Ensuring appropriate nurse staffing levels is key to the financial health of healthcare organizations like hospitals and skilled nursing facilities. High quality nursing care helps to reduce the likelihood of patients safety events and costly medical malpractice lawsuits related to missed errors. The second of a two-part series, this article addresses effective retention strategies that leaders can utilize to help reduce turnover of nursing staff.
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Ensuring appropriate nurse staffing levels is key to the financial health of healthcare organizations like hospitals and skilled nursing facilities. High-quality nursing care helps to reduce the likelihood of patient safety events and costly medical malpractice lawsuits related to missed errors. This means it is critical for leaders to engage in effective retention strategies.
The second of a two-part series, this article addresses effective retention strategies that leaders can utilize to help reduce turnover of nursing staff.
The 2021 National Health Care Retention and RN Staffing Report notes that the average cost of turnover for a hospital-based RN was $44,400 in 2020. This makes retention a key part of an organization’s staffing strategies. You need to work closely with human resources staff to ensure retention strategies are efficient, effective, and in-line with organizational strategies.
Conduct “stay” interviews. Stay interviews help you identify employees who might be thinking about leaving the organization and identify what factors are most important for staying. You can use the information to create an individual retention plan and to inform your larger retention efforts for the unit. Here are some examples of questions you can use to help elicit useful information during stay interviews:
- What do you look forward to each day when you commute to work?
- What are you learning here, and what do you want to learn?
- Why do you stay here?
- When is the last time you thought about leaving and what prompted it?
- What can I do to make your job better for you?
Promote a healthy work environment.
For example, implement zero tolerance policies for patient or visitor violence against nurses and policies that discourage providers from bullying their colleagues. Beyond policies, it is also important to ensure lines of communication are open, so your staff feel comfortable speaking with you when they identify problem areas. Make rounds daily and listen to staff closely. Ask them questions such as, “What do you need to do your job more effectively?” If it’s something that you can take care of, do so and let them know it’s been done. If you can’t address the issue, explain why and, if appropriate, note that it may be able to be addressed in the future.
Avoid sign-on bonuses. Sign-on bonuses may help to ease staffing woes short term, but don’t ensure commitment, and can even lead to resentment from current staff. Instead, focus on improving nurses’ pay scales or offering retention bonuses to show appreciation for your nursing staff’s commitment to the organization.
Recognize employees. Recognition is an easy, but often underutilized, retention tactic. Take every opportunity to offer words of praise. To reinforce the behavior, specify what specifically was done to earn praise. Small rewards such as gift cards can also be effective, but try to match them to the individual’s interest. For example, a nurse who drinks coffee every day may enjoy a Starbucks card, but one who loves to read might prefer a card from Barnes & Noble.
Support career development. Explore nurses’ professional goals and how you can help meet them during stay interviews and other ongoing professional development conversations. It’s a good idea to keep a mental list of options such as serving on committees, acting as a preceptor, and leading project teams. Offer meaningful opportunities for professional growth based on performance, rather than solely based on tenure. Outline for your staff the types of experiences or skills that are most valuable for advancement and reinforce the value of bedside nursing experience for nurses’ long-term career growth.
Consider a job embeddedness approach. Job embeddedness (JE) focuses on why people stay in their jobs as opposed to why they leave. A study by Reitz and colleagues found it’s a good predictor of nurses’ intent to stay. JE looks at ties related to organizations and the community where they exist. These ties are considered in three dimensions: links (formal and informal connections people have with their organizations or communities), fit (how compatible people feel with their organizations or communities), and sacrifice (material and psychological losses people would experience by leaving their organizations or communities). You can leverage these dimensions to promote retention. For example, to help promote JE with the organization:
- Links: Involve nurses in committees and shared governance.
- Fit: Recruit nurses whose goals align with the organization’s goals.
- Sacrifice: Align vacation time and retirement plans with the time of service.
A multifaceted approach
Nurse staffing challenges are unlikely to ease anytime soon. Leaders will need to be creative and take a multifaceted approach to recruitment and retention. These efforts will help gain—and keep—staff. Doing so helps reduce the costs of lawsuits related to errors, but, most importantly, provides optimal patient outcomes.
Article by Georgia Reiner, MS, CPHRM, Risk Specialist, NSO
Advisory Board. Struggling to keep entry-level staff engaged? Try a performance-based career ladder. 2017. https://www.advisory.com/blog/2017/02/pef-career-ladder
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NSI Nursing Solutions, Inc. 2021 National health care retention and RN staffing report. 2021. https://www.nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdf
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Disclaimer: The information offered within this article reflects general principles only and does not constitute legal advice by Nurses Service Organization (NSO) or establish appropriate or acceptable standards of professional conduct. Readers should consult with an attorney if they have specific concerns. Neither Affinity Insurance Services, Inc. nor NSO assumes any liability for how this information is applied in practice or for the accuracy of this information.
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