A Review on Nurse turnover in New Zealand: costs and relationships with staffing practices and patient outcome.
Introduction The article intends to present an analysis of the New Zealand turnover of nurses which was preceded by the existence of nursing need that has been going on for years following an increase of demand for nurses with limited supply. Two studies were done separately on 2001 and 2002 with regards to nursing turnover expenses and it was concluded that the actual cost is not often available. In 2004-2006 a national study was done to identify direct and indirect cost of nurse turnover and how it is related to staffing operation and its effect for nurses and patients. Not long ago, the aforementioned study was given a second
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Turnover cost were determined by two variables. Criteria for expense were as follows, advertising/recruitment and hiring process per new employee direct cost is at NZ$735, indirect cost which consist of preceptor costs, decreased initial productivity of new employee, orientation and training is at NZ$3 142 summing up to NZ$3 878. Moreover temporary cover cost per leaver variable is NZ$19 922. Indirect cost is twice as expensive as direct cost and per leaver variable expense is seven times higher than per new employee expenditure. The sum of the two variables is at NZ$23 800. The data also presents that nurses who fill up vacant position are from outside the organization which consist of international trained nurses, fresh graduates and applicants from other places in New Zealand makes up 83% of the pool of new recruits. From this, statistics shows the total expenditure for a new employee to reach 100% productivity in relation to their professional status prior to hiring. The most costly is hiring a new graduate nurse with expense amounting to NZ$4 804, followed by overseas trained nurses at NZ$4 467. While less expense are spent on nurses returning to ward at NZ$941 and internal transfer at NZ$ 1711, the 2 latter figure evaded cost related to medical screening, uniform allowance, relocation expense and orientation into the organization. The big chunk of financial charge in the turnover practice is on temporary cover. This charge is not only seen in nurses who resigned but also encompasses present shortages and sick absences. The money spent in this variable covers the payment given to a substitute staff, overtime, making arrangement for temporary replacement and productivity loss by a regular staff helping out the interim staff. Another significant data in this study collects the average annual turnover rate which is at 44.3% (North, N. et al,
The nursing shortage and turnover are an issue that continually, constantly and bedevils the nursing leaders and managers. Without sufficient numbers in nursing, patient care and safety is considerably compromised, with lapses in service delivery, overworked and overwhelmed nurses more prone to making mistakes and across board dissatisfaction. Nursing shortage leads to nurse turnover because of the ones carrying our nursing duties are finding it hard to meet the demand, and they eventually burn out. This paper critically examines the issues of the nursing shortage and turnover and how the nurse leaders and managers can tackle the situation, easing the outcomes (The Truth About Nursing, 2012).
As the forthcoming nursing shortage threatens the United States, organizations must be knowledgeable in the recruitment and retention of nurses. The challenge facing health care organizations will be to retain sufficient numbers of nurses to provide safe, efficient, quality care to patients. Organizations will look to recruit and attract quality nurses to fill vacancies. As turnover in nursing is a recurring problem, health care organizations will look for strategies to reduce turnover. The rate of turnover for bedside nurses in 2013 ranged from 4.4 to 44.6% (American Nurses Association, 2013). Nurse retention focuses on keeping nurses in the organization and preventing turnover. The purpose of this paper is to discuss the significance of recruitment and retention of nurses, review the literature, and explore how recruitment and retention apply to nursing.
It can cost hospitals more than $12,000 to replace a nurse (Purcell et al., 2011). Additionally, nurse burnout can affect patient satisfaction levels. A nurse’s level of burnout, which can affect patient satisfaction, is correlated to their desire to quit their job. Patients who were cared for by nurses with low levels of burnout received the highest gratification evaluations (Brooks et al., 2010). When nurses are exhausted and plan to quit their current job, patient’s satisfaction levels decrease (Brooks et al., 2010)....
There are several factors that are considered the causes of the nursing shortage. Literature suggests that the shortage is linked to factors related to current population trends and the nature of the health care e...
The nursing shortage is divided into four different categories. The four categories are as follows; "willing nurse" shortage, funding or perceived funding shortage, shortage of understanding that nurses are needed to deliver care, and nurse education and empowerment shortages (What is the nursing shortage and why does it exist?., 18 October, 2007). To be able to repair this major problem, all four segments of shortages need to be addressed. The first nursing shortage, A "willing nurse" shortage, is the simple fact of not enough supply to fill the demand of nursing positions. This shortage occurs either because there are simply not enough nurses to fill the open positions, or because experienced nurses are opting out of nursing and the willingness to provide care due to the current occupational environment. The second nursing shortage is the funding or perceived funding shortage. This shortage is merely due to nurses not feeling as if they are being compensat...
The nursing shortage most likely does not mean a great deal to people until they are in the care of a nurse. The United States is in a severe nursing shortage with no relief in sight due to many factors compounding the problem and resulting in compromised patient care and nurse burnout. Nursing shortages have been experienced in the past by the United States and have been overcome with team effort. However, the current shortage is proving to be the most complex and great strides are being made to defeat the crisis before it becomes too difficult to change. Researchers anticipate that by 2010, the United States will need almost one million more registered nurses than will be available (Cherry & Jacob, 2005, p. 30).
