Why reliable transportation is the new lever for workforce retention

I spent many years running a float pool of more than a thousand nurses. It was the most humbling leadership experience of my career, not because of budgets or staffing ratios or emergency surges, though we had plenty of those, but because of the countless, invisible barriers that determined whether a nurse actually made it to a shift. If we want to rebuild and sustain our nursing workforce, we must make one fundamental shift: Stop treating transportation as a personal problem and start recognizing it as a workforce strategy.

People assume nurses leave the profession because the work is hard. What they often miss is that burnout does not begin at the bedside. For many nurses, it begins in the dark, early hours of the morning, sitting behind a steering wheel with drowsy eyes, or standing alone at a bus stop hoping the last route of the night still shows up. 

From 2020 to 2021, more than 100,000 nurses left the profession, accelerated by the pandemic. Today, even in 2025, 65% of nurses still report burnout, and nearly half say they would not choose nursing again. We talk a lot about pay, staffing, and culture, but one of the most persistent obstacles is one we rarely name out loud: transportation. 

Transportation is the gatekeeper of our workforce. In my years leading a float pool, I learned this truth the hard way. 

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Why reliable transportation matters

Most people do not realize that over 80% of healthcare workers are women, many of whom are primary caregivers. When your shift starts at 7 p.m., child care is unpredictable, and your car makes a strange sound on the highway, you start calculating whether picking up that next shift is worth the risk. Transportation does not just determine when nurses work. It shapes whether they can work at all. 

I still remember one nurse, Maria, an incredible CNA who regularly worked nights. One winter, she told me she had stopped working evening shifts because the bus near her house no longer ran past 10 p.m. It wasn't that she didn't want to work, she simply couldn't do it safely anymore.

Maria was not alone in her concerns. Research repeatedly shows that nurses with longer or riskier commutes experience significantly higher exhaustion and burnout. One study found commute quality has a measurable impact on emotional exhaustion and task performance. 

These are not abstract statistics to me. They are the lived realities of the clinicians I supervised every day. When transportation holds clinicians back, hospitals feel it in very tangible ways. 

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Key benefits of reliable, affordable transportation for clinicians

Here are six ways transportation support strengthens the entire workforce ecosystem.

1. Expanded recruitment pipeline 
When we remove barriers to getting to the hospital, we suddenly have access to talent we've been missing. Clinicians who live farther away, those who don't own cars, and those who can't risk waiting in an empty bus shelter at odd hours all become part of our workforce. 

While vehicle ownership is often framed as a solution to transportation problems, it creates challenges of its own. Car maintenance, high gas prices and a lack of affordable parking near the facilities where people work can make it harder, not easier, to get to work.

2. Higher retention and lower turnover Burnout pushes nurses out of the profession, but often it's not the work itself — it's everything required to get to the work. Studies confirm that commute length and unpredictability contribute to burnout in healthcare workers. When we ease those burdens, our retention improves. People stay because the job becomes doable again. 

3. Improved attendance and shift coverage 
If you have ever run a float pool, you know this truth: Transportation problems mean consistent call outs. Research backs this up, showing that commute stress correlates with higher absenteeism and worse reliability. Reliable transportation meant fewer gaps in schedules, fewer frantic calls to unit managers, and fewer moments spent asking who can cover a shift. 

When one person misses a shift, there's often a domino effect because someone always has to cover. The challenges in one person's life end up affecting the rest of the nursing team. When we help clinicians get to work, we prevent unpredictability from affecting the entire unit.

4. Reduced clinician burnout 
Burnout is not just moral injury or compassion fatigue. Sometimes, the drive to work itself can be the problem. A study on commuting and exhaustion found a direct link between commute stress and emotional depletion. When we support transportation, nurses arrive more grounded, less stressed and more capable of providing the kind of care they are proud of.  

5. Cost savings and workforce optimization 
Every missed shift has a price and every vacancy has a multiplier effect. Research has long shown that burnout and commute strain correlate with turnover intention. Early in my leadership role, we relied heavily on travel nurses. We paid premiums simply to keep units open. As we improved local workforce reliability, including addressing transportation, our dependency on agency labor decreased. Our staffing budgets became more predictable and far more sustainable. 

6. Stronger employer brand and culture 
When hospitals help clinicians overcome commute challenges, they send a clear message: We see you, value you and are invested in your ability to succeed. Transportation support is not a perk. It's a declaration of respect and a commitment to equity. 

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How hospitals are addressing transportation today

Some hospitals have begun to meet the moment. Cleveland's MetroHealth partnership with the Regional Transit Authority expanded bus shelters, stops, and 24/7 access, making it possible for clinicians to arrive safely at all hours. Other systems have experimented with carpools and shuttles. These have helped, but they still have limitations, such as misaligned schedules, long wait times, and safety concerns in remote lots.

Then something new emerged. ShiftMed and Uber Health created a partnership that put the power back into clinicians' hands. Nurses could claim the shifts they wanted and schedule rides on a single platform, with no upfront costs and no guessing whether a bus would arrive. Since 2022, more than 52,000 nurses have used this program to get to work. 

Research shows commute quality directly influences worker performance and reliability, which translates into better candidates and stronger staffing. That is not just convenience. That is capacity. That is a workforce strengthened by removing one of its simplest and most stubborn barriers. 

The opportunity ahead

Transportation is not the only challenge facing our clinicians, but it is one that technology can finally solve. With real time tools, flexible float pool models and on-demand ride coordination, we are no longer bound by the limits of traditional staffing. When a nurse misses a shift, the hospital feels it. When a nurse gets to a shift, supported, safe and ready, the whole system benefits. 

This is how we stabilize the workforce. This is how we honor the clinicians who keep our hospitals running. This is how we ensure every dollar is spent where it matters most: on patient care and the people who deliver it.