Analysis Of Nurse Retention Strategies: Turning Over A New Leaf

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+).

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).

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 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.

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

Currently, 6% of hospitals in the United States hold Magnet status (Lowell General Hospital, n.d.). Being a Magnet hospital is an accreditation awarded by the American Nurses Credentialing Center (Lowell General Hospital, n.d.). Such recognition is given to hospitals that aim to focus on quality-patient care provided by nurses (Lowell General Hospital, n.d.). This status is earned and achieved after extensive review, and is good for four years before they are required to meet 35 different areas of focus again (Lowell General Hospital, n.d.). Trinkoff et al. (2010) review the working conditions of hospitals to determine whether Magnet status improves nursing working conditions. The authors of this article come from different areas of expertise as they hold nursing degrees, PhD degrees, ScD degrees, and many others with an educational background in statistics, epidemiology, and nursing. However, the authors fail to study the patient outcomes between Magnet and non-Magnet hospitals and to see if Magnet status has an impact on patient outcomes. They fail to look at the entire picture, as their primary focus is on the working conditions of nurses, and not the patients.

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.

Many healthcare organizations worldwide are striving to achieve magnet designation. Having the magnet title is essential because it recognizes healthcare organizations that act as a “magnet” for excellence by establishing a work environment that identifies, rewards, and promotes professional nursing (ANCC Magnet Designation, 2012). A magnet hospital is considered to be one where nursing provides excellent patient care, where nurses have a high level of job satisfaction, and where there is a low staff

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.)

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.

The researchers surveyed 3186 nurses on staff at 56 hospitals; 52 academic hospitals and 4 non-academic hospitals. The researchers compared the results of the nurses’ surveys with information about the location of the hospital (rural or urban), the hospital environment (managerial support, good relationships among team members, the nurses’ involvement in decision-making), the nurses’ educational levels, and the staffing (nurse:patient ratio). The researchers also interviewed nurse managers and leaders to evaluate their input on nurse retention and nursing shortages in a qualitative portion of the study. In the article “Effective strategies for nurse retention in acute hospitals: A mixed method study”, the researchers state “the results show that nurse staffing and the quality of the nurse practice environment (i.e. managerial support of nursing care, good relations between doctors and nurses, nurse participation in decision-making and organizational priorities on quality of care) are significantly associated with intention-to-leave the hospital” (Van den Heede et al., 2013, p. 192). This association is related with increase nurse satisfaction with environment and staffing is related to decreased intention to leave the hospital, or an inverse relationship. These researchers also shed light on the fact that Magnet hospitals have far better nurse retention and nurse satisfaction. Thus, focusing on and achieving a Magnet status can be an effective

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 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.

In the study undertaken in United State at totally different times, the national ratio for hospital nurses was 12-tone system in 1996, 15 August 1945 in 1999, and 26.2% in 2000. within the study done specifically in north central Mountain State, job satisfaction considerably correlate with context, structure, and attitudes variables although age wasn 't correlate with job satisfaction (Shader et al. 2001)..