7 Healthcare Staffing Trends to Watch in 2026

2026 is a watershed year for healthcare staffing. From the implementation of new federal acts to the deepening nursing shortage, facility leaders face competing priorities and ever-changing circumstances.

According to the AONL, Nursing Leadership Insight Study, the top 3 challenges for healthcare organizations in 2026 are all closely related to staffing, namely:

Staff recruitment and retention
Staffing in general
Emotional health and well-being of staff

The same study shows that facilities are investing in stronger staff salaries/compensation, and/or benefits such as scholarships or transportation.

These challenges support the larger trends we see across healthcare staffing, realized in stronger efforts to retain and support staff, a shift away from reactive staffing, and broader efforts to allocate budget resources toward long-term sustainability.

Here are 7 most important staffing trends we are observing that are poised to shape healthcare workforces this year—and how to turn them into opportunities.

1. The nursing shortage deepens

The demand for nurses currently outpaces the supply, a challenge that has persisted for years, is projected to peak in 2027, and could remain high for another decade.

Are nursing shortages likely to worsen?

Yes, for most states across the country, and especially in rural areas with fewer human, financial, and training resources. The aging Baby Boomer generation requires more health services and care, and the same generation is retiring from the nursing workforce.

This means a naturally growing gap, with higher demand compounded by more experienced nurses retiring.

Insights that strengthen this as a trend in 2026:

Rising demand: We’ve seen a 12% increase in the over-65 population from 2020 to 2024. Over 90% of this age group lives with at least one chronic medical condition.
Falling supply: 19% of the current nursing workforce is also over age 65 and is expected to soon retire.

Add burnout, turnover, and a shortage of nurse educators that restricts the pipeline of new nurses, and we struggle to overcome chronic facility understaffing.

While this outlook may paint an alarming picture, many healthcare systems and facilities are already building healthcare staffing strategies. They are investing in training for new nursing staff, embracing new healthcare hiring trends, and retaining experienced nurses to mitigate the worst effects of the nursing shortage.

2. A greater emphasis on employee retention

In light of the worsening nursing shortage, facilities are placing more emphasis this year on retaining their nursing staff. This is particularly important in rural healthcare settings that often have smaller talent pools.

Generation Z nurses (under 30 in 2026) are a naturally growing component of the workforce, and they are willing to walk if they don’t find meaning or balance. Gen Z nurses are prioritizing personal happiness and values over their career path.

This is a healthcare workforce trend that challenges the healthcare industry to find solutions to retention issues.

Healthcare workforce management may take a layered approach to nursing retention strategies. Retention efforts shouldn’t be prioritized after a nurse quits; instead, they should start as soon as a staff nurse begins their first day on the job.

Every moment in a nurse’s experience with a healthcare facility is a potential retention opportunity. From onboarding and training to providing necessary support with short-term, contingent workforce management, retention should be a priority.

To support retention efforts, some facilities are increasing compensation for specialized nursing roles, such as high-acuity care, pain management, or leadership roles.

A stronger focus on employee retention helps healthcare facilities stabilize staffing, reduce turnover and related costs, and sustain patient safety amid ongoing nursing shortages.

Here’s what that looks like in practice:

Prioritize safe nurse staffing ratios

In their new National Performance Goals (NPGs) for hospitals for 2026, The Joint Commission has formalized what managers and nurses have long known: safe staffing is patient safety.

2 key points of NPG #12 are:

A registered nurse (RN) should be directly providing or supervising the nursing services provided by other staff 24/7.
There should be an “adequate number” of licensed RNs, licensed practical (vocational) nurses (LPNs/LVNs), and other staff to provide nursing care to all patients, as needed.

Ignoring The Joint Commission’s NPG #12 for hospitals risks a "double blow" to your facility:

Immediate: Risk to your accreditation standing
Long-term: Acceleration of nurse turnover

Nurses who feel overworked and unable to adequately perform their jobs are more likely to leave.

Studies show that registered nurses reported burnout, inadequate staffing, and a stressful work environment as the most common reasons for job turnover among nurses.

Incorporating multiple staffing strategies to fill shift gaps is a good start for prioritizing retention.

Listen and take action

Your nurses are in the thick of it day in and day out. Provide opportunities for them to give feedback and share their opinions. Token attempts are likely to be met with lukewarm responses and have little to no effect.

