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Nursing is one of the most respected and meaningful career fields. Despite this, the field also suffers high turnover rates. This makes nurse retention strategies increasingly important, particularly as the scope of the field expands and the responsibilities held by nurses become even more advanced.

An alarming survey from the recruitment company NSI Nursing Solutions, Inc. reveals that 21 percent of nurses hope to leave patient care. Another 22 percent want to retire soon. And 10 percent hope to leave the profession altogether. This problem must be addressed promptly as the cost of nursing turnover is considerable: averaging $44,400 for a single bedside RN—leading to approximately $4.8 million in losses due to turnover for the average hospital.

What Is Nurse Retention?

Every industry benefits from high employee retention. This term references the ability to keep the most skilled professionals on staff, rather than losing them to competing employers. An organization with poor retention may find that workers only stick around for a year or two before moving on to greener pastures. This prompts higher training and onboarding costs while limiting the ability to develop a consistent company culture.

In nursing, poor retention is especially problematic as patients report greater satisfaction when they enjoy continuity of care. Facilities with excellent retention can count on a highly skilled group of nurses to build strong relationships with patients, thereby improving not only satisfaction but also long-term health outcomes. Unfortunately, nurse retention is a point of concern in many healthcare facilities due to nurses often leaving their jobs—or nursing in general—due to burnout and other problems.

What Causes High Nursing Turnover?

A variety of issues may spark high nursing turnover. In general, this problem can be found when nurses are dissatisfied with their careers. Key sources of trouble include:

  • Toxic workplace culture

From bullying to sexual harassment, toxic behavior exists in far too many healthcare facilities. For the sake of their emotional or even physical health, few nurses are willing to put up with such problems for long.

  • Long hours

Many nurses report feeling overworked. Shift work can be a struggle, particularly if it means missing out on weekends or holidays. Other nurses feel that their work never truly ends as they are expected to keep up with email or complete other tasks after hours.

  • Limited opportunities for advancement

Many nurses aspire to one day gain leadership positions. For some, this means being a lead nurse or even a nurse practitioner. Others hope to move into specialties involving research or case management. If they don’t think they will eventually be able to move up the career ladder, they may seek jobs elsewhere.

  • Poor communication

The problems highlighted above can quickly be exacerbated by poor communication between nurses and management. Nurses may feel that their concerns are not heard or taken seriously. They may also struggle to form meaningful connections with fellow healthcare professionals, leaving them feeling isolated when they need support.

How Can Leaders in Nursing Help with Retention?

Healthcare leaders shoulder the responsibility of keeping nurses engaged. While some level of turnover is inevitable, retention can be dramatically improved when the following solutions are enacted:

Offer a Flexible Work Schedule

Shift work is a necessary reality at many facilities where nurses need to be available to care for patients throughout the night. These long hours feel manageable when nurses believe that they have some degree of control over their schedule. In some cases, this is possible by providing flexible opportunities. For example, nurses may be able to complete certain administrative tasks on a remote basis. As telehealth takes over, remote solutions may also prove helpful.

Limit Overtime

Overtime may seem like an unfortunate necessity, but a little advance planning can often limit the need for it. Begin by collecting detailed data about who works overtime and under what circumstances. This information can influence overtime rotations which should be established to prevent the same nurses from always working after their shifts have officially ended.

Make Career Development and Advancement a Priority

Do nurses feel that they have the potential to move up a rung or two on the career ladder without seeking opportunities elsewhere? Even if opportunities for advancement are available, nurses may not think these are realistic unless they are explicitly made aware of such possibilities.

Prioritize career development by creating mentorship programs or other initiatives that help nurses prepare to take on new responsibilities. After all, additional schooling may feel daunting but can be rewarding for some. However, a healthy workplace helps to motivate those considering more nursing education which comes with time and financial expenses, to push their career further. Encourage nurses to enroll in upper-level education programs that allow them to develop advanced skills that they can use to eventually move into different niches if desired. Help nurses determine what, exactly, it will take to accomplish their most ambitious goals. This might mean working closely with them to develop and implement personal success plans.

Get Feedback from Employees

Unfortunately, there’s often a significant disconnect between staff and management. Employers that fail to actively seek insight from nurses may never realize the reality of their situation. As a result, they may fail to implement the changes needed to keep talented nurses on staff.

This problem can be prevented by actively seeking feedback via anonymous surveys. These should be distributed regularly to ensure that nurses have the opportunity to sound off on the most recent developments within the facilities in which they work. Nurses should also be encouraged to meet with management and bring up their concerns on a face-to-face basis.

Open a Dialog Between Management and Employees

Employee feedback is important, but ideally, the effort to interact with nurses will go a step further. In addition to collecting surveys, schedule employee engagement panel discussions. Let nurses know that you value their honest feedback—and show them that you actually take their insight into account. This might mean crediting nursing staff with new initiatives or even hosting “thank you” events to let nurses know that their feedback has made a difference.

Create a Positive Working Environment

Workplace culture can determine whether nurses are willing to stick around, regardless of their current pay or hours. Implementing a positive environment begins with hiring; when possible, opt for nurses who share your values and are, therefore, most likely to fit in with your existing company culture.

Onboarding is also essential; nurses should understand expectations for interacting with one another from the start. Later, formalized solutions for conflict resolution can prevent negativity from seeping into the culture and becoming a day-to-day concern.

Reward Longevity and Excellence

Do your most loyal and successful nurses know how much they’re valued? While turnover is always worth avoiding, it’s especially important to hang on to employees who have faithfully served your organization for years or even decades.

Long-term employees crave recognition, so don’t hesitate to highlight milestones with special gifts. Better yet, throw full-blown parties or awards banquets to recognize major achievements. Regular raises and increased allowances for time off are equally important, as nurses may otherwise start to investigate higher-paying positions.

Any effort you dedicate towards keeping the most talented and passionate nurses on staff will be repaid tenfold over time. Let hardworking nurses know that they matter—the stakes are simply too high for anything less than stellar treatment.

If you’re interested in joining a new generation of highly skilled nurses, consider enrolling in one of the online nursing programs from the American Sentinel College of Nursing & Health Sciences at Post University. Reach out today to learn more.


Thank you for reading! The views and information provided in this post do not reflect Post University programs and/or outcomes directly. If you are interested in learning more about our programs, you can find a complete list of our programs on our website or reach out directly!