Nurse Turnover Rate Among Registered Nurses

According to Suzanne Gordon “ whether young or old, nurses are disillusioned because they believe that health care systems guided by bottom-line concerns simply don’t recognize the specificity of their work” (234). Nursing is more demanding than many other professions or occupations, due to the combination of difficult patients, exhausting schedules and arduous physical work (Gordon 235). It can take a significant emotional toll on many, hence the higher levels of burnout. Job dissatisfaction as a result of increased workloads and unreasonable demands, such as inappropriate nurse staffing levels, was cited as the number one reason that drives many experienced nurses to leave the profession (Sanford 38+). Studies have shown that such working conditions also affected the retention of new graduate nurses by leaving their first hospital jobs within two years of graduating (Sanford 38+).

The demand for full time nurses is continuing to boom in the global market (Buerhaus, Auerbach, & Staiger, 2009). However, the unfortunate shortage of nurses in the global scenario is undeniable (Hunt, 2009). The rate at which nurses are graduating from universities today does not sufficiently quench the ever growing demand for nursing professionals. The issue of providing an active replacement for the nurses who have left their respective organization continues to be a source of main concern for health care institutions.

With the prevalence of nursing shortages, more specialty units are now hiring new graduate nurses in positions that were once reserved for experienced nurses (Maiocco, G., 2003).

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.

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.

In order to provide lasting solutions to the nursing shortage, we should determine whether actively recruiting mature new nurses is appropriate. Bedside nursing is an intellectually and physically demanding profession. The burnout rates and first year attrition are disturbingly high. A three year study of over three thousand American NGNs found that 37 percent intend to leave their jobs after one year (Kovner et al., 2007). Another review found that while there are many market variables, the average American NGN costs hospitals over $82,000. Thirty percent of these leave in the first year and 57 percent in the second (Twibell et al., 2012). Given the high barriers to entry, the statistics are surprising. Before we continue to invest in recruiting mature nursing students, we should determine if they are likely to persevere in practice.

The expense of losing an experienced nurse can be costly to the hospital. Not to mention the nursing knowledge and skills. Estimates of the actual dollar amount incurred by nurse turnover range from 10 to 20 thousand dollars per nurse to as much as well over the nurse’s yearly salary. According to Anderson (2004), Nurse Executives estimate that “…visible costs represent only 24 percent of total costs for medical/surgical nurses and only 18 percent for specialty nurses. A true total cost of $42,000 per medical/ surgical RN and $64,000 per specialty nurse is more close to reality.” Turnover costs, average approximately $47,403 per medical/surgical RN and $85,197 for specialty RNs. “A 400-nurse hospital with a 20 percent turnover rate is replacing 80 nurses per year. The direct costs might average $800,000 per year, but

The financial cost of losing a single nurse has been calculated as equal to double the annual salary of a single nurse. Various studies reveal that each hospital in America is losing almost $300, 000 per year because of nurse turn-over. Nurse turn-over can negatively impact the health care system in many ways such as poor quality of patient care, increased medication error, hospital acquired infection, prolonged patient stay at hospital, and increased staffing cost. Many factors contribute to nurse turn-over such as workload, absence of career opportunities, poor work recognition, and lack of communication with management about issues (Hunt, 2009).

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

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 shortage is no longer a projected problem in the healthcare industry in the United States, this problem is present and is not phasing out anytime soon. Addressing this challenge would improve job satisfaction, reduce burnout in the profession and ultimately improve retention.

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

The global nursing shortage is resulting in the need to find multiple solutions to providing adequate numbers of nursing personnel. The shortage is exacerbated by nurses leaving the profession and their current positions. Globally, nursing turnover rates range from 10–21% per year, with countries such as the USA and Australia reporting turnover rates of over 20% per year. Retaining nurses in their current positions will reduce the magnitude of consequences associated with the nursing shortage (Cowden and Cummings, 2012).