Establishing clear avenues for communicating feedback and documenting follow-up and action plans is paramount. Consider a shared governance model to help nursing teams get invested.

Provide opportunities for professional development

Does your nursing staff have a clear path for advancement within your facility or health system?

Consider offering opportunities for continuing education, skill workshops, and mentorship programs to support professional growth. When nursing staff believe their job is good for their career path, they may be less likely to look to external sources of advancement. Professional development is also closely linked with nurse job satisfaction.

3. Staffing for long-term sustainability

In the last few years, there has been a notable change in attitudes toward more deliberate staffing practices after facility administrators overused travel nursing and registry staffing methods. These flexible methods helped keep facilities afloat, but we see schedulers and management shift back to more efficient staffing practices.

Recent data supports this shift in executive-level mindsets. A study from Nursa examined the opinions and attitudes of 203 hospital executives regarding hospital staffing and found that 63% believe they could offer staff more scheduling flexibility if they had a larger pool of nurses.

Additional insights from the study include:

Independent contractor value: An overwhelming 93% of healthcare executives do not believe a contracted nurse is any less valuable than a W2 nurse.
Diversified staffing approaches: More than 50% of health systems surveyed are utilizing at least four different strategies for nurse staffing.
Increased use of per diem staffing: The number of shifts filled by per diem or contracted nurses has increased by 66%.

This doesn’t mean that facilities are scaling up their adoption of contingent staffing. Instead, the study shows that sourcing clinicians from staffing platforms or agencies is serving as a supplement for longer-term staffing mindset, rather than a band-aid for unprepared facilities.

To curb high agency costs, some healthcare systems tie manager incentives like bonuses or performance reviews to metrics that reward minimizing or eliminating external agency staffing.

Facilities are reducing long-term agency dependence while increasing targeted, per-shift contingent staffing and strengthening core W-2 employee rosters. Leaders are looking for the right calibration, but per diem still has its place.

Following a decline in temporary healthcare labor spending in 2023 and 2024, locum tenens is projected to experience 4% growth, while flexible per diem nursing is expected to grow by 2% in 2026. The end results are that healthcare staffing is moving from a reactive crisis model to a proactive hybrid model designed for long-term sustainability and reduced staffing costs.

4. Increased adoption of AI and technology

The use of AI in healthcare to relieve clinicians and managers of burdensome administrative chores, or manage complex information with previously unimaginable speed, is increasingly common.

Key areas that currently benefit from AI include:

Recruitment and hiring: Using AI chatbots for onboarding and Applicant Tracking Systems (ATS) for efficient candidate screening
Clinical efficiency: Deploying AI medical scribes to automate clinical documentation and reduce administrative burdens for practitioners
Workforce management: Utilizing AI automation in healthcare staffing, such as the Nursa Intelligence Assistant, to create, post, and fill staffing gaps more quickly

Other AI tools, such as automated worker surveillance and management (AWSM) systems and clinical decision support systems (CDSS), are more controversial with nursing staff.

National Nurses United (NNU) surveyed over 2,300 registered nurses about the use of AI tools in the workplace. Here are a few highlights:

Problems with AI patient-acuity measurements: Nearly 70% of RNs whose workplace utilizes this type of tool reported that their own clinical assessments don’t match the tool’s assessment.
Problems with AI shift handoff automation: Almost half of RNs whose workplace utilizes automated handoffs claimed these reports don’t match their own assessments.
Clinicians unable to modify AI reports/assessments: Between 29 and 40% of RNs reported that when their own assessments don’t match those of the AI tool, they are unable to modify the report to reflect their clinical assessment.

AI can improve staffing efficiency and reduce administrative burden, but without nurse trust and oversight, it risks undermining clinical judgment and worsening workforce dissatisfaction.

Takeaways and action items for leaders:

Involve nurses early: Nurses have a say in decision-making, modifications, training, and implementation of AI in their workplaces.
Protect clinical judgment: Ensure all AI-driven assessments (e.g., patient acuity scores) have a clear, easy "override" function for RNs to document their professional disagreement.
Don't replace ratios with tech: Use AI gains to reduce burnout, not to justify reducing safe staffing ratios.
Focus on friction: Prioritize AI tools that solve "invisible work" (like scheduling or billing) rather than tools that increase surveillance.

5. Policy and regulatory changes

The 2025 Public Law 119-21 (H.R. 1), previously known as the “One Big Beautiful Bill Act,” is a massive budget-reconciliation bill with far-reaching implications. It brings sweeping changes to the healthcare landscape in 2026.

