Nursing Turnover and Retention Strategies

One of the side effects of the ongoing nursing shortage is that hospital administrators are looking for ways to hold on to experienced nurses. The time and cost involved in filling open positions is just too high: as much as $82,000, according to the Journal of Nursing Administration. That cost includes advertising and recruiting, orientation and training, and the lower productivity of a newly hired nurse. High turnover is also associated with insufficient staffing levels, which in turn can lead to job dissatisfaction and burnout among nurses, as well as an increased risk for medical errors.

Yet hospitals are also finding it hard to retain younger, newly licensed nurses. A 2014 study, “What Does Nurse Turnover Rate Mean and What Is the Rate?” found that nearly 18 percent of new RNs resign from their first nursing job during the first year—and a third leave within two years. If new RNs become overwhelmed, it’s easy for them to conclude they made the wrong career choice and that the answer is to find a different career path. For example, a report in HealthStream noted that “Nursing school deans who were surveyed said their graduate nurses were 90 percent ready, but hospital leaders surveyed said that nursing graduates were only 10 percent ready.”

That’s quite a discrepancy.

And it’s the reason the Institute of Medicine (IOM) and Robert Woods Johnson Foundation (RWJF) support nurse residency programs as a way to help new graduates manage the transition from classroom to bedside and settle into a satisfying career. These structured residency programs can provide a safe environment for novices to gain real-life experience. They are typically paid positions that last about a year and result in full-time jobs for those who complete the residency successfully. The idea is to boost retention of new nurses by supporting them during that critical first year at the bedside.

The 2017 HealthLeaders Media Nursing Excellence Survey found that 61 percent of nurse leaders listed staff retention as one of their top concerns. This survey found that one of the most important factors linked to lower nursing staff turnover was shift length. A large majority of survey participants (62%) said the typical shift at their facility was 12 hours—and the data found that the hospitals with these longer shifts were also the most likely to report nurse retention as a top challenge.

Research also shows that improving the practice environment makes it easier for hospitals to reduce nursing turnover and retain nurses. Nurses who are mostly satisfied with the practice environment are less likely to suffer the effects of burnout. Strategies for reducing turnover include:

  • Reducing overtime and eliminating mandatory overtime.
  • Developing shared governance programs that give nurses a voice in scheduling, workflows, and hospital policies.
  • Ensuring adequate nurse staffing levels and supporting acuity-based staffing tools.
  • Recognizing nurses’ need for work-life balance.
  • Encouraging and developing a workplace culture of collaboration between nurses and physicians.

When it comes to collaborative care, education is the great equalizer, the key to gaining respect across all disciplines. In its landmark report, “The Future of Nursing,” the Institute of Medicine (IOM) discussed the importance of nurses having more educational parity with other members of the healthcare team. Collaboration is more likely to occur when staff nurses are empowered with knowledge and feel more equality with other healthcare professionals who are educated at the graduate and post-graduate level.

American Sentinel University is an innovative, accredited provider of online nursing degrees.

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