DiversityNursing Blog

Nurse Retention Requires More Than Good Bonuses

Posted by Erica Bettencourt

Tue, Oct 05, 2021 @ 03:37 PM


The pandemic has magnified the Nursing shortage and healthcare organizations are struggling to not only recruit Nurses but also retain them. Bonuses are nice, but Nurses need more than that. They want to feel valued and safe in their work environment.

Healthcare organizations must ensure Nurses are equipped with resources and the support they need to provide quality care. Hospitals must invest in initiatives that attract and keep Nurses, such as:

  • Developing An Employee First Culture

Dr. Linda Shell, DNP, MA, BSN, DNS-CT, Chief Learning Officer suggests Nurse leaders cultivate an “Employee First Culture” approach in their facilities.

“An Employee First Culture is built on the concept that employees are the best asset of any company, and they need to be encouraged and appreciated,” says Dr. Shell. “When appreciation goes up in an organization, quality tends to go up. I really believe that for us as Nurses, the more we can do to create a positive work environment and develop our leadership skills, the more opportunities we are going to have to improve the quality of care that we provide every day for patients, as well as the residents that we serve.”

  • Staff Recognition Programs

"A person who feels appreciated will always do more than what is expected." This quote has been scientifically proven to be factual. 

According to research, giving thanks can have important implications for encouraging actions that promote cooperation.

Whether it be a hand written note, or a brief one on one meeting, managers should take the time to recognize the hard work Nurses are putting in.

Recognizing Nurses on their birthdays and work anniversaries is a simple way for organizations to show appreciation for their staff.

Celebrating Nurses with a themed party or gift bags is another way to give thanks.

According to Nursing Management, realistically, quarterly recognition will suffice for larger units; however, if you have a small unit, monthly recognition is recommended.

  • Mental Health Resources

Many Nurses are experiencing severe, adverse mental health effects as a result of the pandemic, and a lot of them are considering leaving the profession entirely.

Organizations must support employee self-care by establishing evidence-based preventive strategies, providing mental health resources, and demonstrating that leadership supports and prioritizes mental health and well-being.

Some health systems are hiring a Chief Wellness Officer (CWO) to support their wellness initiatives.

Dr. Maureen “Mo” Leffler, the first enterprise-wide CWO at Nemours Children’s Health said, “The goal of the Chief Wellness Officer is to promote professional well-being, which is characterized by having everything in place in both the individual and in the system, so those two things work together optimally. When we do that, we can provide the highest quality of care, the safest care, the best care. We can derive meaning in the work we’re doing.”

  • Tuition Assistance Programs

Tuition reimbursement is becoming a popular way for hospitals to attract and retain quality Nurses, especially in areas where demand is high. 

These programs are designed to help Nurses continue their education by relieving some of their financial stress.

  • Good Communication

Routine unit or individual staff meetings should be held to discuss any issues or concerns. Nurses want to feel heard. So it's important management truly listens to what they have to say and then set up action plans and follow up.  

  • Flexible Work Hours

According to a recent McKinsey survey, Nurses that experienced more flexibility in hours and scheduling during the pandemic were highly interested in retaining that flexibility going forward. For Nurses who indicated plans to stay in their current direct patient care role, flexibility in hours and shifts was an influential factor.

Bottom line, health systems must prove to their Nurses that they are Valued, Appreciated, Heard, and Supported if they want to keep them. There are thousands of Nursing opportunities out there and you must work to retain the Nurses you have. This is just as important as recruiting Nurses.

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Topics: retention rate, healthcare leaders, nursing careeer, nurse recruitment, nurse retention, frontline workers, retain nurses, hospital retention rates, nurse hiring

These Factors Influence Retention of Newly Licensed Nurses In Hospitals

Posted by Erica Bettencourt

Thu, Aug 04, 2016 @ 03:10 PM

Nurse_Retention.jpgIf your hospital is experiencing high turnover among your newly licensed Nurses, this article may give you an idea of why they’re leaving and areas where you can improve your work environment.

Some factors influencing low unit-level turnover: first professional degree was a baccalaureate or higher, greater variety and autonomy, and better perceived RN-MD relations

“About 80% of newly licensed nurses find their first work in hospitals,” says New York University Rory Meyers College of Nursing (NYU Meyers) Professor Christine T. Kovner, PhD, RN, FAAN. “Turnovers are one of the costliest expenditures in our profession. In fact, costs are estimated at $62,000 to $67,000 per departure, amounting to $1.4 to 2.1 billion in expenses for new nurses who leave their first jobs within three years of starting.”

Prior research on newly licensed nurses tended to focus on organizational turnover, where a nurse leaves the hospital or organization. However, there is scant literature on internal or unit-level turnover, which occurs when a nurse leaves their current assignment to take up new roles or positions within the organization or hospital.

Recently, Dr. Kovner led a team of researchers at NYU Meyers and the School of Nursing at SUNY Buffalo in conducting a study to fill in the gaps. Published in the International Journal of Nursing Studies, the study of a nationally representative sample of new nurses working in hospitals, sought to better inform unit-level retention strategies by pinpointing factors associated with job retention among newly licensed nurses.

“The internal turnover rate for the one year between the two waves of the survey was nearly 30%,” said Dr. Kovner. “This turnover is in addition to those leaving the organization. This figure is substantially larger than previously reported in other studies, which estimated a 13% one-year internal turnover rate among new nurses.”

The researchers looked to bolster the existing evidence on internal turnover to determine precursors to remaining on the same title and unit-type from the first to the second year of employment.

