Nurse retention is a critical issue for healthcare organizations. High turnover rates can lead to increased costs, decreased quality of care, and reduced morale among remaining staff. To address high turnover among nurses, healthcare organizations should focus on strategies that retain their nurses. Read on for nine ways that healthcare organizations can improve nurse retention.
The connection between nurse retention and patient safety
Nurse retention and patient safety are closely linked. High turnover rates among nurses can lead to decreased quality of care and increased risks for patients. On the other hand, when nurses are retained, patient safety outcomes are often improved. This is why nurse recruitment and retention are top of mind for practically every healthcare organization and healthcare leader.
One of the main ways in which nurse retention affects patient safety is through continuity of care.
When nurses are retained, they can establish relationships with patients and develop a deeper understanding of their unique needs. This leads to improved communication, more accurate assessments, and better care planning.
Additionally, when nurses have been with an organization for a longer time, they are more likely to have a good understanding of the organization's policies and procedures, which can lead to improved adherence to standards of care and guidelines.
Another way in which nurse retention affects patient safety is through staffing levels. High turnover rates can lead to shortages in nursing staff, which can make it difficult for organizations to maintain appropriate staffing levels. This can lead to nurses being overworked and fatigued, which can increase the risk of errors and accidents. This was the case in the 2023 nurses strikes in New York.
Additionally, when staffing levels are low, nurses may not have the time to provide the level of care that patients need, which can lead to delays in treatment and poorer outcomes.
Additionally, retaining experienced nurses can lead to better patient outcomes. Experienced nurses have a broader range of knowledge and skills, and are better equipped to handle complex cases. They can also serve as mentors to newer nurses, helping to ensure that the entire nursing staff is well-prepared to provide high-quality care.
9 ways healthcare leadership can improve nurse retention
Registered nurse (RN) turnover rates reached nearly 30% in 2021 – a significant increase from previous years – with the cost of an RN turnover reaching up to $58,300, according to a 2022 report from NSI Nursing Solutions.
Due to the increased turnover rate, hospitals have seen their staffing costs increase. In 2021, the average hospital lost roughly $7.1 million due to related staffing costs.
The cause? Many point to COVID-19 as the tipping point for many nurses, though staffing issues and nurse turnover pre-date the pandemic. As the crisis unfolded, the challenges facing an already over-taxed healthcare system – like a lack of safety resources, flawed operational processes, and increasing workplace violence – only became more apparent.
While many nurses once anticipated a lifelong career in the field, the effects of the pandemic, compounded with decades of systemic procedural problems, have forced many to leave the profession they once loved.
Resulting staffing shortages have since led to unmanageable work schedules and workloads for those care providers who remain in healthcare, leading to unprecedented rates of burnout.
By addressing nurse retention and employee safety, and creating a positive work environment that promotes professional growth and development, healthcare organizations can improve the quality of care for patients, keep staffing costs in check, and ultimately improve patient safety. Below are seven strategies healthcare organizations can implement to improve nurse retention.
Emphasize professional development: Nurses want to feel valued and respected by their employer. One way to achieve this is by providing opportunities for professional development. This can include tuition reimbursement for advanced degrees, continuing education courses, and in-house training programs. Providing nurses with the tools they need to advance in their careers will demonstrate to them that their organization is invested in their growth and development.
Ensure adequate training: It’s important that each department within a healthcare organization provide adequate equipment and training of safety protocols so that employees understand their responsibilities. Just as every employee must understand their specific role and responsibilities, so, too, should organizations implement new procedures and workflows to ensure that adequate processes are in place for prioritizing safety and avoiding employee burnout.
Promote work-life balance: Nurses often work long and irregular hours, which can lead to healthcare worker burnout and fatigue. To address this, healthcare organizations should consider flexible scheduling options and promote work-life balance among staff. This can include offering telecommuting options, providing paid time off, and promoting self-care and stress management.
Offer competitive compensation and benefits: Nurses are in high demand, and healthcare organizations that offer competitive salaries and benefits are more likely to retain their staff. Organizations should be aware of the compensation packages offered by other organizations in their area and work to ensure that their own compensation packages are competitive. This can include offering sign-on bonuses, tuition reimbursement, and retirement benefits.
Create a safe work environment: Motorola Solutions reported in their 2023 Healthcare Worker Safety Survey that when questioned regarding their primary considerations during employment hunting, 26% of healthcare workers ranked workplace safety among their most significant concerns.
Nurses want to work in an environment where they feel safe so they can do their jobs well. Providing them with a platform to share their observations is one way to maintain a safe environment and improve nurse retention.
By implementing an incident management platform, for example, organizations give voice to nurses by allowing them to (anonymously or not) share their observations around unsafe conditions and events.
This information then becomes part of a larger data set so leaders can look at trends across the organization. Do incidents increase in understaffed shifts? Does the environment of care deteriorate? Is care delayed more often? Leaders can understand the root cause of issues and address it in real time.
Encourage employee engagement: When nurses feel engaged in their work and feel that their opinions are valued, they are more likely to perform better – and stay with their organization.
An Advisory Board engagement study showed that engaged employees had a turnover rate of 9.8%. Even those workers who reported being “content” (or, satisfied in their roles but not necessarily engaged) had rates of 13.4%. Conversely, disengaged employees, beat the industry average.
Healthcare organizations should encourage employee engagement by creating opportunities for nurses to voice their concerns, participate in decision-making, and take on leadership roles.
Utilize safety huddles: Safety huddles allow teams to communicate about targeted concerns, share information, and identify improvements that can be made to efforts across the organization. Huddles have been shown to improve the efficiency of information sharing, enhance a sense of accountability and empowerment of staff, and increase the sense of community across departments and units.
Provide supportive supervision: Nurses want to work for leaders who are approachable, supportive, and responsive to their needs. Healthcare organizations should provide supportive supervision by assigning nurses to managers who are knowledgeable about the nursing profession and can provide guidance, support, and mentorship.
Foster a “just culture”: A just culture in nursing refers to a model of shared accountability that encourages transparency and open communication about potential safety issues so teams can better understand organizational gaps and root causes of harmful events. Establishing a just culture based on trust and taking proactive action to prevent harm enables nurses to feel heard, valued, and that they’re making a positive different in patient care.
By following these strategies, healthcare organizations can improve nurse retention and ultimately improve safety and quality of care for patients.
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