'They're invested in you': Adele Webb on what keeps Gen Z health care workers from leaving

Fifty-nine percent of U.S. health care workers say they are likely to look for job openings, interview for or switch to a new role in the next year, according to the 2026 Healthcare Workforce Barometer released Sept. 16 by The Harris Poll. Employers surveyed estimated that 39% of their employees would do the same.

Among Gen Z workers, the figure was 70%. Sixty-five percent of Gen Z respondents also said they expect to stay with one employer for five or more years, and 89% said clear opportunities for advancement are important to them. Across all employees, 26% said they have a great deal of trust that their employer will support their long-term career growth.

The survey was commissioned by Strategic Education, Inc., the parent company of Workforce Edge, which administers employer education benefit programs. Harris polled 1,514 full-time health care employees in direct patient care roles, about 40% of them physicians, nurses, nurse practitioners and physician assistants, along with 304 health care employers.

Adele Webb, Ph.D., RN, FNAP, FAAN, is health care workforce adviser for Workforce Edge and previously served as executive dean of health care initiatives at Strategic Education.

She began her nursing career in neonatal intensive care before moving to the emergency department, and she has focused on HIV since 1990. For more than three decades, her work has centered on nurse capacity building for communicable and noncommunicable diseases.

She has contributed to World Health Organization guidelines, testified before the Institute of Medicine and the White House, and received the Association of Nurses in AIDS Care Lifetime Achievement Award and the Nicholas Andrew Cummings Award for Excellence in Interprofessional Practice. She is an International Council of Nurses Global Health Fellow and a fellow of the National Academies of Practice and the American Academy of Nursing.

Related content: 59% of health care workers plan to look for a new job in the next year, Harris Poll finds

Medical Economics spoke with Webb about the gap between what employers expect and what workers say, why employer interest in artificial intelligence (AI) skills cooled and what it takes to keep Gen Z workers.

Our conversation, lightly edited for length and clarity, follows.

Before we get into the report, would you share a bit about your background?

Adele Webb: So I've been a nurse probably 45 years. I don't even know the math. I started out as a NICU nurse, went to pediatric ER and ended in HIV. I still practice, so I work with the health department in the county where I live.

I've been a nurse educator for about 40 years, and it's something I love, the opportunity to help create our next generation of nurses. But most recently I was executive dean at Strategic Education. Now I've moved into this role as health care adviser. What I'm really trying to do, what this program tries to do, is help employers build education pathways that address the health care talent shortage.

What's one finding from this year's report that surprised you the most?

Well, the one thing that really surprised me was that Gen Z nurses are willing to stay. I have six grandchildren who are nurses, and they're all Gen Z. They've been born in that period of time, and I talk to them about it. And it's different than it used to be, when you think about how people have to leave their job to get a promotion and so on. If Gen Z can really get that opportunity to do the things they want to do — career advancement, more education, certification — they'll stay.

This is the second year of the survey. What moved the most from the 2025 report, and what would you have liked to see move that has stayed stubbornly the same?

Sure. Well, what moved the most was really the adoption of artificial intelligence. Last year, I think 89% of employers felt that their employees need to be educated on artificial intelligence. That dropped this year. It's still high; in fact, I think it is about 79%. But they're starting to understand that artificial intelligence isn't going to replace nursing. It's going to augment nursing. So when you look at it that way, it gives you the opportunity to think: What needs to be augmented? How important is that to us?

But the one thing that stayed the same is the staffing shortages. We don't have enough nurses now, and they project we're going to be 500,000 nurses short by 2030. What does that mean when the population is aging, and of course nurses are aging out? But also, we just aren't filling enough spots, and so we have a real health care shortage.

Last year, 89% of employers said it was critical for employees to learn AI skills, and this year that fell to 79%. What cooled off as AI has become so prevalent?

Well, I think it is prevalent, and it's in health care, especially things around diagnosis, reading X-rays and so on. But when you look at the nurse's role, the nurse is at the bedside. When I walk in a room to give a medication, I look at how the patient's lying in the bed. What color are they? Can they answer me? Do they need to be cleaned up? Do they need to be repositioned? A robot is not going to do that.

