By Rose O. Sherman, EdD, RN, NEA-BC, FAAN
Following a recent conference session, a labor and delivery manager spoke with me about a conflict she was having with her director. Here is her story:
A new hospital opened several years ago in our area. We are in direct competition with them in all specialties, including Labor and Delivery. They hired several of our very experienced L&D nurses with significant sign-on bonuses two years ago. Well, the time for these nurses to finish out the contract on the bonuses is up in a few months. At least three of them want to return. They only moved to that facility because they had debt and needed the bonus money. All are excellent nurses, and I need them right now to eliminate the travel contracts and stabilize my staffing. My director does not believe in rehiring people. She told me she had bad experiences doing this in the past, but we are in a different place with nurse staffing today. She thinks they were disloyal, and if they did it once, they will do it again. All three were great nurses and eligible for rehire.
As we discussed her dilemma, I told her that her director’s viewpoint is one many leaders have held at least historically. But we are in a different time, and there can be a strong business case for a robust rehire program. Consider the following evidence on the current nursing workforce:
- According to 2025 workforce data (ADP, NSI), 35% to 42% of all new healthcare hires are now former employees returning to the organization. This is a sharp increase from historical norms.
- Current data suggests that up to 60% of RNs who leave for “better pay” or “less stress” find that the new role has the same systemic issues (short staffing, acuity), just with a different logo.
- A study published in BMC Nursing and NIH identified “Career Decision Regret” as a measurable psychological state. It found that nurses who left for “greener pastures” often experienced higher “decision regret” when the new role failed to offer the promised flexibility or culture, leading to a rapid return to their original employer, where they had social capital and tenure.
I suggested that she put together the business case for what she was proposing using the following data:
- A “Road to Rehire” (or Alumni/Boomerang) program is one of the highest-ROI strategies a hospital can deploy because it targets a talent pool that is pre-vetted and pre-trained.
- Cost-per-hire for a boomerang nurse is estimated to be 50–70% lower than for a new external candidate.
- A standard new graduate or external hire requires 12–16 weeks of orientation. A rehire often needs only 2–4 weeks to get up to speed on policy changes, as they already know the EMR (Epic/Cerner), the facility layout, and key stakeholders.
- Because the rehire requires less hand-holding, your senior nurses (who are arguably suffering from preceptor fatigue) are not pulled away from patient care as frequently.
- When a nurse leaves for a competitor and then chooses to return, it sends a powerful psychological message to the remaining staff: “The grass was not greener on the other side.”
Interestingly, today many organizations have specific rehire policies and processes that often include the following:
- Bridge of Service: If a nurse returns within 12 months, their tenure (years of service) is bridged. This means they do not restart at the bottom of the PTO accrual tier or lose their retirement vesting status.
- “No Questions Asked” Window”: A policy where, if a nurse regrets their resignation within 30–90 days, they can return to their role without going through a complete re-application process.
- Alumni Community: Creation of a quarterly “Alumni Newsletter” that highlights facility wins, new technology, and open leadership roles, keeping the door psychologically open.
- Nurse Manager Follow-up: Nurse managers follow up with all valued exited employees in the first 60 days to invite them back.
The ability to have this as an option open to any leader is extremely important but especially in Labor and Delivery. Recent NSI data indicates that it is one of the toughest specialties to recruit for and that new graduate turnover is very high because of the maternal acuity now seen in hospitals across the country. Labor and delivery has become a combination of an ICU, ED, OR and L&D. Her director’s mindset is one that was very common a decade ago but may not be the right approach today. A rehire could very likely be your best hire in today’s turbulent healthcare environment.
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