online. There’s a 10-day on-campus stretch in Kansas City, and clinical placements happen near where students live. It’s 16 months and 60 credit hours, with 583.5 clinical hours, and Rockhurst reports a 97 percent NCLEX pass rate for its 2023 BSN grads. Residents of Missouri, Kansas and Iowa can apply.
Local clinicals can help with retention too. Students get to know a hospital, and its people, before they’re ever hired. Hospitals get a good look at future employees. That familiarity can make year one a lot less of a shock.
What’s next?
The next couple of years will tell us whether Missouri can push that RN turnover number back down. The MHA’s next workforce report should give a clearer read on whether things have turned. Some regions have already shown it can be done. When hospitals invest in their pipeline and actually support new nurses, turnover can fall fast.
If you’re thinking about nursing in Missouri, that’s pretty encouraging. Hospitals need you. And more of them are working hard to make sure that once you’re in, you’ll want to stay.
