Nursing Turnover

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).

Shortage of nursing staff in the long-term care continues to rise due to a couple of reasons. Many studies have revealed several factors that play a significant role in nursing shortages over the years. These factors include health care organizations downsizing the number of staff on a unit and increasing workloads, prolong work hours, and the people leaving the workforce. These factors have a significant impact on the quality of care in the long-term setting. This paper will compare and contrast the effect of lack of staffing has on the quality of patient care in a long-term settings. Over the years, the toll of the economy has had an impacted on the healthcare system which led to the reduction in the number of nursing staff and increasing the workload.

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 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.

The information contained in this report was gathered in a private nursing home over 2 weeks that for the sake of this essay, be called “facility x”

“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

There have been problems within Long-Term Care and many of these abuses were turned over to the patients, there was hardly any direction on how to handle Long-Term Care. “Poor houses and Almshouses and developed in response to an impoverished, aging, and

According to Huber, (2010) nursing shortage is defined as the occurrence where the demand (the number of nurses a company is willing to employ) is greater than the available supple of nurses willing to work at the proposed rate of pay. This definition goes beyond the word understaffing because it can be caused by several factors. These include but are not limited to less than desirable working conditions or tight budgeting in an attempt to cut costs. Turnover is defined as the cessation of employment or membership in an organization. Research on nursing shortage and turnover indicate that the basis of the problem correlates to low wages, the nature of work, poor working conditions and

Theories for burnout in the nursing profession are presented in the jobs-demands resources model. “This study uses the job-demands resources model to clarify the role of burnout among nursing staff in the relationship between stress factors and intention to leave the profession”

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,

Hospitals nationwide are experiencing nurse shortage and increased workloads because of shorter hospital stays, fewer support resources and higher acuity in patients (Vahey, D. C., Aiken, L. H., Sloane, D. M., Clarke, S. P., & Vargas, D., 2004). Higher nurse workloads are directly associated with job burnout and job dissatisfaction which in turn causes more voluntary nurse turnover and relates to the increased nursing shortage. According to the Missouri Hospital Association the turnover rate of nurses has increased by fourteen percent in the last five years (Browning M., 2012). Nursing shortage is a real threat to the patient population. According to the Quality Health Outcomes Model by the American Academy of Nursing by Donabedian, effects of the healthcare interventions are characterized by the environment the staff works in (Vahey et al., 2004). Donabedian describes that quality metrics can be divided into three broad categories, structural, process, and clinical.

Numerous studies in the past 3 decades have explored the relationships betweenstaffing levels in nursing homes and quality of care measures. (Systematic Review of Studies ofStaffing and Quality in Nursing Home). There have been an increases amount of turnovers in thepast couple years causing a decrease in the quality care of residents, according to Feurberg M.In a recent study. Staff turnovers are causing residents to have less care provided rather thanhaving the amount of care needed, which is causing an increase in the morality rate. Turnoverrates were higher in hospitals in which the staff were paid lower wages rather than hospitalswhose staff were paid higher.I feel as if this situation is very important regarding needed care for residents.

The growing of turnover rate among Saudi nurses threatens the quality of care provided to patients and the health care organizations productivity. The government spends their financial resources in equipping vacant positions by increasing nursing colleges and recruitment expatriate nurses as solutions for this issue. However, The Minister of Health does not pay attention to main cause of the turnover that is lack of qualified leaders and managers. Poor of the healthcare system management creates unhealthy work place environment where decreases their willingness and effectiveness. The lowering of nursing retention puts pressure on nurses who are on the position, which leads to work overload, burnout, decrease moral and finally more turnover.

According to Wong and Laschinger (2012) authentic leadership is defined as “a pattern of transparent and ethical leader behaviour that encourages openness in sharing information needed to make decisions while accepting input from those who follow” (p. 948). For instance, under the authentic leadership, nurses are more empowered to be part of the decision -making process and exerted their autonomy to respond positively to their work using available resources to meet the job demands. Furthermore, job control and autonomy give staff the ability to control their environments and deal with job demands and burnout; studies show that staff who have more control over their work are less likely to experience burnout (Portoghese et al., 2014). It was also shown that staff who were more autonomic were able to use their personal resources (optimism, self-efficacy, resiliency, and engagement) to control their surroundings. Therefore, this type of environmental behavior increases nurses’ engagement level which in turn increase their job satisfaction, productivity, and performance (Wong & Laschinger,

Inadequate staffing continues to be a clinical management issue within the nursing profession. Ineffective scheduling of qualified nurses presents various challenges to staff, patient population, and healthcare organizations. These challenges arise from extensive physiological and psychological demands placed on nurses, poor nurse-to-patient ratio, unfavorable relationships among staff, low monetary compensation, and job dissatisfaction. Without proper stress management tools, nurse burnout and withdrawal from profession eventually occurs. Clinical leaders have a responsibility to promote nurse wellbeing and retention through fair-minded and supportive behavior. Additionally, authentic clinical leaders should inspire staff members to consistently