Article Review of Retaining Nurses and Other Hospital Workers: An Intergenerational Perspective of the Work Climate

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.

Current internal and external hospital stressors are impacting NCs nursing shortage. With the release of many reports from different sources suggesting a change is needed. Most have been accurate in their projections; however, the struggle continues. Strong implications for the direction the crisis is heading, from campaign research to thesis and dissertations, written by professional groups and organizations add credibility to the cause; however, the shortage remains. Although some would argue that job satisfaction has no bearing on the nursing shortage and more pressing problems are prevalent; for example, the ageing population, undereducated nurses, patient safety and more positive patient outcomes; therefore, this paper highlights suggestions for change, with a concentration on nursing dissatisfaction and the nursing shortage.

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

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.

Nursing turnover data suggests an estimated 17% of nurses entering first year of employment leave within that year and one in three nurses leaves within 2 years (Robert Wood Johnson Foundation, 2014). Staffing shortages paired with a profession that has high turnover rates can be financial costly for HCO. Costs related to RN turnover can cost large acute HCO as much as $6.4 million a year (Robert Wood Johnson Foundation, 2014) or per nurse cost estimates range from $37,000-$58,000 according to the 2016 National Healthcare Retention & RN Staffing Report (Nursing Solutions, Inc, 2016). This research paper suggests root causes and factors to nurse turnover and evidence-based solutions to increase nurse retention. Healthcare organization rely and require engaged and skilled workforce to provide effective patient care and

The issue of healthcare personnel scarcity continues to be an ongoing challenge across the globe. Invariably, nurses are at the pinnacle in the delivery of quality care in any healthcare setting. The ever-increasing demands for care stem from a patient populace that is emergent, growing older and needing more care due to the escalating shift in their disease process. Hence, nurses are torn between balancing an overloaded schedule, working extra hours and maintaining astuteness and professionalism. This transcends to compromised patient care, nursing burnout makes it difficult for them to experience the rewards of caring for patients in the way they had expected; thereby, adding to the shortage of

Additionally, the study found that a high patient to nurse ratio resulted in greater emotional exhaustion and greater job dissatisfaction amongst nurses. Each additional patient per nurse was associated with a 23% increase in the likelihood of nurse burnout, and a 15% increase in the likelihood of job dissatisfaction. Moreover, 40% of hospital nurses have burnout levels exceeding the normal level for healthcare workers, and job dissatisfaction among hospital nurses is four times greater than the average for all US workers. 43% of nurses involved in this study that reported job dissatisfaction intended to leave their job within the upcoming year. (Aiken et al.)

The current and growing shortage of nurses is posing a real threat to the ability of hospitals, long-term care facilities, and others to provide timely access to quality care. Nurse staffing shortages and nurse turn-over contributes to the growing reduction in the number of staffed patient beds available for services, increasing costs, and rising concerns about the quality of care. Health care organizations highly depend on nurse managers and leaders to reverse this trend. This paper discusses the reasons for nursing shortage and turn-over, different approaches to solve this issue, and my personal philosophy about this issue.

The nursing situation at Renfrey Memorial Hospital is unsustainable and in dire need of correction on several levels and for several reasons. The primary problem facing this institution is the same problem faced by medical institutions throughout the nation and indeed much of the world: many nurses are nearing retirement age, and the nursing profession is no longer the draw for younger college students and potential applicants that it once was. Because of this general underlying problem, Renfrey memorial hospital has been confronted with a series of practice and financial problems that only promise to grow worse as more nurses employed at the hospital age and retire. Increasing physical and emotional stress as the result of reduced numbers of nursing staff are increasing the motivation to leave Renfrey for many nurses, and in the past few years what has been described as an "exodus" has occurred in the hospital's nursing staff. This has required the hospital to obtain the services of nurses from a temporary nursing pool operated by a nearby agency, which of course leads to issues with the quality and the cost of nursing care.

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,

The nursing occupation is facing tough working conditions as a result of a nurse shortage in the industry. (Bowles & Candela, 2005). Due to this, hours are prolonged to unhealthy lengths and increase in patient – nurse ratio means that nurses are being stretched to their maximum productivity to provide extensive care for everyone. This essay examines the reasons behind why nurses are choosing to leave the occupational field and the consequences of these working conditions on both nurses and patients. Secondly, it’ll look at how improvements can be made to in order to lower stress levels aswell as retain existing and attract new nurses to the occupation.

Though Bally and Nemcek are both concerned about high attrition rates in registered nurses and seek ways to increase retention rates and decrease the rate of turnovers, the factors which they consider critical in addressing the shortage of nurses by increasing rates of retention are vastly different. Nemcek is concerned with the internal emotional states and experiences of registered nurses and the impact that has on the nurse's experiences with respect to job satisfaction and life satisfaction-two factors which are already closely related. Bally on the other hand approaches the problem of nurse shortages by exploring the importance and consequences of environments which have strong mentoring cultures on job performance and satisfaction. Particularly, she focuses the role of nurse leaders in fostering such a mentoring environment.

One issue in nursing curriculum is nursing turnovers in the workplace. Nursing turnovers is a problem that is not currently a major part of nursing curriculum yet it affects a significant portion of nursing practice. “Nurse turnover is also a critical issue impacting hospital budgets worldwide and a significant proportion of turnover costs are attributed to temporary replacement, highlighting the importance of nurse retention” (Duffield, 2014, pg. 2703). Another underlying concern also remains because there is no clearly defined categories to collect data to predict nursing turnovers trajectory.