Strategic Foresight for Nurse Practitioner Retention

A health organization in Southern California engaged me for strategic workforce planning as part of their long-term clinical operations strategy. Leadership was confident in its ability to retain nurse practitioners (NPs), pointing to historically low turnover and a strong internal culture.

But as I dug deeper, a different picture emerged. Our workforce data review revealed that a large percentage of the NP workforce would become eligible for retirement or likely to leave within 3–5 years. That alone was concerning—but it wasn’t the full story.

At the same time, I uncovered a more urgent external threat: larger competing health systems in the region were preparing aggressive recruitment campaigns, fueled by much bigger budgets. The catalyst? A recent change in state regulations that expanded the scope of practice for NPs—combined with worsening RN shortages. NPs were about to become the most highly targeted clinical talent in the region.

Leadership’s confidence turned to clarity—and readiness.

The Approach

I delivered a compelling strategic insight report and conducted a working session with HR, leadership, and finance. We framed the NP challenge not as a crisis, but as an opportunity to act ahead of disruption.

Together, we mapped out:

• Vulnerability points by department and specialty
• Predicted external pull factors (e.g., compensation, growth, prestige)
• Internal gaps in career pathing, development, and communication
• Regulatory and workforce trend overlays.