Staffing And Retention

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+).

Nursing satisfaction has criteria for change; as documented in the Future of Nursing’s report, by the Institute of Medicine in cooperation with the Robert Wood Johnson Foundations’, Campaign for Action. (IOM, 2010) (RWFF, 2010) Both reports lay the groundwork that influences NC current nursing shortage. At the same time; to make health care more affordable, the Affordable Care Act was entered into law (ACA, 2010). Additionally, hospitals and other health care facilities are applying for, and meeting criteria for accreditation and is very clear about implementing a mandatory, entry level, BSN

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.

Stanton, M. R. (2004, March). Hospital Nurse Staffing and Quality of Care. Research in Action. Rockville, MD, USA: Agency for Healthcare Research and Quality.

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

Staff satisfaction is empirical in retention of nurses in any healthcare setting. Although a slight turnover is necessary to maintain the diversity of ideas, too much of it causes instability that might affect patient and employee satisfaction negatively (Marquis & Huston, 2015). The planned change is to be executed at a small, private hospital (SPH) in Los Angeles with a 200-bed capacity, which offers emergency and medical-surgical services for adults. After a six-week hospital orientation, only 20% of new RNs hired at SPH in 2015 rated their confidence levels at >70% (Appendix A). Out of 32 new hires, 7 left during orientation, and 12 left before reaching 1 year- leading to 41% retention or a 59% turnover (Appendix B). The RN turnover of SPH is thrice the

Those who were being interviewed were able to choose their setting. One of the researcher’s findings through the interviews were the top three themes that emerged when participants were asked the decision of why they left: (1) unfriendly workplace, (2) emotional distress related to patient care, and (3) fatigue and exhaustion. The conclusion of the study directly tries to relate to the nursing shortage; how hospitals must find a way to retain experienced nursing staff, and should recognize when their colleagues are appearing distressed or socially isolated. Knowing the reasons of why nurses leave clinical practice will benefit the nurses, patients, family, and most importantly, improve the quality of care.

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 limitations could be the generalizability and the absolute certainty to say that this will work for all nursing environments. The sample sizes vary and can be small in one of the studies. The methods of the research are interviews and another subjective sampling, however; this is the only means to assess the situation which is at hand completely. The studies do not address how to correct or adapt a non-magnet hospital to perform in a more nurse friendly manner to address the nurse environment. They further do not expand on any attempts at correction these hospitals have taken to improve the environment.

An identified area in which healthcare managers are failing consistent effectiveness is in the retention of their nursing staff. With the need of nurses shaping the way many healthcare managers look at their staff, often it is the veteran nurse persuaded in staying. While in some settings this is truly beneficial, in others the cliché of nurses eating their young instills fear into new graduates; this fear and the lack of support ultimately leads to their exit (Rush, Adamack, Gordon, & Janke, 2014). With the associated costs of nursing attrition meeting rates of nearly $186,000 per registered nurse, it is imperative we institute nursing residency programs immediately and continually retaining staff and protecting healthcare institutions’ sustainability (Cubit, K.A. & Ryan, B., 2011; Lee, Tzeng, Lin, & Yeh, 2009).

For nurses, the workload and patient assignments are the most significant factors in their perception of their ability to provide quality care to their patients. Of course, this is directly related to nursing job satisfaction. Nursing is a career in which patient satisfaction and caregiver satisfaction go hand in hand. When the nurse is happy, he or she provides high quality care to the patient, which in turn makes the patient happy. In addition, when the patient is pleased with the care they are receiving, this makes the nurse happy and improves nurse job satisfaction.

Rondeau et al. (2008) reported that lack of awareness pertaining to the significant changes of employee market factors in nursing turnover and vacancy. Effective and efficient nurses retention strategies are some of the ways to handle with turnover in healthcare organizations, not all reasons for turnover are employer

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

For the most part, attracting and retaining employees in today’s market is one of the biggest challenges that are faced by Human Resources. In today’s society, retaining employees is rather difficult as various employees are known to jump from job to job, almost always in search for more benefits or for their personal dream. Whatever the reason be, high turnover rates can be very expensive to employers as training and hiring one employee and then training and hiring a new employee requires time and money. According to Chron.com, it has been found that “employee replacement costs can reach as high as 50 to 60 percent of an employee’s annual salary.” As this is a one-time transaction, employees that are retained only “charge” the company once and so it is allowing more work for the dollar when the employee stays with the company for a longer time period. Companies that have high turn-over rates spend more money on employees which affects the bottom line of the company, this determines the state on how fast or a matter of if the company will use its money to expand.