Most healthcare leaders are sure violence drives nurses out. Here is what the evidence supports, what it does not, and the number that holds up either way.
Every workforce leader in healthcare believes workplace violence is driving nurses out the door. Ask a chief nursing officer, a chief human resources officer, or a board member, and you get the same answer without hesitation: violence is a retention problem. That belief isn't wrong. It also isn't proven, and the gap between those two things matters more than most people building a business case realize.
I built the full cost model in our article on the cost of workplace violence in healthcare: four streams, three attribution scenarios, every assumption named. This one is about the single stream in that model your board already accepts, whether the evidence backs the belief all the way or not.
Turnover does not need to be discovered. It already has a dashboard, a budget line, and a name in the boardroom.
That makes it the fastest door into the whole conversation. It does not make the connection as airtight as the room assumes, and the honest version of that gap is where this one starts.
The intent-to-leave evidence is real. The observed-departure evidence is not. Dozens of studies link violence exposure to a nurse's stated intent to leave. Not one has followed exposed nurses into employment records to confirm they actually left because of it.
Turnover is already on the CFO's radar. Unlike workers' compensation claims or the Occupational Safety and Health Administration (OSHA) 300 log, nurse turnover already has an owner, a monthly dashboard, and a board-level line. That's why it's the fastest entry point into this conversation, not because it's the largest number.
One retained nurse is worth roughly $74,200, and that figure needs no attribution guess. It comes from published replacement and backfill benchmarks, not from estimating what share of turnover violence caused. That's a different, and more defensible, kind of number than the aggregate cost model in our business case article.
The newest national survey puts a harder number on intent. National Nurses United's 2025 to 2026 survey of 1,267 registered nurses found that 25.5% had considered leaving the nursing profession because of workplace violence, and 18.6% had taken time off work after an incident.
Training shows up as a protective factor in at least one study. It is not a fix on its own. A small study of emergency department nurses found those without communication skills training were over four times more likely to consider leaving after a violent episode than those with it. One study, one country, one small sample. Directionally useful, not proof.
Our article on the cost of workplace violence in healthcare showed that the real cost of workplace violence sits in four systems, each with a different owner: workers' compensation claims with risk management, the OSHA 300 log with occupational health, backfill and premium pay with the staffing budget, and clinical turnover with HR and nursing leadership. Nobody owns the sum of all four, which is exactly why almost no hospital has a real number for what violence costs it.
Turnover is the exception, and it's worth being precise about why. A workers' compensation claim sits in a system a CFO rarely opens. The OSHA 300 log gets pulled out once a year, usually when a surveyor asks for it. Nurse turnover, by contrast, is reported monthly, sometimes weekly, tied to a vacancy rate the board already tracks, and in a growing number of systems it's linked directly to nursing leadership's own performance targets. It was already on the agenda before anyone mentioned workplace violence.
That explains something that puzzles a lot of people building this business case for the first time. Executives who will argue for an hour over whether a workers' compensation benchmark applies to their hospital will nod along instantly when you say violence drives turnover. They aren't being careless. They're pattern-matching against a number they already watch constantly, and the pattern feels obvious because the number is familiar. Familiarity isn't proof. It's just the reason this conversation is easier to start here than anywhere else in the cost model.
National Nurses United's newest survey, fielded from July 2025 through May 2026 across 1,267 registered nurses in 28 states and the District of Columbia, found that 25.5% of respondents had considered leaving the nursing profession because of workplace violence, and 18.6% had taken time off work following an incident. That is a considered-leaving figure, gathered close to the point of exposure, and it's the most current national data point available on the question.
It is worth distinguishing that figure from the 19.2% figure cited in our cost model, from National Nurses United's earlier 2024 survey. The older figure reports the share of nurses who have changed or left a job due to workplace violence, across a self-selected sample. A nurse changes jobs several times over a career, so the two numbers are measuring different things and shouldn't be added together or treated as the same claim measured twice. Both are directionally consistent. Neither is a share of any single year's separations.
A smaller study adds texture, with real limits attached. Researchers surveyed 132 emergency department nurses across public hospitals in Cyprus and found that those who reported decreased work motivation after a violent episode were dramatically more likely to consider leaving the profession entirely, with a wide confidence interval that reflects how small and specific the sample was. One country, one specialty, 132 nurses. The direction of the finding matches every larger study in this category. The magnitude shouldn't be quoted as a rate that applies to your hospital.
Here is the honest limit underneath all of it, and it's the same one the cost model in our business case article flagged. Dozens of published studies link workplace violence exposure to a nurse's stated intent to leave. Not one has followed violence-exposed clinicians into actual employment records to confirm the exposure caused an observed departure, as opposed to a departure that would have happened anyway, for reasons a nurse can't or won't fully separate from the ones they name in an exit interview. Intent and departure correlate in survey after survey. Nobody has proven the causal chain end to end, and a business case built as if someone already has is one hard question away from trouble.
None of that means the connection isn't worth acting on. It means the number you build should rest on what's actually published, not on stretching a survey finding past what it measured. Here's a number that clears that bar.
NSI Nursing Solutions' 2026 report puts the fully loaded replacement cost of a staff registered nurse (RN) at $60,090, covering advertising, recruiting, onboarding, orientation, and the productivity ramp of a new hire. That cost lands the moment a nurse leaves, regardless of why. NSI also reports that the average RN vacancy takes 78 days to fill, and that a travel RN runs $31.77 an hour above an employed staff RN including benefits. Applied to the average 78-day vacancy window rather than a full year, that premium adds roughly $14,100 in backfill cost before the seat is filled.
Add the two together and one prevented separation, one nurse who would have left over a safety concern and didn't, is worth approximately $74,200. That's the replacement cost your organization avoids plus the backfill premium it doesn't have to pay while the seat sits open. The floor is $60,090, if the unit absorbs the gap through internal reassignment or overtime rather than travel staff. The rare ceiling, if a position runs vacant and travel-covered for a full year, is about $126,200. Neither of those extremes is the number to plan around. The middle figure, built from NSI's own published averages, is.