The nurses (n=1,569) were classified into four categories based their unit and title retention. 1090 nurses (69.5%) remained in the same title and unit-type at wave two, while 129 (8.2%) saw a change in title, but not in unit-type. A similarly small group of 185 (11.8%) had no change in title, but changed unit-types, while 165 (10.5%) had a change in their title and unit-type.

In addition to collecting the new nurses’ demographical data, Dr. Kovner and her team assessed their perceptions of their work environment in both surveys.

“In doing this we were able to examine the changes in work environment perceptions over time between nurses who remained in the same unit and title to those who changed unit and/or title,” said Dr. Kovner.

Upon analysis, the researchers found five factors most strongly associated with retention: holding more than one job for pay (negative), first professional degree was a baccalaureate or higher, negative affectivity, greater variety and autonomy, and better perceived RN-MD relations, all positively related.

“Our results point to the variables on which managers can focus to improve unit-level retention of new nurses,” said Kovner.

Related Article: Fellowship Program Improves New Nurse Retention, Nets Savings

Have more questions about employee retention? Click below to ask one of our Nurse Leaders!

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Funding. Funding for this research was provided by the Robert Wood Johnson Foundation.

Topics: retention rate, retention

Fellowship Program Improves New Nurse Retention, Nets Savings

Posted by Alycia Sullivan

Fri, Sep 13, 2013 @ 11:44 AM

By Megan Murdock Krischke

Why do new nurses often leave their jobs in the first year? And what can be done to keep their careers on track, improve nurse retention and keep the costly issue of turnover in check?

A new study published in the July-August issue of Nursing Economic$ may help to answer these questions.

A few years ago the North Shore-LIJ Health System (NSLIJ) in New York set out to identify some of the key reasons for nurse loss in the first year of employment and created a nurse residency program to counteract that loss. A team of nurses at NSLIJ monitored the before and after results in order to measure the efficacy of program.

M. Isabel Friedman: New nurses in the nurse fellowship program support each other.

“What we recognized was the way we were orienting new nurses wasn’t meeting the needs of this computer-minded generation,” said M. Isabel Friedman, DNP, MPA, RN, BC, CCRN, CNN, program director of nurse fellowship programs for the Center for Learning and Innovation at North Shore-LIJ Health System and the lead author on the study. “We created a program that met the needs of our new nurses and helped them transition from new graduate to functioning practitioner.”

This study looked particularly at the Pediatric Nurse Fellowship Program (PNFP) at Cohen Children’s Medical Center for pediatric critical care, pediatric emergency department and hematology/oncology specialties. This specialty orientation program was designed to bridge the gap between the novice nurse and the new high-acuity pediatric specialty while providing new graduate RNs with important mentoring and support tools.

“We found that when nurses feel supported, their loyalty to the hospital system increases,” Friedman explained. “Additionally, our new hires go through the fellowship program in cohorts of 5-10. The community and peer support offered by the cohort is a factor in increased retention.” 

The PNFP used a blended learning model. The core curriculum that nurses focused on during the initial weeks of the program was chosen from the curriculums offered by the national professional organization for each specialty. Each week had a theme, such as respiratory. Nurses then had seminars, skills and simulation labs, and clinical days that addressed that week’s topic. 

One of the key findings of the study was the effectiveness of having a senior nurse whose specific job it was to work with the cohort of fellows as they were transitioning to working in direct patient care.

“Study of our previous orientation showed that the transition from orientation to direct patient care in the six- to nine-month timeframe was when first year retention rates began to drop significantly. Having a senior nurse who could be by a nurse’s side as he or she did a new procedure, or easily available to ask questions, increased the confidence of our new nurses and the quality and safety of the care they provided.” Friedman stated. 

Friedman and her colleagues found that the nurse fellowship program decreased turnover significantly in the PICU and that general retention rates were statistically significant when comparing length of employment before and after the program was implemented. “As you can imagine this was good for the bottom line. When comparing expenses for the 2.5 years before instituting the PNFP and the 2.5 years following, there was a potential cost savings estimate of over $2 million.”

As an added bonus to increased nurse retention and cost savings, nurses who participated in the PNFP are showing a greater value for continuing their education through specialty certifications and pursuing master’s programs. 

“This program is easily adaptable for other specialties. We had our first residency program in adult critical care. In addition to the PNFP, we have fellowships in cardiac cath lab and labor and delivery nursing, as well as having a fellowship for nurse practitioners. Every fellowship cohort is altered to some degree in response to the feedback we receive from our fellows, preceptors and others involved in the program.” 

Donna M. Nickitas: Nurse fellowship programs can improve nurse retention and save money.“One reason this particular manuscript was a good fit for Nursing Economic$ is because it addresses the measures, methods and metrics. If we are going to make a business case for caring we have to make sure that we have the data that supports nursing’s work. This article showed in black and white how what they were doing helped the bottom line,” remarked Donna M. Nickitas, PhD, RN, NEA-BC, CNE, editor of Nursing Economic$.

“It emphasizes what we have been saying all along: to have a healthy work environment, you have to have a healthy workforce,” Nickitas continued. “We need to make sure our nurses are more than adequately educated and trained. This study demonstrates that the PNRP is worth the investment in time, effort and finances.”

“I love the program and I love my fellows,” Friedman effused. “They are bright and capable young people and we owe it to ourselves to educate the next generation of people who are going to be taking care of us and our loved ones. It is a fabulous feeling to see their success and see them grow and become nurse managers and to see them continually aspire to bigger and better things.” 

For more information, see the Nursing Economic$ study:
Specialized New Graduate RN Pediatric Orientation: A Strategy for Nursing Retention and Its Financial Impact

Source: NurseZone.com

Topics: turnover, support, retention rate, loyalty, orientation, nurse

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