Registered Nurse Turnover

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 concept of nurse residency programs is not by any means a new concept. Programs have been grounded on Benner’s theory of novice to expert. Benner established the notation that nurses develop skills and understanding of job skills over time through an education also with hands on experiences. She noted a nurse passes through five levels of proficiency: novice, advanced beginner, competent, proficient, and expert and was generally reached only after years of gaining experience as a practicing nurse. A nurse residency can facilitate new nurse graduates to transition smoothly through the levels and sometimes even more quickly. As a new graduate a nurse residency program is very appealing, not only does it help mentor you through novice period but also helps develop competent nurses for the organization.

The rising rates of seasoned nurses have resulted in replacing the more experienced and skilled professionals by infusing fresh graduates who lack the required skill and experience needed to effectively adapt to a clinical environment. This is coupled by the booming level of workload witnessed by these graduates who many are unable to cope with. Adding fuel to fire the initial work experience is discouraging for many graduates who hence are exhausted .This results in numerous fresh graduates completely burning out in just 18 months of their introduction to professional medical environment (World Health Organization, 2006).

There is a shortage of all health care professions throughout the United States. One shortage in particular that society should be very concerned about is the shortage of Registered Nurses. Registered Nurses make up the single largest healthcare profession in the United States. A registered nurse is a vital healthcare professional that has earned a two or four year degree and has the upper-most responsibility in providing direct patient care and staff management in a hospital or other treatment facilities (Registered Nurse (RN) Degree and Career Overview., 2009). This shortage issue is imperative because RN's affect everyone sometime in their lifetime. Nurses serve groups, families and individuals to foster

Transitioning from nursing school to working in a hospital setting can be a challenging time for a new graduate. Due to the nursing shortage, new graduate nurses are being hired with little to no experience. This is overwhelming for new nurses, especially when they are not getting adequate support or training from the hospital. The amount of stress, pressure, and lack of training is leading to a high turnover rate for new graduate nurses. With patient acuity on the rise, new graduate nurses that are filling these vacancies in the hospitals, need to be competent nurses to provide proper and safe care to the patients.

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).

The national shortage of Registered Nurses (RNs) has helped generate formidable interest in the nursing profession among people entering the workforce and those pursuing a career change. According to a report issued by the U.S. Department of Health and Human Service in 2002, the national population is continuing to grow and age and medical services continue to advance, so the need for nurses will continue to increase. They report from 2000 to 2020 the predicted shortage of nurses is expected to grow to 29 percent, compared to a 6 percent shortage in 2000. With the projected supply, demand, and shortage of registered nurses and nursing salaries ever-increasing, the nursing profession can offer countless opportunities. But first one must

The United States healthcare industry faces many challenges everyday, such as the rising cost of care, medical errors, access and quality problems etc. Within the next few years, the United States will experience a shortage of Register Nurses (RNs). “Registered Nurses are considered one of the largest health professions in the health care industry. The Nurses duty is to provide direct patient care and can be done in a hospital, public health facility, nursing home and many other different settings. Other services included are patient education on disease prevention, administering treatments and promoting a healthy lifestyle.” ("The Future of the Nursing Workforce: National- and State- Level Projections 2012-2025”) The shortage will occur due to Baby Boomers aging and the demand for health care will dramatically rise. With the baby boomers aging, Registered Nurses are at the top of the list for demand in health care. Unfortunately the supply and demand does not meet. “According to the Bureau of Labor Statistics’ Employment Projections 2012-2022 released in December 2013, RNs will increase of about 526,800 within that time frame but will still have job openings of 1.05 million by 2020)”("Nursing Shortage") Indicating that there is no growth between 2012- 2022. There are multiple factors to this shortage and one of them is that nursing schools across the nation are struggling to increase the capacity of students to meet the rising demand. Considering the fact

Historically, the nursing field is one that has consistent positive job outlooks, as there is typically a continued shortage. Healthcare is the backbone of most communities, not just for its services, but also for the jobs it provides and the economy stimulation. Jill Bernstein, author for “Changes in Health Care Financing and Organization” states, “The health care industry is a critical component of the national, and most regional and local economies of the United States” (4). The nursing field has suffered challenges due to the economic, social, and the political downturn of the U.S. Nevertheless, there is still some noticeable growth taking place and opportunities available. This shows encouraging signs for new nursing graduates.

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).

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.

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.

Upon reflection of this assignment, I must refer to my personal journey as an RN to BSN student. Currently, there is an influx of nurses returning to school at the same time and none of us have graduated yet. During my journey as an RN to BSN I have learned that changes are not as easy to implement. In addition I have grown to appreciate that I can no longer make a statement, or ask why a change is being implemented. Furthermore I have developed a sense of appreciation to learning new policies and procedures. I have become more flexible. Prior to my RN to BSN program I had no desire to be apart of any nursing committees. Over time I have developed a sense of awareness as to time management and ways to decrease feelings of burnout.

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