Improving Nurse Retention Through Nursing Specialization

Fostering career development through nursing specialization opportunities is an essential but often overlooked approach to improving nurse retention.

Registered nursing (RN) turnover is expensive. With the average cost of turnover at over $46,100 per nurse, it can quickly deplete a health system’s budget. This estimated figure may even be higher than it is today, as the COVID-19 pandemic has accelerated nursing turnover. Although healthcare systems know retention is a problem, they often don’t have formal plans to improve it.

What can healthcare systems do to improve retention? One of the ways may seem counterintuitive — let the nurse leave their current position but encourage them to seek a position in a different specialty within your current system.

Nursing specialties

There are close to 100 different nursing specialties that an RN can pursue. Health systems likely don’t have every single one (such as correctional facility care) but probably do have dozens currently available. From critical care, labor and delivery, home health care and more, options exist for nurses who are ready to leave their current role and seek change.

Why are nurses leaving?

Evaluating the reasons why nurses are leaving the profession can be useful. The need for healthcare has never been greater. With an aging patient population that is living longer, and with healthcare now accessible to millions more people, there are numerically more people needing care than there were even just a few years ago.

Also, as a factor of the aging population, more nurses are nearing retirement age and leaving the workforce. The COVID-19 pandemic also had a role to play, with many nurses choosing to retire even if they weren’t quite ready. At the beginning, when furloughs were in place for many nurses, they took the opportunity to retire.

The increased stress and demands placed on nurses today has also caused many to leave the profession. It’s also a problem that perpetuates itself — as nurses work short staffed due to the shortage, they are forced to take on more work and responsibility. This then causes them to tire quickly and get burned out, and they quit. This leaves another position to be filled that puts more work and stress on other nurses.

How can promoting nursing specialization help?

The nurses who retired early or who are quitting due to stress may not necessarily want to leave the field altogether, but at that moment may not see another option. Making it easier for nurses to switch to another area of nursing in their current healthcare system may be a way for nurses to stay, but in a way that is healthier for them.

A medical-surgical nurse may grow weary of the constant physical and emotional stress of caring for critically ill patients in a hospital unit. They may desire a position where they can still have patient contact, but in a way that’s not so taxing to them. This nurse may be a prime candidate for a case management position. The downside? They don’t have formal case management experience. Would you hire them without it?

Another example may be a critical care ICU nurse who has been working tirelessly to care for critically ill patients. This nurse is burned out and experiencing compassion fatigue. They want to do something different and have had their eye on a labor and delivery nursing opening but has only ever worked in critical care for years. Would you hire them for the labor and delivery position without that experience? Or would you let them leave the system altogether, which is likely their only other option?

Offer opportunities for current employees

Provide a culture for nurses to admit when they’re struggling or having difficulty with continuing in their current role. It could be as simple as allowing nurses to shadow other nurses in a different area, to get a feel for how the other unit works and what it does. This could provide the nurse an opportunity for a better idea of what’s out there and how they may (or may not) like it.

Encourage a change in nursing specialization through the offering of additional formal educational experiences for nurses. Nursing fellowships or other formalized training and educational plans for nurses who are switching can help provide a smoother transition to a new role.

Provide internal networking opportunities for nurses to meet other nurses outside of their own unit. These meetings can give a nurse who may be questioning a new role the chance to meet someone who’s currently in it. This relationship can provide an additional educational experience for the nurse who’s looking to transition to something new.

Hosting internal job fairs may be an unconventional way to help nurse retention as well. This would allow nurses to see that it’s OK, maybe even encouraged, to see what else is available for them. Although it may seem counterintuitive to take nurses away from other units, it can save significantly in the long run.

Leaders and recruiters who understand what motivates nurses to stay or leave will have an advantage in retaining nurses, increasing job satisfaction, and growing nurse leaders. To learn more about what matters to nurses in their careers (including perspectives on nursing specialization), you can review the findings within the 2022 Nurse Salary Research Report.

Download the report here.