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Nursing Turnover and Retention Strategies

Anita Kudlyuk

School of Nursing, James Madison University NSG 462: Issues in Contemporary Nursing

Practice Professor Janelle Garman MSN, RN, CEN; Dr. Jill Delawder DNP, RN, ACCNS-AG,

CCRN-CSC, FCCS; Dr. Angela Wallace, DNP, NNP-BC; Dr. Karen Jagiello, PhD, RN, CNE

October 6, 2022
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Nursing Turnover and Retention Strategies

A hot topic of discussion in the nursing community is high nursing turnover. Dissatisfied

nurses are leaving their current employment and seeking other jobs. Some simply seek new

bedside employment, some pursue a career that does not entail direct patient care, some seek

remote jobs or jobs in aesthetics, and some nurses completely change career paths. This paper

will discuss why nurses leave and why, and suggestions on what hospitals can change in order to

retain nursing staff. Hospitals must begin to listen to their nursing staff and include them in

decision making through shared governance.

Why nurses are leaving

According to Lockhart (2020), the current nursing turnover rate in the United States is

19.1% and that number is expected to get even bigger in the coming years. The top reasons

behind leaving are high workload, poor work-life balance, and nurses not feeling valued and

heard by hospital management (Lockhart, 2020; Eriksson et al., 2022).

High Workload

Many nurses initially pursue a career in nursing due to the opportunity to help other

people and to feel fulfilled by serving the community. However, if the initial driver for the career

is gone, it leads to dissatisfaction and pushes many to seek a new job. Nurses who left reported

being overloaded with work responsibilities in their previous job leading to burnout and feeling

unfulfilled in their job (Eriksson et al., 2022)

Poor Work-Life Balance

Another important reason why nurses left was a poor work-life balance. Many nurses

reported feeling like they didn’t own their own time when they were not working. With staffing

shortages, management would implement changes that triggered nurses to leave. Changes like
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increasing call requirements, requiring that every nurse work night shift, or nurses working

overtime makes it difficult to separate work from personal life, eliminating the opportunity to

rest and disconnect from work. This also makes it difficult to coordinate home schedules

including childcare and extracurricular activities (Eriksson et al., 2022).

Nurses Feeling Not Valued by Management

Yet another critical reason nurses decided to leave was because they did not feel valued

by their unit management as well as upper management in the hospital. Nurses reported feeling

like management was not listening to the employees, and instead would implement decisions that

staff nurses were strongly against, leading to turnover (Eriksson et al., 2022).

How Institutions Can Reduce Nurse Turnover

Hospitals can reduce number of nurses leaving by simply listening to what nurse want to

change rather than focusing on what is most financially beneficial to the hospital. When a person

feels heard, they are more likely to have a sense of belonging in an institution. Often nurses leave

because time and time again what they ask for is not listened to, and change is not made where it

is most needed. Hospitals will even play on the nurse’s guilt, whether intentionally or not, by

praising burnt out employee for their willingness to serve the community while putting

themselves in danger of infection. This approach leaves the nurse feeling like they are being less

compassionate if she or he needs to leave their position due to their mental health or because

they feel like they are not being treated fairly.

According to Duru & Hammoud (2022), a case study was performed in a one hospital

that found three common themes related to nursing retention strategies. Nurses wanted to feel

more fulfilled and satisfied with their job. The nurses also wanted to have what they considered
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to be a fair pay for the work they performed. Lastly, nurses wanted to feel heard and have

effective communication with seniors and peers (Duru & Hammoud, 2022).

The hospital was able to retain more nurses when changes were implemented that

focused on these three elements. The hospital used strategies such a shared governance to help

the nurses feel heard, tuition reimbursements and sign-on bonuses to address the financial aspect,

and a special focus on recognition for accomplishments to help nurses feel more satisfied with

their jobs (Duru & Hammoud, 2022).

Conclusion

Just like in any other profession, nurses want to feel respected, heard, and valued.

Unfortunately, nurses are often mistreated and forgotten due to hospitals weaponizing the

nurse’s passion for serving the community. Phrases like “healthcare hero” and “nursing is not

just a job but a calling” play on the nurse’s compassion in order to steer away from the fact that

nurses are often doing more work than what they are payed to do, under subpar conditions,

while understaffed. Hospitals must stop ignoring the elephant in the room and begin treating

nurses not just as servants of the community but like professionals that must be treated fairly

and compensated fairly for their work. Once hospitals begin to respect nurses for the work they

do, provide competitive financial compensation, and implement shared governance, more

nurses may stay, and nursing turnover rates are likely to decrease.
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References

Duru, D. C., & Hammoud, M. S. (2022). Identifying effective retention strategies for front-line

nurses. Nursing management (Harrow, London, England : 1994), 29(1), 17–24.

https://doi.org/10.7748/nm.2021.e1971

Eriksson, A., Vulkan, P., & Dellve, L. (2022). A case study of critical reasons behind hospital

nurses turnover due to challenges across system levels. Journal of Multidisciplinary

Healthcare, Volume 15, 1213–1224. https://doi.org/10.2147/jmdh.s363390

Lockhart, Lisa MHA, MSN, RN, NE-BC. Strategies to reduce nursing turnover. Nursing Made

Incredibly Easy!: March/April 2020 - Volume 18 - Issue 2 - p 56.

doi: 10.1097/01.NME.0000653196.16629.2e