Root Causes And Factors To Increase Nurse Turnover

The annual turnover rate among health care employees is startling. Some turnover is unavoidable: people get married, move away, go back to school or retire. However, other types of turnover are preventable. According to the Human Resource Management Association, 20.4 percent of health care employees (one in five) quit their jobs every year. The number easily exceeds the

The costs to replace nurses that leave is noted to be around $42,000-$64,000; it is clear that reducing nurse turnover can save a lot of money (Buffington, A., Zwink, J., Fink, R., Devine, D., & Sanders, C., 2012) . The good news is orientation costs can be recovered if they new graduate remains within the healthcare organization (Woten, M. B., & Heering, H. C., 2016).

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 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 expense of losing an experienced nurse can be costly to the hospital. Not to mention the nursing knowledge and skills. Estimates of the actual dollar amount incurred by nurse turnover range from 10 to 20 thousand dollars per nurse to as much as well over the nurse’s yearly salary. According to Anderson (2004), Nurse Executives estimate that “…visible costs represent only 24 percent of total costs for medical/surgical nurses and only 18 percent for specialty nurses. A true total cost of $42,000 per medical/ surgical RN and $64,000 per specialty nurse is more close to reality.” Turnover costs, average approximately $47,403 per medical/surgical RN and $85,197 for specialty RNs. “A 400-nurse hospital with a 20 percent turnover rate is replacing 80 nurses per year. The direct costs might average $800,000 per year, but

“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

The financial cost of losing a single nurse has been calculated as equal to double the annual salary of a single nurse. Various studies reveal that each hospital in America is losing almost $300, 000 per year because of nurse turn-over. Nurse turn-over can negatively impact the health care system in many ways such as poor quality of patient care, increased medication error, hospital acquired infection, prolonged patient stay at hospital, and increased staffing cost. Many factors contribute to nurse turn-over such as workload, absence of career opportunities, poor work recognition, and lack of communication with management about issues (Hunt, 2009).

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.

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

CG4 is a telemetry unit that cares for patients with cardiac and respiratory issues. The unit frequently scores one of the highest HCAPs within PinnacleHealth on a monthly basis when compared to other nursing units, but it is not without headache. Like previously stated, CG4 is approximately forty percent staffed with nurses. When analyzing the causes of this issue, a few patterns can be identified. Clark (2009) explains there are two relevant reasons why nursing staff continue to leave CG4. First, the nursing staff is primarily single females less than thirty years of age. This causes for rapid turnover with many nurses aspirations to travel to big cities and obtain various experiences as nurse early in their career. There is a pull

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.

Nursing job satisfaction continues to rank high as an area of concern for Nurse Executives. Dissatisfied nurses can lead to a decreased ability to recruit nurses and increased turnover (Ruggiero, 2005), leading to lower patient satisfaction. The costs of nursing turnover has been hard to measure and varies from study to study (Li & Jones, 2013), however Brewer, et al. (2011) estimates $856 million per year as the cost of new nurse graduate turnover to health care organizations. Additionally, Jones (2005) found that the cost for RN turnover is 1.3 times the cost of average salaries of hospital RN’s. These costs, coupled with the pure loss of nursing experience that comes with turnover, continues to put nursing satisfaction in the forefront of issues for nursing executive practice.

One issue in nursing curriculum is nursing turnovers in the workplace. Nursing turnovers is a problem that is not currently a major part of nursing curriculum yet it affects a significant portion of nursing practice. “Nurse turnover is also a critical issue impacting hospital budgets worldwide and a significant proportion of turnover costs are attributed to temporary replacement, highlighting the importance of nurse retention” (Duffield, 2014, pg. 2703). Another underlying concern also remains because there is no clearly defined categories to collect data to predict nursing turnovers trajectory.

Research has shown that hospitals with better nurse staffing and work environments have better nurse outcomes—less burnout, job dissatisfaction, and intention to leave the job. Many studies, however, have not accounted for wage effects, which may confound findings. By using a secondary analysis with cross-sectional administrative data and a four-state survey of nurses, we investigated how wage, work environment, and staffing were associated with nurse outcomes. Logistic regression models, with and without wage, were used to estimate the effects of work environment and staffing on burnout, job dissatisfaction, and intent to leave. We discovered that wage was associated with job dissatisfaction and intent to leave but had little influence on burnout, while work environment and average patient-to-nurse ratio still have considerable effects on nurse outcomes. Wage is important for good nurse outcomes, but it does not diminish the significant influence of work environment and staffing on nurse outcomes. The abstract is overall clear and comprehensive.

A continuous concern that continues to present itself within the healthcare environment is adequate staffing on nursing units. Most hospital organizations try their very best to accommodate staffing needs, though many units remain understaffed for an unspecified amount of time. Inadequate staffing can negatively affect patient outcomes, lead to nurse burnout, and decrease patient satisfaction scores. Combating this issue will require a great deal of effort, as many geographical face nursing shortages when seeking new graduates and qualified candidates. Employees may begin to feel that they are unable to pursue personal goals within a healthcare organization, due to inability to transfer as a result of staffing shortages. This often results in nursing seeking employment or career advancement outside of the organization or geographical area, which further intensifies ramification associated with inadequate staffing.