The average cost of turnover for a bedside registered nurse (RN) ranges from $37,700 to $58,400, according to a 2016 survey from nurse recruitment and retention firm NSI Nursing Solutions that examined hospital figures from 2011 to 2015. The average hospital loses $5.2 million to $8.1 million due to RN turnover, and each percent change in RN turnover costs or saves a hospital an additional $373,200.
Unfortunately, figures are not trending in the right direction. Approximately a third (32.9 percent) of hospitals report a vacancy rate of 10 percent or more. The RN vacancy rate in 2016 was 8.5 percent, representing a 1.3 percent increase from the previous year.
Hospitals should implement nurse retention strategies to improve these numbers. “While an overwhelming majority (84.8%) of organizations view retention as a ‘key strategic imperative’ it is not evident in operational practice/planning,” according to the authors of the survey. “Although viewed in such a strong light, only half or 51.5% have a formal retention strategy.”
Nurse Retention Strategies
Create a Positive Working Environment
Engagement starts with recruiting, according to HealthStream, a healthcare workforce solutions company. Hospitals should create an efficient, two-way interview process that showcases what the institution has to offer and analyzes the candidate’s behavioral competencies. Non-clinical skills like positive attitude, teamwork, collaboration, drive and initiative impact performance and retention.
Provide Opportunities for Professional Development
Offering tuition reimbursement can help nurses further their education and open up their career opportunities. The landmark 2010 Institute of Medicine report, The Future of Nursing, called for increasing the number of bachelor’s-prepared nurses in the workforce to 80 percent by 2020. Hospitals can improve quality of care by helping nurses advance their education to the bachelor’s level and beyond.
A Health Affairs study by Amy Witkoski Stimpfel, PhD, RN, and others found that nurses who work shifts longer than 12 hours are 1.45 times more likely to leave their jobs within a year. Hospitals can respond by making a “fundamental culture change from overtime being the ‘rule’ to overtime being the exception,” says Karlene Kerfoot, PhD, RN, in Hospitals & Health Networks magazine. “If hospitals implement measures to reduce shift and workweek length, and set guidelines for what is an acceptable amount of overtime, nurses will not feel obligated to tack on extra hours.”
Adopt a Nurse Residency Program
Hospitals that enlist new graduates in a residency program have improved nursing retention, according to Debra Wood, RN, in AMN Healthcare Briefings. Residency programs can help experienced nurses feel less frustration and greater satisfaction when assisting with orientation.
Reward Longevity and Excellence
One hospital in St. Louis achieved a voluntary turnover rate of less than 1 percent by creating a culture where nurses wanted to stay at the bedside, in part due to the rewards the hospital offered, Wood reports.
- Staff members received up to five days of pay when the hospital met its goals.
- An incentive program allowed nurses to earn as much as $2,000 for accomplishments like presenting at a conference, completing a fellowship program or receiving thank you notes from patients.
- Nurses with 15 or more years at the hospital automatically received an additional five days of vacation time.
Practice Shared Governance
About 13 percent of nurses are dissatisfied with their work schedule and lack of independence, according to Witkoski Stimpfel. Shared governance measures like self-staffing, which enables nurses to select shifts based on availability, can give nurses a sense of ownership over their unit.
Advancing Nurse Education
Current nurses can further their education to enhance the quality of patient care and pursue more advanced career opportunities. Alvernia University’s online RN to BSN degree prepares nurses for specialty and management roles. The online DNP is designed for APRNs seeking a practice doctorate in clinical leadership to advance their careers to the highest levels in nursing.
Each program takes place in a convenient online learning environment that accommodates students’ work and personal schedules.