Nurse Ratio And Nurse Retention

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.

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

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

Yes, I agree that the there is an issue in regards to orientation process and the relationship it has on staff retention within our unit.

The American Nurses Association say the shortage is the product of several trends, including: a diminishing pipeline of new students to nursing, a decline in RN/CNA earnings in comparison to other career option, aging nursing workforce and an aging population that will require health care services (Writer, 2016). With the shortage of staff and the baby boomers turning sixty and many already in retirement, healthcare staff members are going to have to pick up more shifts and a tougher workload. Healthcare industries need to focus on recruiting and retaining staff because hiring more nursing staff is expensive in the short term. But having too few staff leads to being burned out. Having the right amount of CNAs and nurses is essential for manageable workload distribution. Facilities need to prevent and protect current employed nursing staff from being overworked and stressing out because good health care workers only quit when they are overwhelmed. Most are afraid that they are not providing the best care anymore and feel like they can not do what they love the most anymore (Cimiotti, 2017).

For over a decade researchers have been performing studies examining the effects patient-to-nurse ratios have on adverse outcomes, mortality rates, and failure-to-rescue rates of patients and on job dissatisfaction and burnout experiences of nurses. Aiken, Sloane, Sochalski, and Silber (2002) performed a study which showed that each additional patient per nurse increased patient mortality within 30 days of admission by 7% and increased failure-to-rescue by 7% as well. This same study also showed that each additional patient per nurse resulted in a 23% increase in nurse burnout and a 15% increase in job dissatisfaction. Additionally, Rafferty et al. (2007) performed a study in which the results showed that patients in hospitals with higher patient-to-nurse ratios had a 26% higher mortality rate and nurses were twice as likely to have job dissatisfaction and experience burnout. Blegen, Goode, Spetz, Vaughn, and Park (2011) performed a study where results showed that more staffing hours for nurses resulted in lower rates of congestive heart failure morality, infection, and prolonged hospital stays. The same study also showed that increased nursing care from registered nurses resulted in lower infection and failure to rescue rates and fewer cases of sepsis.

Across the United States, hospitals are experiencing a nursing shortage. Yet, according to the American Association of Colleges of Nursing, 63,857 students graduated from nursing school in 2015 alone and enrollment is increasing. It seems like a lot of new nurses to fill those vacancies, does it not? Studies show, however, that within a year, about thirty percent of those new graduates have voluntarily left their job (Hillman). Further studies have attributed the high turnover rate to new nurses’ lack of competency to handle conflict, make critical decisions, and function autonomously (Bratt). Many of the new graduates are disappointed with the hospital’s orientation, or lack thereof. Lack of knowledgeable preceptors and lack of nursing staffing in general has led to new nurses being thrown into autonomous function more quickly. Without proper training, these nurses must make sound clinical judgements and provide competent care to patients, which anyone can imagine is stressful. Today, Nurse Residency Programs (NRPs) are being instituted in numerous hospitals as a way to improve new graduate nursing skill, but research shows many other benefits to these programs. NRPs also reduce hospital spending costs, increase patient safety, and most importantly increase new nurse retention rates.

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,

America is one of the most affluent countries in the world, but is also a nation that has a healthcare industry that is in much turmoil. One of the more pivotal influences of this turmoil is nurse turnover rate. Nurse turnover does not have a universal meaning, consequently making it difficult to associate turnover rates in healthcare facilities and geographical areas. In all actuality, “"Nurse turnover" is an undesirable trend for healthcare employers. It 's expensive, it 's disruptive, and it threatens the quality of care and patient safety” (Kovner, Brewer, Fatehi, and Jun (2014). All throughout America healthcare organizations demand a steady, extremely trained and completely engaged nursing staff to provide efficient levels of patient care. However, a budding shortage of experienced nurses has led the United States healthcare industry to a continual increase in the turnover rate among registered nurses. As a matter of fact, “Hospitals are experiencing an estimated 16.5% turnover rate of registered nurses (RNs), increased from 14.7% in 2012” (Yarbrough, Martin, and Alfred, 2014). Turnover costs of these leaving nurses are as much as a universal problem throughout the healthcare industry, occurring at staggering prices. According to Yarbrough, Martin, and Alfred (2014) “Estimates of RN turnover costs range from US$44,380 to US$63,400 per nurse—an estimated US$4.21 to US$6.02 million financial loss per year for hospitals.” This ascending trend in turnover rates is a clear

Aylward, M., Gaudine, A., & Bennett, L. (2011). Nurse recruitment and retention in rural Newfoundland and Labrador communities: The experience of healthcare managers. Online Journal Of Rural Nursing & Health Care, 11(1), 54-69.

Nurse staffing have an effect on a variety of areas within nursing. Quality of care is usually affected. Hospitals with low staffing tend to have higher incidence of poor patient outcomes. Martin, (2015) wrote an article on how insufficient nursing staff increases workload and job dissatisfaction, which in effect decreases total patient care over all. When nurse staffing is inadequate, the ability to practice ethically becomes questionable. Time worked, overtime, and total hours per week have significant effect on errors. When nurses works long hours, the more likely errors will be made. He also argued that inadequate staffing not only affects their patients but also their loved ones, future and current nursing staff, and the hospitals in which they are employed. An unrealistic workload may result in chronic fatigue, poor sleep patterns, and absenteeism thus affecting the patients they take care of.

The ongoing instability evidenced from the high mobility of qualified nurses in the nursing workforce has raised many questions about the issue of nursing shortage and nurse turnover (Gates & Jones, 2007). The paper below discusses the issues of nursing shortage and nurse turnover. The paper also describes how leaders as well as managers in the nursing fraternity and other leaders can resolve those problems effectively and the different applicable principles, skills, roles of the leader, and theories of leadership and management.

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.

Nursing care delivery is defined as the way task allocation, responsibility, and authority are organized to achieve patient care. Tiedeman and Lookinland (2004) suggested that systems of nursing care delivery are a reflection of social values, management ideology, and economic considerations. (Tiedeman&Lookinland, 2004) According to Fewer (2006), the quality of nursing care delivery systems affects continuity of care, the relationship between nurse and patient, morale, nurse job satisfaction and educational preparation.(Fewer, 2006) Nurses are essential human resources to provide medical services with professional knowledge and skills in the healthcare setting. However, the registered nurse turnover rate has increased in recent years resulting

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.