How Student Attrition Affects Programs, Students, and the Nursing Workforce

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At first glance, nursing program retention has two potential outcomes: graduation or attrition. When retention systems fail, the most immediate consequence is student departure or delay. In fact, over half of nursing programs report on-time graduation rates below 70%.¹ Many of these struggling students are would-be nurses who may never join the workforce.

Unfortunately, that’s not the entire story. Not even close. The real impacts of student retention stretch far beyond the individual student, influencing program performance and the future of the nursing workforce itself. Taken together, these individual successes and failures can have serious implications for the healthcare system.

Thankfully, the powerful ripple effects also mean that significant improvements to student retention can send shockwaves throughout the system. They can create new opportunities for students, bolster program credibility, and strengthen the pipeline of practice-ready nurses.

Of course, the retention story—and the far-reaching impacts that follow—start at a much smaller scale. It begins with individual nursing students, including the challenges and opportunities that shape their path through nursing education.

The Student Impact

At their most basic level, student attrition and retention are personal outcomes with personal consequences. To start, there are financial repercussions for lack of completion, such as the loss of tuition, fees, and supplies already invested in education. On top of that, many students might leave their programs with new student loan obligations, minus the increased income and strong long-term employment demand that comes with being a nurse. Even for those with licensure, student debt remains a pressing issue.²

But financial consequences are only the beginning. Leaving a nursing program can postpone career goals in general and delay professional progress during career transitions. For some, attrition can also affect overall professional identity, which research suggests is strongly linked to continued student persistence.³ In other words, these consequences can last well beyond a single success or failure.

The Program Impact

For nursing programs, retention is far more than a singular outcome. Student attrition influences cohort performance, institutional reputation, financial sustainability, and a program's ultimate capability to contribute to the nursing workforce. Each of these impacts has its own effect on nursing programs, which is why it's so important for educators and administrators to understand the entire retention story.

The Workforce Impact

The nursing workforce is powered by a pipeline under pressure. What does that mean? After several years of contraction, many high-level metrics have rebounded—with two notable exceptions.⁴

The first is that educational capacity is still constrained, with more applicants turned away every year.⁵ The second is that the number of PhD candidates continues to shrink, meaning fewer educators and researchers will join the workforce of the future. The consequences are twofold: fewer practice-ready nurses and fewer graduate-level professionals to push the industry forward.

This doesn’t indicate an immediate crisis. It doesn’t mean massive shortages. It does, however, mean that nursing and nursing education are particularly vulnerable to anything that might put a strain on the workforce.

It’s a pipeline under pressure.

Why Remediation Makes a Difference

Much like retention, remediation isn’t a singular outcome. For some, it’s win or lose. A student is already struggling, and remediation efforts will solve the problem—or, they won’t. This approach to remediation is entirely reactive, addressing academic challenges only after warning signs have become difficult to ignore.

The best remediation efforts do not confront something that is already a problem. Instead, they use data and predictive analytics to quickly confront gaps in knowledge as soon as they appear. By identifying risks early, programs can intervene when students still have multiple pathways to success. In fact, research suggests that early identification strategies may help institutions support struggling students well before their story ends in attrition.¹¹

For nursing programs today, it isn't about simply providing remediation. It's about providing the right support at the right time. That's why institutions are increasingly turning to the data-driven tools from ATI to identify risk, personalize interventions, and give faculty clear insights into student progress. These systems make remediation proactive instead of reactive, which means students are more likely to persist with learning and recover from setbacks.

Why Retention Is an Investment in the Future

Student retention is also not focused on a single outcome. The consequences extend far beyond a single number or percentage.

For students, retention can mean the difference between reaching a career goal and abandoning one. For nursing programs, it can mean the difference between a glowing reputation or floundering enrollment. For the healthcare industry, student retention directly affects the number of practice-ready nurses available for a workforce that is always under stress.

Taking action on retention is a strategic investment in the future of nursing and nursing education. Every student who stays on track is another opportunity—for themselves and the organizations they support. In this sense, retention is doing more than keeping students enrolled in programs from year to year. It’s strengthening the future of nursing, one student at a time.

