Turnover: Costs, Causes, and Management Strategies Turnover is defined as the loss of an employee because of transfer, termination, or resignation. The turnover rate is derived by divid¬ing the total number of nurses who left a work unit m 1 year by the total number of nurses employed on that unit. Transfer is the movement of an employee whose performance is satisfactory from one area to another within the same institution or corporation. Termination is the discharge of an employee who is performing at a less-than-satisfactory level or is not a good match for the organization. Resignation/voluntary turnover is the failure to retain an employee who is performing at or above satisfactory level. Although all turnovers have an associated cost to …show more content…
According to Hunt (2009), the literature indicates that the total/real costs associated with nurse turnover have been evaluated using various approaches, such as direct and indirect, visible and invisible, and pre-hire and post-hire (In Huber, 2014, p. 360). According to Hunt (2009) and Jones (2007), the most common factors used in determining nurse turnover costs include the following: advertising and recruitment, vacancy costs, hiring, orientation and training, decreased productivity, termination, potential patient errors/decreased quality of care, poor work environment and culture, loss of organizational knowledge, increased accident and absenteeism rates, and increased nurse and medical staff turnover (In Huber, 2014, p. 360). High staff turnover has been found to be related to (i) low payment; (ii) Lack of recognition and low professional status; (iii) job dissatisfaction and inadequate opportunity for professional development; (iv) excessive stress, low morale and promotion prospects, the need for high standards of education, the difficulties posed by family responsibilities and lack of proper leadership; (v) working long shifts, overtime, as well as weekends, nights and holidays, scheduling and staffing level; and (vi) moral incongruence as nurses are expected to implement actions which they might …show more content…
Other key findings in the study were the importance of the manager role in the establishment of the milieu that fosters nurse engagement, ongoing professional development, positive collegial working relationships, and adequate resources that ensure highly skill nurses remain engaged in their work (Huber, 2014, p. 362). According to Weberg (2010), transformational leadership has been shown in the literature positively impact burnout, exhaustion, increased wellbeing, and job satisfaction in the healthcare
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+).
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.
With a shortage of nurses, the care and safety of patients may become compromised. The nurses themselves may be having feelings of dissatisfaction, overwhelm and distress. Nurses who may become overwhelmed with the high number of patients may become frustrated and burnt out. And inadequate staff of nurses may lead to a negative impact on the patient’s outcome. The quality of care the patients may receive in facilities with low staffing may be poor.
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
Hi Lilia, thanks for the post. I agree that the article you found is a secondary source because it has the words literature review in the title. I was unable to read the article because I could not find it in Kaplan’s online library. I was able to read the abstract through a website. I agree that nursing turnover is prevalent in all facets of health care. It impacts not only to patient care and safety, but also to staff safety. Browsing through the different article titles in Kaplan’s online library, I have noticed that articles were done exploring staff or nurses attitudes and determinants why they leave their jobs. I am wondering whether there has been research done on facilities or organization that adopted or have implemented strategies
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
Mor, V., Mukamel, D.B., & Spector, W. D. (2009). The costs of turnover in nursing homes. The Costs of Turnover in Nursing Homes. Retrieved from www.ncbi.nlm.nih.gov/... National Cent
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
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,
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.
Although I was not directly able to observe conditions on the floor of the units under my manager I feel as though some of the causes of poor nurse retention consist of: decreased average age of nurses; increased rates of younger individuals relocating; increased technology demands for older nurses; increased turnover rates which leads to increase workload for remaining nurses therefore causing an increased rate of burnout; demand by
The global nursing shortage is resulting in the need to find multiple solutions to providing adequate numbers of nursing personnel. The shortage is exacerbated by nurses leaving the profession and their current positions. Globally, nursing turnover rates range from 10–21% per year, with countries such as the USA and Australia reporting turnover rates of over 20% per year. Retaining nurses in their current positions will reduce the magnitude of consequences associated with the nursing shortage (Cowden and Cummings, 2012).