Beyond Email: Why Communication Failures are Driving the Nursing Crisis

New research from Firstup highlights a growing communication crisis in hospitals, with 81% of nurses reporting that patient care issues stem directly from organizational miscommunication. As hospitals face tightening margins and a projected global shortage of 11 million health workers by 2030, ineffective communication is emerging as a critical “last-mile” problem—one that contributes to clinician burnout and drives a costly “retention tax” averaging $61,110 for every registered nurse lost.

Based on a survey of 1,000 U.S. hospital nurses, the 2026 State of Nursing Communication Report finds that hospitals are communicating more frequently, but not more effectively. The primary issue is continued reliance on email, which remains the main communication channel for 86% of hospitals despite nursing being a shift-based, deskless profession. One-third of nurses say they don’t have time to read updates during shifts, while nearly half report that messages are only marginally relevant to their roles. As a result, two-thirds admit to skimming or deleting messages without fully reading them—creating gaps that can affect safety and care quality.

Firstup argues that hospitals need to rethink how they reach frontline staff. Recommended changes include shifting to mobile-first communication so nurses can access updates on their own devices, replacing mass emails with role-specific targeting, enabling two-way feedback before policies are finalized, and clearly prioritizing critical safety messages so they cut through digital noise. According to Firstup CEO Bill Schuh, nurses are being asked to make fast, high-stakes decisions while relying on communication systems never designed for clinical realities. When timely, relevant information fails to reach the frontline, he said, the entire care system is put at risk.