Nursing Turnover: Costs, Causes, & Solutions

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Introduction: Nurse turnover is defined as “the number of nurses changing jobs within an organization or leaving an organization within a given year” (Baumann 2010). Retaining nurses is one of the most important issues in health care as its effects range from challenges in human resource planning, to high costs in financial and organizational productivity (Beecroft et al, 2008), to workgroup processes and morale, to patient safety and quality of care (i.e. patient satisfaction, length of patient stay, patient falls, and medication errors) (Bae et al, 2010). Nursing Solutions Inc (NSI) reported the national average turnover rate for hospitals increased from 13.5% in 2012 to 14.7% last year. Nurses working in Med/Surg had more turnover than any other specialty with a rate of 16.8%. Other specialties that exceeded the national average were ER, Behavior Health, Step Down, and Telemetry. The cost of this high turnover ranges from $36,000 to $88,000 to lose a bedside RN, resulting in an average hospital losing $3.74M to $6.98M (NSI, 2014). The NSI 2013 “National Healthcare Retention Survey” found that almost 90% of organizations view retention strategies as imperative for success, however less than half of them have a retention strategy in place. With a large population of nurses approaching retirement and a growing economy that historically supports higher turnover rates, hospitals cannot afford to not invest in a nurse retention strategy, since a high nurse turnover results in nurse burnout and job dissatisfaction which in turn results in more turnover, forever feeding the cycle. Literature Review: Extensive research on impacts and determinants of nursing turnover has been done for decades resulting in numerous causative theories,... ... middle of paper ... ...n, D., Barton, D., Davis, C., and G. Rook. 2012. Tripping over the welcome mat: Why new nurses don’t stay and what the evidence says we can do about it. American Nurse Today. O’Brien-Pallas, L., Murphy, G., Shamian, J., Li, X., and L. Hayes. 2010. Impact and determinants of nurse turnover: a pan-Canadian study. Journal of Nursing Management. 18: 1073-1086. PricewaterhouseCoopers Health Research Institute. 2007. What Works: Healing the Healthcare Staffing Shortage. New York: PricewaterhouseCoopers. Smith, J., and L. Crawford. 2003. Medication errors and difficulty in first patient assignments of newly licensed nurses. JONAS Healthcare Law Ethics Regulation. 5(3):65-67. The University Healthsystem Consortium/American Association of Colleges of Nursing. 2009. Nurse Residency Program.

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