High-stress units (ICU, OR, ED, Cath Lab) continue to experience the highest turnover rates, not because clinicians lack commitment, but because these settings operate with sustained cognitive and physical load. When staffing ratios destabilize, turnover accelerates fast, and backfills become harder just as the unit becomes less attractive to new hires. Reducing turnover in these environments has less to do with pizza parties and more to do with operational design: staffing g