Leadership Paper
Nurse Retention Strategies in a Changing World
Suzanne O’Leary
East Tennessee State University
NRSE: 4060 Transition to Professional Practice
November 2, 2015
Identification
The never ending nurse shortage looms constantly as a reminder in the healthcare setting that with the increase of human population, superior medical technology, major changes to the nation’s medical healthcare, that this nursing shortage is predicted to worsen. The past four years have seen a steady rise in hospital turnover rates. More than 40% of the currently working registered nurses (RNs) will begin to approach retirement age in the next 10 years. (Pellico, 2009) This in addition to the turnover rate will compound matters. Hospitals
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According to a report released in 2014 by NSI Nursing Solutions Inc., the national average turnover rate for registered nurses rose to 14.2% in 2013, an increase from 2012’s rate of 13.1%. As the economy improves, the potential for related increases in RN turnover poses a challenge for hospital administrators and may signify that a larger nursing shortage is looming. A high turnover rate can be costly, considering that recruitment, training and orientation costs can range from $36,000 to 57,300 per RN. In spite of the excessive costs of turnover, recruitment costs, training and orientation costs, average hospitals report losing between $4 million and $6 million, fewer than half of these hospitals have a retention strategy.
Forces Influencing the Issue
When leadership is ineffective, morale suffers and productivity declines creating a negative impact on patient care and outcomes. Ultimately, an effective nurse leader shapes and influences nursing practice into opportunities for better performance and effective change. Additionally, when RN turnover is high, morale, patient care and recruitment suffer. On the other hand, retaining experienced nurses leads to stronger teams, better morale, improved patient care and significant cost savings. Today, health care providers are experiencing changes such as fiscal constraints, workforce shortages, sophisticated health care consumers and
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
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
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.
Registered nurses are an integral part of the healthcare system, and make up the largest number of healthcare professionals. According to the Bureau of Labor Statistics (2015) “The employment rate for registered nurses is expected to grow by 16% between 2014 and 2024”. This is more than double the average rate of growth for a profession. The rapid growth rate can be attributed in part to better management of chronic diseases and the baby boomer generation. The growth in the nursing profession is paramount, however the demographics of the nursing population does not mirror the demographics of the population served.
Rondeau et al. (2008) reported that lack of awareness pertaining to the significant changes of employee market factors in nursing turnover and vacancy. Effective and efficient nurses retention strategies are some of the ways to handle with turnover in healthcare organizations, not all reasons for turnover are employer
In healthcare it is very important to have strong leaders, especially in the nursing profession. A nurse leader typically uses several styles of leadership depending on the situation presented; this is known as situational leadership. It is important that the professional nurse choose the right style of leadership for any given situation to ensure their employees are performing at their highest potential. Depending on which leadership style a nurse leader uses, it can affect staff retention and the morale of the employees as well as nurse job satisfaction (Azaare & Gross, 2011.) “Nursing leaders have the responsibility to create and maintain a work environment which not only promotes positive patient outcomes but also
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.
Current literature continues to reiterate the indicators of a major shortage of registered nurses (RNs) in the United States. The total RN population has been increasing since 1980, which means that we have more RNs in this country than ever before (Nursing Shortage). Even though the RN population is increasing, it is growing at a much slower rate then when compared to the rate of growth of the U.S. population (Nursing Shortage). We are seeing less skilled nurses “at a time of an increasingly aging population with complex care
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.
Moreover, RN retention is essential for the current and future workforce management. Currently at 10%, the University District (UD) enjoys a low voluntary turnover rate when compared to the national average of 17.1% (Nursing Solutions Inc., 2016). According to Dr. Farber, there are no current retention strategies, however, the UD is a small hospital with an extremely collaborative, communicative, and engaged administration. Promotion and fostering of a health work environment through effective leadership, such as seen at UD, significantly influences nurse retention (Blake, Leach, Robbins, Pike, & Needleman, 2013).
Nursing turnover is a great contributor to the shortage of nurses being experienced. It is believed that about 18% of new nurses leave their jobs within the first year with a national average registered nurse
The demand for RNs shows no sign of abating. An aging population has contributed significantly to the shortage of professional nurses. Employment research predicts “more than a
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).
A recent study has shown that the nursing shortage trend might continue over the next two decades. This shortage also reflects key changes in population demographics, career expectations, work attitudes, and worker dissatisfaction. Whereas the growth in nurses as part of the workforce has been slow, there has been a subsequent increase in the demand of RN’s. This fundamental imbalance points out a key factor i.e. the unwillingness of young adults to join the workforce as nurses. Today 's difficulties are further complicated by other changes in hospital care, such as new medical technologies, lack of training and education, the ACAs’ Hospital Readmissions Reduction Program (HRRP) and a declining average length of stay, that have led to
For many decades, the nursing field has been experiencing numerous problems and amongst them is high nursing turnover and nursing shortage. Without a doubt, this problem is not unique to just a few countries, but has been affecting the entire world, bearing in mind that new diseases are cropping up day in day out and hence the need to have more nurses attending to the ever increasing number of patients. As Feldman (2010) clearly explains, the issue of nursing shortage is largely attributed by the high level of nurse turnover. This means that whenever a health care organization advertises for vacancies and recruits the required number of nurses, the problem of the nursing shortage is still imminent if no measures will be put in