A Brief Note On The Issue Of Retention

As the general population continues to age and grow, the nursing workforce is aging alongside. Approximately half of the current nursing workforce is apart of the baby boomer generation (Mion). RNs are eligible to retire at age 55, which will affect the majority of “baby boomer” nurses between 2005 and 2010 (Mion). According to the Nursing Management Aging Workforce Survey in 2006, “55% of surveyed nurses reported their intention to retire between 2011 and 2020” (Nursing Shortage). The demand for skilled nurses is growing at an exponential rate. According to information from the U.S. Department of Health and Human Services, the supply of nurses has been

Booth, B. (2011). Alarming Rise of New Graduate Nurse Attrition. Journal of Practical Nursing, 61(1), 3-5.

Workload was described to be heavy, stressful, increase in intensity and overtime hours. As a result 25.8% consider resigning, 20.2% consider retiring and 25.6% consider leaving profession. Another problem that was observed at individual level was poor commitment to care. One of the factors that often limited nurses to provide therapeutic care was the change in nurse to patient ratio. As nurses assignments increase with the increase in the number of patients (i.e. 1 nurse to 6-8 patients) the quality of care provided decreases. Nurses’ ability to maintain safe environment became challenging. As part of caring, nurses also showed decreased amount of time spent with their patient. This eventually led to nurses being less satisfied with their current job. Self – efficacy was often low. Nurses felt that they did not have enough knowledge and skills required for professional practice (Newhouse, Hoffman, & Hairston, 2007). This often led into stressful transition and the ability to care for a patient even harder. New graduate nurses often had difficulty maintaining leadership role. They often felt that they did not have the ability to self advocate and raise their voice to be heard by others. They often feared that they would be over heard and that no one would listen to them (Mooney, 2007).

There are many challenges facing today’s nursing leaders and managers. From staffing and scheduling, to budget cuts and reduced reimbursements, today’s nursing leaders must evolve to meet the ever changing health care environment. Constance Schmidt, Chief Nursing Officer at Cheyenne Regional Medical Center (CRMC), identified retaining experienced registered nurses (RN) as one of the biggest problems she faces as a nursing leader. She went on to state “Nationally, most hospitals have more than 60% of their nurses with at least 5 years of experience. At CRMC, it’s the reverse. We have more than 60% of our nurses with less than 5 years of experience” (personal communication, March 28, 2014). The two largest factors affecting those numbers are the nursing shortage and nursing retention. The first, the nursing shortage, was identified years ago and has been researched countless times. Some projections indicate the number representing the gap between available registered nurses, and the positions needing to be filled, could be over a million before the end of the current decade. The latter, retention of nurses, is a problem in every health care facility in the nation. Nursing turnover results in both a significant financial cost to hospitals, and a significant impact on the community through its effects on patient outcome.

There are many major challenges facing the nursing shortage environment today. One of those challenges includes the facility recruitment of registered nurses and then the facility retention of the registered nurses that they have recruited. Factors to consider would be as to why a registered nurse chose to accept a particular job and will they choose to stay at the facility after being given an employment opportunity. A facility’s reputation, union status, autonomy and salary are among some of the factors that influence recruitment. Factors that influence retention includes the inclusion in decision making, practice

The cost to train new nurses becomes so enormous for hospitals it would be much smarter to figure out why new nurses are leaving and provide tools to assist new nurses with their transition. Looking at reasons NGRN leave their new chosen profession seems simple enough find out what it is that decreases job satisfaction and fix it. One study looked at burnout in new nurses and possible causes, they looked at workplace environment, workplace incivility and empowerment.(Spence Laschinger et al., 2009) They found

There is a lot of retention in nursing homes. According to the article “The Importance of Supervision in Retention of CNAs” by Choi, JiSun and Johantgen, Meg, the average annual turnover rate in nursing homes is 74.5% for CNAs. The article states CNA annual turnover was as high as 121% in some states. This article reminds the reader that the retention in our nursing homes are high and is something that needs to be addressed. It affects Centerville Specialty Care residents and staff and we need to create ways to lower the turnover in our home.

