Avoiding the Organizational Pain of High Nurse Turnover

By Keith Carlson via Multibriefs

In healthcare and nursing, employee turnover can have an outsized impact on staff morale, the financial bottom line, and the retention of organizational memory and knowledge.

In the 21st century, healthcare staff come and go for a variety of reasons; that said, prudent and forward-thinking organizations work diligently and consistently to combat inordinately high levels of nurse attrition.

The Pain of Nurse Turnover

Nurse attrition is no small thing — it impacts hospitals and other healthcare facilities and agencies in very significant ways, including the dampening of morale, a chaotic scheduling process, oodles of wasted money, and thinly stretched human resource teams.

First and foremost, nurse attrition hits the staffing process where it hurts. Having holes in the nursing schedule makes life that much harder for nurses who are likely already giving their all to patient care despite staffing issues.

Overworking the nurses who remain may seem prudent in the short term to a harried nurse manager, but increasing nurse-patient ratios can itself lead to burnout and even more attrition — a very vicious cycle, indeed.

According to the Robert Wood Johnson Foundation, replacing a nurse costs a healthcare organization between $22,000 and $64,000. The University of New Mexico reports that hospitals stand to lose $5.2 to $8.1 million annually in direct relation to nurse turnover. Adding insult to injury, Streamline Verify documents that 43 percent of new nurses leave their first job within three years.

With an overall average nurse attrition rate of 8 to 14 percent, the cost of losing and replacing nurses is significantly impactful.

Institutional/organizational memory receives little attention yet can impact organizational success quite powerfully. High levels of nurse attrition can lead to a loss of important institutional memory.

Staff nurses accrue specific types of institutional memory throughout the course of their tenure with any employer, and the loss of multiple nurses over a short period of time can result in a scarcity of nurses who hold the knowledge needed to carry the team forward.

The pain of nurse turnover is multifaceted and pervasive — stemming the tide is every healthcare or hospital organization’s cross to bear.

Multiple Bottom Lines

For healthcare organizations who give the lion’s share of their attention to the financial bottom line and precious little thought to those on the front lines, missed opportunities abound. After all, money isn’t everything.

In some management circles, the notion of “the triple bottom line” is a commonly shared ideal.

The triple bottom line generally refers to people, planet, and profit — this allows for a broader view of what “the bottom line” truly means. And in organizations who make money their sole focus, nurses can feel that they’re being given short shrift in relation to their own work-related satisfaction.

Healthcare facilities and agencies that alter their approach and make people equal in importance to profit will see positive gains.

When staffing issues are addressed in order to improve employee wellness and patient outcomes, the ripple effect on employee (and patient) satisfaction may be significant. Staffing procedures that make nurses’ jobs more efficient and productive are crucial efforts, especially when nurses subsequently have the wherewithal to spend more time with patients.

Some employees will appreciate that their employer is attempting to cut down on waste, increase recycling efforts, and otherwise lessen the significant environmental impact of healthcare delivery. Other employees will appreciate different employer initiatives.

In the final analysis, boldly moving beyond the old paradigm of a single bottom line will reap multiple rewards for all concerned.

Ignore at Your Peril

The organizational pain of high nurse attrition is significant and widespread. Tales abound of terrible management, high nurse-patient ratios, mandatory overtime, and general disregard for the wellness and satisfaction of the nurses who serve as the backbone of healthcare.

Burnout, compassion fatigue, and other ills of working in nursing are real. The institutions who employ nurses have a responsibility to stem the flow of nurse attrition, which ultimately benefits nurses, patients, and even that oft-cited financial bottom line.

The organizational pain of nurse turnover can never be fully resolved, but improved workplace environments and staffing practices can make an appreciable dent in a phenomenon that plagues healthcare organizations the world over.

Keith Carlson, RN, BSN, NC-BC, has been a nurse since 1996. He is the blogger behind the award-winning blog, Digital Doorway and a widely read freelance nurse writer. Keith is also the co-host of RNFM Radio, a popular Internet radio station devoted to the nursing profession. Under the auspices of Nurse Keith Coaching, Keith's passion is helping nurses and healthcare professionals create ultimate satisfaction in both their personal and professional lives.