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5 Ways to Reduce Nursing Turnover in Year One

John Commins, for HealthLeaders Media, February 7, 2011

Turnover among first-year nurses remains a huge cost driver and source of frustration for hospital managers. It's hard enough to find these skilled clinicians, and even more annoying that they quit, just when they should be settling into their new careers. That leaves harried HR staff to start the process anew and with no more assurances of retaining the next new recruit.

Beyond the hard-and-fast cost of finding and on-boarding replacements or hiring temps, first-year nurse turnover impacts patient care. It also signals larger workforce management issues, most notably a failure to effectively engage employees and sell them on the mission.  

There are theories about why first-year nurses quit. Perhaps some of these new nurses weren't trained well in school, a cold fact that comes home quickly in the life-and-death hospital setting. Some new nurses probably have unrealistic expectations that collide with on-the-job realities. Some nurses get better offers elsewhere for their high-in-demand skills. Maybe, just maybe, your hospital is not a good place to work. Whatever the reason, the problem persists.

If it's any consolation, Shebani Patel, a director with PwC Saratoga, the workforce research arm of PricewaterhouseCoopers LLP, says retaining new workers is a challenge not unique to healthcare.

"First year turnover tends to be the most problematic length of service for most organizations across most industries," she says. "What is occurs is the assimilation process -- that is really critical for organizations -- but sometimes the goal is just filling positions and getting people in the door and the steps aren't always done in the best way possible."

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6 comments on "5 Ways to Reduce Nursing Turnover in Year One"


vdutton (3/4/2011 at 2:53 PM)
This is just more Hogwash! - The main problem with retaining nurses, patient safety, drug errors and nurses leaving the bedside (Hospitals do not hire enough nurses to safely take care of the patients)Hospitals are the biggest obstacle to improved healthcare.

Beth Boynton, RN, MS (2/12/2011 at 12:51 PM)
Great article! I especially like that you are including "employee feedback" in #3. I would add, "look for ways to invite and integrate input from staff for any problem solvin". It increases buy-in, role models collaboration, increases creative options, enhances outcome success, and builds assertiveness! Beth Boynton, RN, MS, author of "Confident Voices: The Nurses' Guide to Improving Communication & Creating Positive Workplaces"

Christina M. Guillen-Cook, MBA,BS, RN (2/8/2011 at 5:40 PM)
The key point that was not mentioned, was how hospital administrators[INVALID]managers, directors, CNOs, CEOs, etc.[INVALID]need to actually engage in practices that let nurses know how valued and respected all nurses are, new and seasoned, if they want to retain them. As I nurse of over 30 years, I continue to witness the chronic mismanagement of our profession. What nursing needs is actual leaders. Leaders who care about each other and the profession. Leaders who advocate for the profession. Leaders who can inspire and bring out the best in all nurses. I'm tired of nursing managers who cares only about themselves, their next job or the next rung on the professinal ladder. The current behavior among to many nursing managers is killing our profession. We need nurses who care about the profession, nurses and can advocate for our value in the workplace. Until we have that kind of leadership, we will continue to have nursing leave the profession and who can blame them.