For staffing managers, three key provisions will have a direct impact on patient census and candidate pipelines.

Medicaid & insurance shifts

New work and pre-enrollment verification requirements, as well as cuts to Medicaid and Affordable Care (ACA) subsidies, could leave 12 million more people uninsured by 2034.

Staffing impact: Expect a surge in uncompensated care and heavier crowding in emergency departments as patients delay preventative care.

The student loan "professional" cap

Effective July 2026, the Department of Education will exclude nursing from the "professional degree" list for federal loans. This exclusion will reduce the borrowing limit from $200K to $100K.

Staffing impact: This may constrict the pipeline of new nurse graduates just as demand peaks.

Immigrant protection changes

Guidelines protecting undocumented immigrants in "sensitive locations" (like hospitals) have been rescinded.

Staffing impact: Facilities will be preparing frontline staff for potential legal/law enforcement interactions while ensuring patient trust remains intact. Will we see an increase in emergency medical care?

6. Consolidation through mergers and acquisitions

The era of the "mega-system" is here.

Facing the need to combat rising costs and expand margins, 2025 healthcare staffing news reported a wave of billion-dollar mergers that have fundamentally reshaped the landscape for 2026.

When 2 organizational cultures combine or, at times, collide, frontline staff often feel the friction first. 2026 will require managers to prioritize cultural integration alongside operational integration.

The landscape at a glance

Health system giants Northwell Health and Nuvance Health finalized a merger, creating a massive $22.6 billion system with 22,000 nurses.

Similarly, UnitedHealth Group (Optum) acquired Amedisys ($3.3 billion), and Cayuga joined Arnot to form Centralus Health.

The support industry is following suit.

Major staffing vendor players like TrueBlue, TotalMed, and StaffDNA have acquired or merged with other specialized firms (like HSP, TNAA, and Kevala) to create larger workforce platforms and expand their technology.

For staffing managers, this consolidation is a double-edged sword that requires a shift in strategy:

Some consolidated systems are creating massive internal resource pools across the system and investing in AI tools for billing, diagnosis, and smart staffing.

Manager takeaway: If your facility is undergoing a merger, treat your current staff as new hires. Clearly communicate how changes will affect their shifts and benefits.

Impact: Consolidation may create more work opportunities for nurses by expanding internal float pools, specialty roles, and mobility across a larger health system, though it may reduce choice among employers in a single market.

7. An increased emphasis on cost containment

The cuts in Medicaid reimbursements, compounded by inflation, force managers to examine every line item, and labor is the largest expense for any healthcare facility.

Cutting staff is not the solution. Managers are turning to smart labor spending.

During the pandemic and the aftermath, many facilities saved the day with travel nurse contracts to ensure safe coverage, but this came at a high cost.

Now we see less travel nursing, in contrast to more local per diem staff and internal float pool models.

A major trend for healthcare facilities is filling specific shift gaps with PRN nurses, avoiding the costs of paying for the guaranteed hours and housing stipends associated with expensive travel contracts.

Facilities are also implementing stricter controls on overtime, utilizing per diem clinicians to fill gaps at a flat rate that is often lower than the time-and-a-half cost of a burnt-out full-time employee.

Consolidated health systems (like the newly formed Northwell/Nuvance giant) are leveraging their new size to create massive internal resource pools. Staff members float among different facilities within the same system, reducing the need for external spending on labor.

Facilities are also using predictive analytics to forecast patient census with high accuracy 48 hours in advance. This allows managers to align staffing ratios precisely with demand, minimizing costly overtime and preventing overstaffing during lulls.

Impact: Facilities are optimizing staffing models, reducing reliance on expensive labor, and using data-driven scheduling to control costs without compromising care.

The state of healthcare staffing is ever-changing

These trends create opportunities for innovation, engagement, and improvement. Facilities can overcome the healthcare staffing challenges they face with targeted strategies that prioritize nurse staffing and retention, listening to nursing staff feedback, and thoughtfully implementing innovative ideas.

Looking to fill urgent call-outs, meet patient census, or add flexibility to your staffing strategy? Explore how the Nursa platform helps healthcare facilities find qualified clinicians.

Sources:

Healthcare staffing trends to watch in 2026

Key takeaways:

1. The nursing shortage deepens