Driving nurse retention and performance as turnover rates climb

Chances are your organization is struggling to fill nurse vacancies today, and nurses under your roof are struggling with burnout. Some are actively looking for a way out, ready to jump ship for better compensation, work/life balance, or retirement. 

You’re not alone in that predicament, of course. Earlier this spring, a letter from the American Hospital Association to Congress reported two-thirds of hospitals have a nurse vacancy rate of 7.5% or higher, and 95% of healthcare facilities report hiring external contractors to fill the gap, though contract labor costs have more than doubled in the last decade. By the end of 2022, four in 10 nurses plan to find a nursing job elsewhere, and nearly a third plan to leave the field altogether, reports Fierce Healthcare.

As turnover rates climb, healthcare leaders have an opportunity to reverse the tide by investing in nurse leaders in a new way. In this post, we offer up three keys to drive nurse retention, engagement and performance in your organization.

Investing in individual development

Today’s nurses are looking for ways to progress professionally, favoring employers who invest in their development. More than a way to retain skilled professionals, providing strong leadership development for nurses is also a high-return investment for hospitals. 

Historically, organizations have presumed that strong performance as clinicians would translate into strong performance as leaders. Instead, many have learned — the hard way — that promoting nurses into roles that demand a sharply different set of skills can sink their effectiveness. It’s why proactive leadership development is so important.

It’s also important to note that building new leadership competencies requires sustainable behavioral change and deep self awareness, and those aren’t changes someone can sustain from a course, self-led training, or even mentoring relationships. When it comes to behavioral change, one-on-one leadership coaching is the most effective way to make new leadership skills and meaningful transformation “stick” long-term. (More on how humans are wired to learn and change here.)

Reassessing low-impact tasks

Not only are nurses covering duties for peers who’ve resigned, they’re also picking up extra duties stemming from support staff shortages. Altogether, they’re shouldering an onslaught of low-impact, administrative/support tasks that drain their time, energy and attention away from what they do best: caring for patients.

As patient advocates, it’s hard for nurses to imagine what they can stop doing; it all feels important. But to serve patients well, they don’t have the luxury of doing it all. To remain effective, nurse leaders should consider what tasks they can reduce, eliminate, reassign or automate to free up nurses to deliver their best to patients. 

Reframing compensation as long-term investment, cost avoidance

Today’s workers know they can and should expect more from their employers. Growing demand for better pay, work conditions, flexible schedules and more means you’ll have to reconsider how your organization compensates nurses in light of the alternative: spending far more down the line on external contractors and backfilling vacancies. 

It’s helpful to keep in mind that each time a bedside nurse resigns from your organization, that turnover comes with an average cost of $46,100, resulting in the average hospital losing $5.2–$9 million. Each percent change in nurse turnover costs or saves the average hospital an additional $262,300 per year, according to the 2022 NSI National Health Care Retention & RN Staffing Report

To avoid costly turnover, “organizations should provide clear career advancement opportunities, skills growth and training, and offer more flexible scheduling options. Health systems also need to offer competitive pay, encourage better teamwork and transparency, and offer stronger management training,” writes Fierce Healthcare. We agree.

A necessary investment

Healthcare organizations looking to remain profitable, relevant, and effective in fulfilling their mission need to invest in nurses now. The reality is that nursing leaders — especially those who are new to their role — will burn out and find greener pastures elsewhere if they don’t.

Investment in nurse leadership development is akin to insurance in the sense that it protects your organization from wasteful spending and decreased patient safety. The rewards are just as significant, returning improved retention, engagement and performance of nursing teams.

Debra Harrison
About the author

Debra Harrison was the Chief Nursing Officer for Mayo Clinic in Jacksonville, Florida from 2006–2016. She retired in May 2016 and joined MEDI as an Executive Coach early 2017.
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