How Hospitals Can Reduce Nursing Turnover

Published on : 1/20/20
  • Turnover in any job is a challenge, but in the nursing industry, the ramifications are significant. While your hospital recruiters search for new hires, current nursing team members stretch their already overloaded schedules to pick up the slack of missing colleagues — leading to their own burnout and subsequent turnover. Nursing turnover is a systemic problem, but hospitals still must determine what can be done to stem the tide.

    How Bad Is the Nursing Turnover Pandemic?

    Even though nursing turnover is not a disease, like a pandemic, it is widespread, growing and currently out of control.

    According to NSI Nursing Solutions, in their first year, 22.9% of nurses left their jobs. That’s more than a quarter of all RN departures. The turnover rate for bedside RNs increased to 17.2%, up from 14.6% in 2016. This increase comes at a time when 45% of hospitals anticipate expanding their nursing teams.

    With an aging population needing more medical attention, your hospital needs to be fully staffed, yet once a nurse leaves, finding a replacement can be difficult. Unlike in some careers, medical professionals must receive exhaustive training — they can’t just get on-the-job training. With the pool of applicants already filtered, finding candidates becomes more difficult.

    Going from Bad to Worse

    As the nursing shortage gets worse, the squeeze comes from both ends of a nurse’s career. Nursing school enrollment isn’t growing fast enough to fill the 1.1 million anticipated nursing jobs that will be available by 2022, the American Association of Colleges of Nursing says. At the same time, nursing schools accept fewer students because of faculty shortages. So, fewer candidates are entering the nursing field.

    Add to that, a large segment of nurses may be leaving. By 2020, 50% of current registered nurses will be eligible to retire, the Society of Human Resources Management anticipates.

    One more challenge: It takes an average of 86 days to recruit an RN — and this process can take even longer for those in specialties like surgery, critical care, and labor and delivery.

    For nurses who stay, life is hard on the job, as they carry the additional patient load, jamming more responsibilities into their 12-hour shift and even having mandatory on-call overtime shifts. Not to mention that cumbersome electronic medical records system that can feel like a distraction from tending to the patient. Their schedules are so hectic while on duty, nurses may not have a chance to eat a meal or use the restroom.

    3 Ways Hospitals Can Keep Their Nurses

    Some of the contributing factors to turnover are beyond your control. You cannot regulate how many students come through the nursing pipeline, or command a candidate to accept a job offer or forbid a nurse from leaving.

    But you can reverse nursing turnover by focusing on selecting the best-fit candidates and providing an excellent work environment. Here are some tips on how to get started.

    1. Develop a Thorough Onboarding Process

    The significant number of nurses who leave within the first year highlights the difficulty transitioning to the new job. By spending months longer than the typical 1- or 2-day onboarding process, you can help new nurses navigate a new setting and a new role. A good onboarding program is a powerful retention tool.

    An effective onboarding program could include elements like:

    • Providing clear communication to the new hire on what to expect during the first days and weeks and sharing a new hire essentials list
    • Developing a buddy system with the new hire and a high performing team member
    • Conducting 30-60-90 day stay interviews between the new hire and hiring manager
    • Having a 90-day evaluation and periodic meetings between the new hire and hiring manager to discuss the onboarding process

    2. Reduce Non-Nursing Responsibilities

    Patient care, whether it involves direct patient contact or something more tangential like updating an electronic medical record, is a full-time job. But nurses, especially in short-staffed institutions, may be asked to take on other responsibilities, such as delivering patient meals from the hospital cafeteria or transporting patients around the hospital. Nurses should not be performing these tasks. It adds additional responsibility on top of their real patient care duties.

    Another non-nursing responsibility to eliminate is environmental services. The idea that nurses have been asked to clean hospital rooms is unthinkable, and yet, it happens.

    Graphic: Aside from being far outside of their job duties, having nurses decontaminate rooms and sanitize sheets asks them to complete tasks following protocol that is not their specialty, increasing the risk of infection.


     

    3. Ensure Nurses Have Breaks and Vacations

    It may be easier said than done, but the statistics prove the long-term benefits of making sure nurses have sufficient break times. Harborview Medical Center in Seattle created a 6-month pilot program that increased the number of relief nurses, allowing team member nurses time to use the restroom, eat a meal and maybe even get a few minutes of sunshine. Within a couple of months, nurses reported increased satisfaction and increased retention rates. Patients benefited too, with a sharp decline in patient falls and medication errors.

    Nurses also need vacations — longer periods to fully disengage from work. But 55% of US employees don’t take off all of the days they earned. Nurse shortages result in scheduling challenges, which makes it difficult for nurses to plan time away. As leaders, it is essential to recognize the physical and mental benefits of vacation, and encourage nurses to enjoy a period of downtime.