Nurses sound the alarm: EHRs are still fueling burnout and attrition in 2025

As U.S. healthcare systems double down on digital infrastructure, a clear message is emerging from the front lines: nurses remain frustrated with electronic health records (EHRs), and it’s costing hospitals more than just morale. This year, nurses continue to identify EHR usability — or the lack of it — as one of the top drivers of job dissatisfaction, burnout, and resignation.

Findings from Black Book Research’s 2024–2025 national nurse survey, which included over 9,000 nurses across multiple care settings, and the HIMSS 2025 Nursing Informatics Workforce Survey paint a consistent picture of disconnect. Nurses, despite being the most frequent users of EHRs, are still left out of key decisions regarding their design, optimization, and deployment.

EHR usability still a key challenge

According to Black Book Research, 69% of nurses cited digital documentation burden and poor EHR usability as key factors driving their job dissatisfaction or decision to leave the profession. Even more concerning, 80% said they would prefer to work for an employer with a “nurse-centered EHR,” indicating the issue is now a critical recruitment and retention factor.

This trend is especially evident among younger nurses. 2 in 3 nurses under age 40 now list the EHR experience among their top three considerations when choosing a new job, suggesting that usability has shifted from being a backend concern to a frontline career deal-breaker.

The HIMSS survey echoed these sentiments, with 60% of nurse respondents identifying usability challenges as the most frustrating aspect of EHR systems. Despite widespread digitization, nurses continue to report that the systems they rely on daily are inefficient, cumbersome, and fail to reflect their clinical workflow.

Training, design, and feedback gaps

New nurses, despite growing up in the digital age, are not immune to these frustrations. Black Book found that 88% of newly licensed nurses had limited or no hands-on experience with real-world EHR platforms during their academic preparation. Nearly all respondents agreed that nursing programs are falling short in preparing graduates for the complexity of multi-system documentation environments.

Compounding this, only 11% of nurses surveyed believe that their EHR vendor or hospital IT team actively seeks nurse feedback when implementing updates or launching new tools. That figure has barely changed in over a decade — a troubling sign that systemic oversights persist even as digital expectations increase.

Burnout, turnover, and safety risks

Many nurses describe EHR systems that seem built around the needs of physicians and administrators rather than bedside providers. Core nursing tasks like shift reporting, medication tracking, and wound care assessments are often buried within menus or split across multiple platforms. Black Book respondents identified four persistent challenges.

Redundant data entry: Nurses often enter the same information into multiple disconnected systems due to poor integration across EHRs, task management apps, and nurse call tools.

Click fatigue: Excessive navigation through rigid interfaces extends documentation time and reduces time spent with patients.

Lack of mobile access: Nearly 9 in 10 nurses expressed interest in mobile-optimized charting or voice-assisted documentation, especially in high-intensity units like EDs and surgical recovery.

Exclusion from decision-making: Many hospitals roll out updates or new features based on administrative or physician feedback, ignoring nursing input and front-line workflow impact.

These digital inefficiencies aren’t just frustrating — they also contribute directly to burnout and turnover. Hospitals with high nurse attrition rates were 3.5 times more likely to be using outdated or difficult EHR systems, the survey found.

Even where onboarding exists, nurses say that support often fails to meet their needs. HIMSS respondents noted that EHR training is often too generic, led by IT teams unfamiliar with bedside demands. By contrast, facilities that included nurses in peer-led training and clinical informatics teams saw significantly higher satisfaction and reduced errors in documentation.

Nurse-centered EHRs deliver results

In both surveys, nurses shared a clear and practical vision for improving electronic health records (EHRs). They emphasized the need for modular dashboards tailored to shift-specific needs, offering quick access to vital signs, medication logs, and alerts. Nurses also called for the integration of voice-to-text tools to alleviate the typing burden, particularly in high-acuity units. Mobile interfaces for charting at the point of care were another key request, especially for nurses working in ambulatory, emergency, and home care settings.

Additionally, they highlighted the importance of integrated handoff and rounding modules to minimize duplication and reduce miscommunication during shift changes. Nurses also advocated for establishing advisory roles, ensuring they are involved during software upgrades and system implementations.

Moreover, they expressed strong support for peer-led informatics programs, where experienced clinical staff offer EHR support, training, and real-time troubleshooting. In hospitals that have implemented these programs, nurses reported greater confidence, fewer charting errors, and lower stress levels.

Examples of progress in leading health systems

Despite facing widespread challenges within the healthcare industry, several organizations are making notable strides in improving EHR usability. Black Book’s 2025 rankings of the Top 20 nurse-rated health systems for EHR usability highlight some key examples of progress.

The Cleveland Clinic (OH) has implemented nurse-led usability redesign teams embedded directly in units, enhancing system functionality. Inova Health System (VA) stands out for its peer mentorship and nurse-specific optimization programs, fostering a supportive environment for clinical staff. Geisinger Health (PA) is advancing with mobile-first platforms and voice-enabled charting tools, improving efficiency and accessibility for nurses.

Novant Health (NC) is utilizing simulation labs for onboarding and tailoring bedside workflows to better support nursing tasks. Northwell Health (NY) has established a dedicated nurse innovation lab, collaborating with IT departments and vendors to co-develop tools that address the unique needs of nursing staff. These efforts reflect a growing commitment to improving EHR systems by prioritizing the perspectives and requirements of nursing professionals.

Each of these systems shares a key feature: nurse inclusion at every stage of EHR lifecycle, from planning to testing to deployment. This collaborative model not only improves the user experience but also supports better documentation, workflow efficiency, and patient safety outcomes.

Reframing nurses as primary users in digital strategy

For too long, EHR system design in U.S. healthcare has treated nurses as secondary users — expected to adapt to tools designed with billing, administration, or physician workflows in mind. That approach has cost hospitals dearly in terms of staff engagement and clinical quality.

In contrast, peer nations with more agile digital governance have embraced frontline clinician feedback. In countries like the Netherlands and Sweden, iterative design models and clinician-led innovation councils have led to higher satisfaction with digital tools across professions.

U.S. hospitals now face a critical inflection point. As staffing shortages intensify and the need for efficient care delivery grows, elevating the nurse experience must become a strategic priority. Hospitals that treat EHR usability as a matter of workforce well-being, not just compliance, will be better positioned to recruit and retain talent.

EHR usability is no longer optional

The data is clear: poor EHR systems are not just an inconvenience — they are a serious threat to workforce stability, care quality, and operational success. By 2025, nurse dissatisfaction with EHRs is one of the most consistent pain points reported across specialties, geographies, and experience levels.

Yet, where nurse voices are included and respected in digital planning, meaningful improvements are happening. Health systems that build around the reality of nursing work, not outdated assumptions, are showing that technology can empower rather than hinder the care experience.

The path forward involves structural change, not just new features. That means formalizing nurse involvement in digital governance, prioritizing training that reflects real-world needs, and investing in tools that make care safer, not slower.

As hospitals refine their digital roadmaps, listening to nurses may be the difference between building systems that support healing and those that silently drive more caregivers out of the profession.