Nurses make up the largest proportion of healthcare workers in the US. Nurses are involved in almost all aspects of care, including monitoring and assessing patients, bedside and medication management, assistance with surgeries, data collection/reporting, etc. In fact, a large proportion of the recordings that medical transcription companies transcribe consist of nurse dictation.
However, recent reports indicate that the nation is projected to experience a shortage of Registered Nurses (RNs) due to factors such as the aging Baby Boomer generation and the growing need for health care services (www.aacnnursing.org).According to US Bureau of Labor Statistics (2018) projections, 1.1 million additional nurses are needed to avoid a further shortage.
The RN Work Project, a 10-year national longitudinal study of new nurses started in 2006, found that more than 18% of new nurses quit their first job within a year and more than 26% leave it within two years. Healthcare organizations need to take measures to retain their nurses. The first step in this direction is to look into the reasons why nurses decide to stay or decide to leave their job. Here are the findings of the 2018 Press Ganey Nursing Special Report on this matter:
- Nurses across all age groups and experience levels cited dissatisfaction with the work environment as the key factor driving them to quit.
- For nurses who had been practicing less than two years, praise, recognition, nurse manager support, certification, and joy in work were the key predictors of intent to stay.
- For RNs practicing for more than 20 years, intent to stay was driven by leadership, influence over their schedule, and quality of care.
- Nurses in adult step down and med/surgical units with sick patients and less staffing than a critical care unit, were more likely to say they were going to leave within one to three years.
As one expert notes, to prevent nurse attrition, organizations need to understand the varying motivators of job satisfaction across the nursing life cycle (www.healthleadersmedia.com). The following strategies can help organizations retain nurses in the workplace:
- Improve the work environment: It’s hardly surprising that organizations with a negative reputation see an outflow of nursing staff. According to the Health Leaders Media report, one hospital struggled with nurse recruitment and retention due to its punitive environment leading to a lack of respect toward nurses by physicians and administrators, and from nurse to nurse. The hospital also acquired a negative reputation because of its poor quality outcomes and a restrictive policy of recruiting only experienced nurses. The situation improved significantly when the hospital took steps to improve the work environment.
- Overhaul the recruitment process: The healthleadersmedia.com report describes how the hospital reversed its policy of hiring only experienced nurses and focused simply on recruiting graduates. The CNO met each candidate personally and spoke about the hospital’s vision for the future.
- Flexible scheduling: Flexible work options can serve as organizational recruitment/retention strategies. While needing significant work, nurses want to balance their many work-life responsibilities. With flexible work schedules for nurses, hospitals can manage their round-the-clock patient care needs. Flexible work options are a win-win situation for health care organizations and nurses.
- Efficient role assignment: Hospitals will benefit if they deploy older nurses as mentors for new nurses. Experienced nurses can guide younger nurses and help them discharge their duties efficiently. The organization will benefit as the protégé’s confidence grows and the mentor contributes to the retention of a new nurse.
- Fostering career development and recognition: Implementing measures to promote both career development and recognition are important to keep both experienced and fresh RNs. Nurses need professional support to stay abreast of technological advancements and innovations and get to the top of the game. Career ladders rooted in accomplishment vs. tenure can help organizations retain RNs.
- Promoting a healthy work environment: Creating a healthy work environment allows nurses to provide high standard, compassionate patient care while promoting professional fulfillment and self-care to prevent burnout. Measures to improve working conditions and ease workload include adding more elevators and ceiling lifts, and investing in quality medical transcription services.
Organizations should also offer compensation and benefit packages to retain seasoned nursing staff. Older nurses should be adequately compensated for their role and experience. Additional incentives for retention include rewarding high performers, offering paid training opportunities, and providing more opportunities for internal advancement.