Wipe out Causes of Nurse Turnover To Boost Retention

Ever think about putting in the painstaking effort of looking at the nurse retention data in your organization?

We hear you — it may not look pretty. The nurse turnover rate for RNs hovers around 17.2% in the U.S., according to the 2019 National Health Care Retention& RN Staffing Report.

By analyzing nurse retention rates — though not an easy venture — the results can reveal a telling story about your employees, according to Megan Bailey, RN, BSN, MHA, workforce product manager with University of Utah Health Regional Network in Salt Lake City.

“When we looked at retention, we had turnover for multiple reasons, such as nurses moving to other local hospitals, going on to pursue higher education and career paths, or nurses moving on for opportunities in other states.”

Bailey led a team of seven hospitals in five states and collected data from 1,771 nurses to pinpoint nurse turnover based on their years of employment. The team broke it down into five segments.

“We looked at retention rates across the board to see where our turnover was happening,” she said.

Nurses were segmented by years of employment in the following categories:

  • 1 year
  • 4-6 years
  • 10 years
  • 15 years

The team started collecting data in December 2018 and finished in May 2019. Bailey designed the standardized survey questions for all hospitals and the timeline for collection. They collect this nurse turnover data every six months.

In the year 1 group, Bailey said they showed 100% retention.

“Year 4-6 varied between hospitals,” she said. “If they were near a university it was higher turnover because they work there for experience and then move away.”

The data collection showed nurses with 10 and 15 years who work at rural hospitals showed better retention rates, which Bailey said is likely because of home ownership and belonging to a community.

But in urban areas, nurses with 10 to 15 years of employment showed a drop in retention rates, something Bailey attributes to the group’s career advancement goals.

Deep dive into why nurses leave

Ask any nurse if they experience things such as an aching back or burnout. Chances are, after years of lifting patients, many would raise their hand with an emphatic yes to both.

For some, these are reasons to leave. That is, unless the facility provides the right equipment and supplies needed to perform their jobs, said Christine Kovner PhD, RN, FAAN, the Mathy Mezey professor of geriatric nursing at New York University’s Rory Meyers College of Nursing.

“As a nurse manager, you can effect some of these changes,” she said. “You can buy the right kind of equipment. You can have lifts to decrease the amount of injuries nurses get, and the chief nursing officer has some control over that.”

More often than not, the No. 1 reason nurses leave a good job is because of their supervisor, Kovner said based on a 10-year project that segmented nurses by the year they graduated from nursing school.

The RN Work Project has provided Kovner and her team data that they are still analyzing and reporting.

There are two main reasons why nurses leave their jobs, Kovner said.

  1. First is because of their nurse manager.
  2. Second is because they have an injury or the feeling that they are at high risk of injury, such as a needle stick or back problem.

As a recruiter, both of these nurse turnover factors are beyond your control, according to Kovner.

Instead of trying to work magic, focus on what is within your control.

Kovner suggests making improvements to the work environment. That includes making sure nurses have enough supplies, such as catheter kits, and working computers, which is something that drives more efficiency.

Plus, Kovner said having to fetch a cath kit from another department, “on 12 West,” is not only inconvenient, but it also delays patient care.

“Considering other industries, it would be unusual to expect people to do their job without having the supplies they need,” she said.

Internships can reduce nurse turnover

Like many healthcare organizations, University of Utah Health Regional Network is affected by nurse turnover rates and the nursing shortage. That is why they decided to launch a six-month paid internship program for nurses.

“We have nurses with a lack of experience,” Bailey said. “But because of the nursing shortage, we cannot just leave those vacant positions open otherwise it leads to nurse burnout, feeling overwhelmed and decreased nurse satisfaction.”

All of those factors contribute to a lower quality of care for patients.

“Everything we are doing is patient-centered, and when we are short staffed, our patients suffer,” she said.

Bailey explained that they plan to launch the internship in March 2020 with six nurses — and a golden nugget nurses will adore.

“When we hire them into this internship, it will be with a commitment to be hired into a position,” she said. “That way we know we will retain those nurses.”

The internship combines classroom learning activities with working on the floor with seasoned nurses. Interns will make their rounds at four different hospitals but will remain within their specialty area, which ties into the education.

“We will have their education track tailored to their specialty,” Bailey said. “We will pay for their housing and travel reimbursement.”