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Nurse Retention Strategies: How to Combat Nurse Turnover

5 min readMay, 19 2023

There are various reasons for nurse turnover. By understanding why nurses leave their current position or the profession altogether, health care leaders and hospital administrators can devise nurse retention strategies to reduce turnover rates in the workplace.

Why Is Nurse Retention Important?

In any field, employee retention rates are indicators of job satisfaction, morale, and team cohesion. But in the medical profession, nurse retention is more urgent than ever. That's because the growing nursing shortage (over one million nurses are expected to be needed by 2030) was accelerated by the Covid-19 pandemic. There's also the cost factor associated with hiring and training. That can range from $28,400 to $51,700 for a registered nurse (RN), according to Becker's Hospital Review. These expenses add up quickly, costing $3.6 to $6.5 million annually per hospital.

Understanding and Preventing Burnout

Burnout among nurses is widespread and on the rise. Increasingly, the feeling of frustration many clinicians feel is referred to as "moral injury." This is also a leading cause of nurse turnover and is commonly characterized by:

  • Depleted energy, including compassion fatigue and apathy
  • Lack of on-the-job enjoyment and satisfaction
  • Diminished efficacy and attention to detail

As a health care administrator, it's essential to understand how to spot and reduce moral injury. Surveys like a Burnout Assessment Tool (BAT) can measure burnout. Genuine appreciation can also go a long way in decreasing mental fatigue among your team. Incorporate meaningful recognition for a job well done, such as shout-outs during team meetings or paid days off. Encourage your staff to recognize their peers' hard work. And get creative with other morale boosters like a gratitude board in a shared break room.

Provide education about burnout and its symptoms to empower your employees to identify and self-manage the signs. And ensure that team leaders feel appreciated since their contentment will impact their staff. In 2017, the ANA created Healthy Nurse, Healthy Nation™, a program designed to improve the health of the nation's nurses.

Why Nurses Leave — and Ideas for Retaining Nursing Staff

Two common reasons why RNs leave their positions include relocation and career advancement, according to Becker's. Other catalysts include unsustainable working conditions, ineffective leadership, workplace violence and aggression, high patient-to-nurse ratios, and nurses feeling generally undervalued. Understanding and anticipating your nurses' needs can help you develop an action plan for retention. Other ways you can reduce nursing turnover rates include the following:

Eliminate Mandatory Overtime

Mandatory overtime isn't the only solution to staffing shortages. The National Library of Medicine points to a study associating overtime with adverse consequences. These include physical exhaustion, safety issues, and decreased quality of patient care.

Present Opportunities for Autonomy

Allow team members to make decisions and take charge within their scope of practice. Research indicates doing so can improve overall job satisfaction and patient outcome.

Provide Employee Wellness Programs

Workplace perks like meditation courses or discounts on gym memberships can help nurses cope with stress and improve their self-care skills. But keep in mind that these offerings should supplement rather than replace more substantive workplace improvements.

Create a Flexible Culture

Implementing a more accommodating culture entails listening to and anticipating your employees' needs, such as staggered shift options.

Offer Competitive Salaries

Nurses have more career options than ever, including transferring to work as traveling nurses. Wage increases and bonuses are viable incentives for them to want to stay where they are.

Creating Paths for Professional Advancement

A group of healthcare workers are standing in a hallway and are gathered for a picture. They are leaning into the camera and smiling.

A career advancement path is critical to nurse retention. In a recent study by McKinsey & Company, 32% of registered nurses in the U.S. surveyed said they were considering leaving their direct-patient-care positions. As an administrator, you can reduce that turnover rate by providing opportunities for career growth. That may include offering continuing education programs or running formal mentoring and residency programs.

Recruitment Strategies with Retention in Mind

According to the National Library of Medicine, nearly 18% of new nurses leave their job within the first year. Enhancing your nursing recruitment and retention strategies during the onboarding process can help reduce the loss of recent hires.
Create retention strategies for nurses on your team to make them want to stay, such as:

  • Offering signing, quarterly, referral, or retention bonuses
  • Providing above-average paid time off for your area
  • Reimbursing them for continuing education courses
  • Include student loan repayments

Encouraging Direct Lines of Communication

Open communication between nurses, managers, and administrators reduces workplace frustration and dissatisfaction. Ensure that your nurses have clear outlets for voicing concerns over conflicts and overwhelming feelings of stress or fatigue. That includes listening to and promptly addressing any staff safety concerns. It's also essential for nurse managers to be accessible, available, and demonstrate a genuine interest in their staff. Implementing an open-door policy for nurse managers fosters more robust communication and rapport.

Knowing how to retain nurses is critical to your team's long-term success and the overall patient experience. Implement steps to improve the work environment, make them feel appreciated and valued, and build a strong, dedicated team that's likely to stay with you.

Find more resources on creating a healthy work environment for nurses.


Images sourced from Getty Images

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