The Mount Sinai Morningside (MSM) and Mount Sinai West (MSW) hospitals are sister hospitals in a seven hospital enterprise in New York City. As with many hospitals and emergency departments (EDs), staffing levels have been a significant concern since the COVID-19 pandemic. In 2021 the national registered nurse (RN) turnover rate was 27.1%. This rate remains elevated, despite a decrease on a national level to 18.4% in 2023.

A story of progress and stability.

In 2021, the MSM ED had a turnover rate of 27% and MSW ED a turnover rate of 21%. These rates have since trended down, ending 2024 at MSM ED with a 12% turnover rate and MSW ED 7.25%. Today, in 2025, both sites are boasting zero vacancies. This is credited to strategic planning, talent development commitment, and strong partnerships.

A different approach to utilizing travel RNs.

MSM and MSW strategically utilized travel RNs to bridge staffing gaps. However, instead of viewing them as temporary fixes, leadership integrated them into the department culture, ensuring collaboration with permanent staff. A certain percentage of travel nurses ultimately converted to full-time roles, drawn by MSM and MSW ED’s supportive environment and strong team cohesion.

To help strengthen workplace loyalty, we try to focus our recruiting efforts on those nurses who both understand and enhance the culture. We have created and built a strong relationship with our human resources partners, and take a proactive approach. Open interview days are scheduled throughout the year, and assist with filling vacancies.

Building a pipeline through the New Graduate RN Fellowship.

In response to the national nurse staffing shortage after the COVID-19 pandemic, our New Graduate Fellowship program was initiated to create our own pipeline. This structured training and mentorship program provides a comprehensive onboarding experience, equipping new graduates with the clinical skills, decision-making capabilities, and confidence required to thrive in the fast-paced ED setting. This initiative has played a critical role in bolstering MSM and MSW ED’s workforce, ensuring a steady influx of skilled nurses who are both technically proficient and highly engaged and committed to the department’s mission.

The program has proven instrumental in building a loyal workforce, with many fellows choosing to remain at MSM and MSW ED long after completing the program. Since the program’s inception in 2022, MSM and MSW EDs have hired close to 100 new graduate RNs, with a 95% retention rate.

Turning the tide: what made the difference?

Staff recognition and engagement are important to sustaining a healthy nursing team. We send STAR Awards to the team when they go above and beyond in patient care. We take the feedback from the STAR awards and select a nursing team to be showcased on our Wall of Excellence. This is a multidisciplinary display of our team members and their comments that truly impacts our dynamics. ‘Great Catch Awards’ are given to staff members who identify potential safety issues, thus reinforcing the department’s commitment to patient safety.

Building excellence.

The teams have had numerous achievements and peer-to-peer recognitions; as a result, we submitted an Emergency Nurses Association (ENA) Lantern Award application in 2024 for MSM and MSW. The ENA Lantern Award is awarded to EDs that display excellence in education, quality improvement, nursing practice, and a successful interdisciplinary team. Our teams’ work and quality improvements have been outstanding, and resulted in the Lantern Award designation for 2024-2027 for MSM and MSW EDs.

A culture of support and wellness that makes people want to stay.

The emergency nursing team is a family and we show support and care. Staff wellness and work–life balance are emphasized for a healthy work environment. Nursing has been changing and evolving, and increasing pressures have taken a mental and physical toll on the workforce. We have implemented employee assistance programs and a Center for Stress, Resilience and Professional Growth. These resources provide mental health wellness opportunities, access to licensed support professionals, and education and tools to help manage stress. As a small example, we offer massages on a quarterly basis to the staff to help them take a breather and rejuvenate during hectic times. Wellness is integral to the health and strength of nursing retention.

Leadership that listens.

Our overall success reducing vacancies would not have happened without the support of our talent acquisition team and executive leadership. Our executive nursing leadership and physician leadership partnership are integral to our success. They work endlessly to ensure the leadership and clinical staff are well and set the standards for nursing excellence and a healthy working environment. As our internal leaders, charge nurses have been the liaisons between leadership and frontline staff. The charge nurses are integral to communicating the needs and thoughts from our frontline staff. Leadership on all levels has assisted in staff retention.

The future.

All the efforts and partners involved in our nursing retention and zero vacancy rate have played a role in helping us reach this achievement. We hope to make a zero vacancy rate our standard. This isn’t just about reducing turnover; it’s about creating an environment where nurses feel valued, supported, and empowered to grow in their careers. As MSM and MSW EDs continue to lead the way in emergency nursing excellence, we hope this story inspires EDs nationwide—showing that when staff are prioritized, your department goals are achievable. It takes a village to support and staff an emergency department and foster a healthy organizational culture for nursing growth and longevity.

Anthony Duncan, MBA, BSN, RN, CPXP
Director of Nursing
Emergency Department
Mount Sinai Morningside

Jill Frick, DNP, RN, CEN
Director of Nursing
Emergency Department
Mount Sinai West