In spite of the shortage among nurses, there are number of options and recommendations that can better help to maintain an adequate staff level and provide greater strategies needed to increase nursing. The choices open to cover for insufficient staff range from reallocating and postponing work, relocating staff within unit or from other units, to employing temporary additional nurses according to Buchan and Seccombe (1995). In health care, some of these options may not be available because ...
However, upon securing a job, they find that things on the ground are not as they had expected them to be and this results in some of them deciding to leave the profession early. Research shows that turnovers within the nursing fraternity target person below the age of 30 (Erickson & Grove, 2011). The high turnover within the nursing fraternity results in a massive nurse shortage. This means that the nurses who decide to stay have to work for many hours resulting in exhaustion. A significant percent of nurses quitting their job sites exhaustion and discouragement as the reason that contributed to their decision. In one of the studies conducted on the issue of nurse turnover, 50% of the nurses leaving the profession argued that they felt saddened and discouraged by what they were unable to do for their patients (Erickson & Grove, 2011). When a nurse witness his/her patients suffering but cannot do anything because of the prevailing conditions he/she feels as if he/she is not realizing the reason that prompted him/her to join the nursing profession. The higher rate of nursing turnover is also affecting the quality of care nurses provide to
In addition to concerns about the adequacy of the supply of nurses the financial impact of high turnover was startling. According to Jones (2005) Using the updated Nursing Turnover Cost Calculation Methodology, the per RN true cost of nurse turnover is calculated to be 1.2–1.3 times the RN annual salary. That estimate is derived from a retrospective, descriptive study of external RN turnover cost data at an acute care hospital with over 600 beds. The findings indicate that the three highest cost categories were vacancy, orientation and training and newly hired RN productivity. (as cited in Kooker & Kamikawa, C. 2011). For example, At the Queen’s Medical Center, the annual salary of an experienced RN is currently $91,520. Therefore, using the
The prolonged shortage of skilled nursing personnel has been a serious concern to the healthcare industry, and this shortage has impacted the quality of care delivery. In addition, nursing turnover has also exacerbated the problem of nursing shortage. Nursing shortage has been blamed on many nurses retiring and less younger nurses joining the occupation. There is also an increase in life expectancy (baby boomers) leading an increase in both physical and mental ailment with subsequent demand in nursing care. Nurses are also leaving nursing profession because of inadequate staffing, tense work environment, negative press about the profession, and inflexible work schedules. Even though nursing is a promising career and offers job security, the
Recent literature reports that there is a nursing shortage and it is continually increasing. Data released by the American Association of Colleges of Nursing (2011) projects that the shortage, would increase to 260,000 by the year 2025. AACN (2011) also reported that 13% of newly registered nurses changed jobs and 37% were ready to change within a year. A study conducted reports that there is a correlation between higher nursing workloads and nurse burnout, retention rates, job dissatisfaction and adverse patient outcomes (Vahey & Aiken, 2004). Among the nurses surveyed in the study, over 40% stated that they were suffering from burnout while 1 in 5 nurses intended
The purpose of this paper is to address the issue of nursing staffing ratios in the healthcare industry. This has always been a primary issue, and it continues to grow as the population rate increases throughout the years. According to Shakelle (2013), in an early study of 232,432 surgical discharges from several Pennsylvania hospitals, 4,535 patients (2%) died within 30 days of hospitalization. Shakelle (2014) also noted that during the study, there was a difference between 4:1 and 8:1 patient to nurse ratios which translates to approximately 1000 deaths for a group of that size. This issue can be significantly affected in a positive manner by increasing the nurse to patient ratio, which would result in more nurses to spread the work load of the nurses more evenly to provide better coverage and in turn result in better care of patients and a decrease in the mortality rates.
Management spends several hundred dollars for each new nurse that it hire and train. Using Benner’s theory, and investing in nurse retention will decrease costs, as well as having resulted in better patient outcome. A savings of one and one- half to two times of a salary is estimated to have occurred in reducing nursing turnover (Friedman, Delaney, Schmidt, Quinn, & Macyk, 2013). During my first four to five years in my current post,. I noted there to be an increase in novice and advance nurses not staying very long. Upon doing exit interviews it was brought to my attention, that the orientation, he or she received was not enough to make them feel comfortable. The nurses felt that he or she had been rushed through orientation, and did not feel confident in dealing with some
Davidson, M. C., Timo, N., & Wang, Y. (2010). How much does labour turnover cost? International Journal of Contemporary Hostpitality Management, 22(4), 451-466.
Singh and Loncar utilized information from two hundred registered nurses who are union members to gain insight upon the changes nursing and hospital management should make to reduce turnover among the nursing staff and gain the maximum benefit from their employee investment. Employees who become disproportionally dissatisfied with their employment fail to strive for the best possible output and instead perform to the bare minimum of standards. This may cause failure to meet service standards, leading to customer dissatisfaction.