The nursing shortage in healthcare has been a highlighted issue for many years. With the ever-growing health care system, hospitals and healthcare facilities often find themselves searching for ways to acquire new nurses and retain their very own. Throughout the years, the number one solution to this problem remains the same: decreasing nurse turnover, and increasing nurse retention. This paper discusses the causes of high nurse turnover rate, the negative effects on health care, and ways to improve the turnover rate.

“High rates of staff turnover in nursing homes is not a recent phenomenon. As far back as the mid-1970s studies have documented average turnover rates for registered nurses (RNs), licensed vocational nurses (LVNs) and certified nurse’s aides (CNAs) ranging between 55% and 75%” (Mor,V., Mukamel, D.B., & Spector,W. D. 2009, 1). Long term care facilities (LTC) have staffing issues related to the high turnover of licensed staff. The effect can have a heavy financial burden and also affect the care given to residents. Many ask the question why is it hard to attract and keep nurses at a long term facility. The International

Retaining a stable and sufficient supply of nurses is an important hospital and nationwide concern. Numerous factors affecting retention of registered nurses comprises of practice autonomy, managerial respect, workload, and inclusion in decision making, flexible schedules, education, and pay (“Recruitment”, 2013). Hospitals not capable of retaining qualified registered nurses may result in the loss of experienced and knowledgeable staff. Additionally this will lower hospital productivity during this transition. High turnover rates for registered nursing staff may also impact job fulfillment and nursing moral altogether. Retaining qualified registered nurses will enhance patient care quality and satisfaction.

Nurse retention for this company is of utmost importance for multiple reasons. According to Forest and Kleiner (2011) replacing an RN can cost as much

Surveyed nurses from Magnet hospitals reported a mean of 1 to 5.3. The survey revealed a moderately strong negative correlation, or inverse relationship between job satisfaction and nurse retention. As job satisfaction decreases, likelihood of considering leaving the job increases. Additional 75% of respondents stated that the number of patients assigned to them had resulted in job dissatisfaction, and 69% were influenced to stay at their current job given the economic downturn (Hairr, Salisbury, Johannsson, & Redfern-Vance, 2014, p.

With the ongoing changes in the healthcare field, nursing workforce retention presents itself as one of the greatest challenges facing healthcare systems today. According to the American Nursing Association, nursing turnover is a multi-faceted issue which impacts the financial stability of the facility, the quality of patient care and has a direct affect on the other members of the nursing staff (ANA, 2014). The cost to replace a nurse in a healthcare facility ranges between $62,100 to $67,100 (ANA, 2014). The rising problem with nursing retention will intensify the nursing shortage, which has been projected to affect the entire nation, not just isolated areas of the country, gradually increasing in its scope from 2009 to 2030 (Rosseter,

Nurse turnover is defined as “the number of nurses changing jobs within an organization or leaving an organization within a given year” (Baumann 2010). Retaining nurses is one of the most important issues in health care as its effects range from challenges in human resource planning, to high costs in financial and organizational productivity (Beecroft et al, 2008), to workgroup processes and morale, to patient safety and quality of care (i.e. patient satisfaction, length of patient stay, patient falls, and medication errors) (Bae et al, 2010). Nursing Solutions Inc (NSI) reported the national average turnover rate for hospitals increased from 13.5% in 2012 to 14.7% last year. Nurses working in Med/Surg had more turnover

Alegent Health Care Clinic located in Omaha, Nebraska named one of the "Best Places to Work" in Omaha has not always been this way. A couple of years ago the company consisted of about 8,900 employees to include physicians within their 200 locations. The turnover rate was 24 percent and this cost the company roughly $15 million a year. After realizing that the HR department need some "acute care treatment" Alegent began forming an employee-retention task force. Since the task force has come in and made changes the turnover rate has dropped significantly. So how did Alegent's practices match with the recommended retention practices covered in Chapter 5 and why was Alegent's broad-based approach to the nursing retention