And there's also that nursing intuition. Once you get experience, you can almost look at somebody and think, 'There's something here that's not right.' A robot's not going to do that. So while it might help us, maybe artificial intelligence can help with our charting and electronic medical records, reduce some of that burden. There's really that piece of nursing, that human touch, that it's just not going to replace.

Fifty-nine percent of health care workers said they're likely to look for a new job in the next year, but employers estimated 39%. What are employers missing?

So think about Gen Z. They are our future, right? These are going to be the kids that are taking care of us as we get older. They are very important to health care, and I think employers have a disconnect between what they think Gen Z wants and what Gen Z actually wants. So I think it's a matter of prioritizing what's important to that group, finding out what's important to that group, and if we don't do that, they're not going to stay.

Seventy percent of Gen Z workers said they expect to look for a new role in the next year, yet 65% expect to stay with one employer for five years or more, and 95% said job stability matters to them. How do you interpret those numbers?

Well, I look at some of the older nurses. When I say older, I don't mean age; I mean some of the more experienced nurses above Gen Z. They're part of that generation that I feel is always looking for something else. But Gen Z, if you're willing to invest in them, they're invested in you, and they want to stay.

I have six grandchildren who are nurses, all Gen Z, as I told you, and I talk to them about it. My grandson had a job he loved, and he's been there three years. When he got the job, he said, 'I'm never leaving this organization. I love it here.' Now he wants to get certified in his specialty area, which is the emergency room. They don't offer anything, so he's leaving.

So if we don't understand their expectations and meet those expectations, there's just too much opportunity. They're going to go.

Burnout was the top reason employers gave for why people leave, and that answer jumped 15 points in one year. What do you think is behind that?

We didn't look specifically at what the cause is, but anecdotally, I can say workplace violence and overwhelming staffing shortages. My granddaughter's a nurse in California. She works six [12-hour shifts] because they don't have enough people. Think about that. How long could you do that? She can do that because she's 26. I can't do that.

So I think burnout is attributed to several things, and I think that's what leads these nurses to wanting more: to wanting that education, to wanting to know you're invested in them, so that they can, number one, learn how to advocate for their patients, learn how to be a leader, maybe move up to charge nurse and so on, but start to make a difference in some of those concerns that are causing burnout.

Only 26% of workers said they have a great deal of trust that their employer will support their long-term career growth. What breaks that trust between workers and employers?

Well, I think first of all you have to earn it, right? Trust isn't a given. You come into the organization, and you know what your expectations are. You think you know what their expectations are, and sometimes they don't mesh. So when your expectation as a Gen Z is to have the opportunity to have them invest in your career, and they don't see it there, they're not going to trust that their employer cares about them.

And I think one thing we have to remember is it's not just that Gen Z wants more education. Gen Z wants to understand that their employer is willing to invest in them by giving them opportunities for education. I think that's a very different lens than just saying, 'I want it.' This is, 'I need you to help me. I need to trust you.'

Employees said they trust their direct manager the least of anyone when weighing a decision about their own career, at 22%, behind co-workers and the human resources department. What does that tell you about where retention strategy is breaking down?

Well, I think part of it is communication. I know we looked at this: 77% of employers say they offer [education] benefits, but only 58% [of employees] understand that those benefits are available. So there's a breakdown in them seeing the opportunity, that you are going to invest in them, that you have those programs. It's really that disconnect. I think that kind of drives the misunderstanding and the lack of communication about availability.

If an employer were to change one thing in the next 12 months, what's the one change that pays off?

I think they need to invest in their employees, and they need to look at education and career development. When I say education, I don't just mean a master's degree, right? Of course, I mean that. But there are also opportunities for certification in your field. If you're an ER nurse, you could get certified. Those are expensive, and they're a time commitment, so a lot of programs have offered flexible scheduling for courses to meet that time commitment.

But employers need to understand that offering career pathways, offering education and communicating those opportunities to their employees needs to be a strategic pillar in what they provide.

Is there anything I didn't ask about that you think is important for readers to keep in mind about this report?

Well, one thing: If the employees, the nurses, are seeing this, they need to be comfortable asking the question. If they don't know their benefits, or if they know their benefits and don't know how to use them, they need to be comfortable going to the employer and saying, 'What do we have? What can I do? What can you offer me?' When they're able to do that and get those honest answers, that trust is going to develop.