ATI and Stronger Systems of Student Retention

Graduation rates tell you one thing: the final metric of success and failure. What they don’t show you is how that metric was produced and what it ultimately means. They don’t show all the factors affecting attrition and how those different pressures played out from cohort to cohort. They don’t show the impact that retention has on students, educators, and the nursing workforce.

It’s a simple percentage, but it hides a much more complicated truth: The ripple effects of retention are vast, and remediation is one of the only ways to keep them in check. That's why the most successful nursing programs are investing more in retention, both internally and through partnerships.

ATI helps programs identify risk early to provide meaningful interventions before students fall behind. With industry-leading assessments, predictive analytics, multimodal content, personalized remediation, and AI-enhanced support, ATI builds stronger retention systems. In fact, programs that partner with ATI experience an average student retention rate of 90%, demonstrating what's possible when retention becomes proactive and driven by data.¹⁰

References

1. Spector N, Silvestre J, McIntosh Q, Kaminski-Ozturk N. National Nursing Education Database: 2023–2024 Aggregate Data. National Council of State Boards of Nursing; June 2025. https://www.ncsbn.org/public-files/2023-2024-AggregateData-digital-v2.pdf
2. University of Michigan News. High Nursing School Debt, Proposed Education Loan Caps Threaten US Health Care Access. Jan. 26, 2026. https://news.umich.edu/high-nursing-school-debt-proposed-education-loan-caps-threaten-us-health-care-access/
3. Mei XX, Wang HY, Wu XN, Wu JY, Lu YZ, Ye ZJ. Self-Efficacy and Professional Identity Among Freshmen Nursing Students: A Latent Profile and Moderated Mediation Analysis. Frontiers in Psychology. 2022;13. doi: 10.3389/fpsyg.2022.779986
4. American Association of Colleges of Nursing. Schools of Nursing See Enrollment Increases Across Most Program Levels, Signaling Strong Interest in Nursing Careers. May 7, 2026. https://www.aacnnursing.org/news-data/all-news/article/schools-of-nursing-see-enrollment-increases-across-most-program-levels-signaling-strong-interest-in-nursing-careers-1480
5. Walker A. Record 93,000 Nursing Applications Turned Away in 2025 — Despite Rising Enrollment. Nurse.org. May 15, 2026. https://nurse.org/news/nursing-applications-turned-away-2025/
6. Walker A. Record 93,000 Nursing Applications Turned Away in 2025 — Despite Rising Enrollment. Nurse.org. May 15, 2026. https://nurse.org/news/nursing-applications-turned-away-2025/
7. Spector N, Silvestre J, McIntosh Q, Kaminski-Ozturk N. National Nursing Education Database: 2023–2024 Aggregate Data. National Council of State Boards of Nursing; June 2025. https://www.ncsbn.org/public-files/2023-2024-AggregateData-digital-v2.pdf  
8. National Council of State Boards of Nursing. NCSBN Research Highlights Small Steps Toward Nursing Workforce Recovery; Burnout and Staffing Challenges Persist. April 17, 2025. https://www.ncsbn.org/news/ncsbn-research-highlights-small-steps-toward-nursing-workforce-recovery-burnout-and-staffing-challenges-persist
9. American Nurses Foundation. Pulse on the Nation’s Nurses Survey Series: Annual Assessment Survey. November 2022. https://www.nursingworld.org/practice-policy/work-environment/health-safety/disaster-preparedness/coronavirus/what-you-need-to-know/annual-survey--third-year/
10. ATI Nursing Education. Data collected from ATI graduate cohorts in 2024-2025. Based on standardized program entry and completion requirements for RN programs. Results validated by ACS Ventures
11. Georgieva M, Henshall C, Scott I, Merriman C. Evaluation of an Intervention Package Developed to Reduce Pre-Registration Nursing Student Attrition Rates: A Mixed Method Study. Nurse Education Today. 2025;146:106531. doi:10.1016/j.nedt.2024.106531