Nursing Retention in Healthcare

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Nurses play an integral part in the provision of health care the United States. In America, there is a shortage of nurses across the country that is estimated to increase within the next few years. The nursing shortage is only compounded by the increasing number of Baby Boomers and the numerous amount of nurses expected to retire in the coming years. With that being said, health systems are struggling to retain a satisfactory number of nurses per year. The turnover rate regarding nurses is higher in healthcare than any other field. In the coming years, HR managers will be tasked with dealing with the recruitment and retention of talented nurses who by and large greatly affect health system finances.

In 2014, nursing turnover rates reached 17.2% according to Nursing Solutions (2015), which was a 4% increase from 2010. Hospital RN vacancies increased to 20.6% in 2014 and are expected to rise significantly with the retirement of many experienced nurses. Filling vacancies for hospitals now takes between 53 to 110 days for recruiters (Nursing Solutions, 2015).

Studies show that the loss of one nurse costs anywhere between $22,000 to $64,000 (Jones & Gates, 2007).

Why should hospitals be concerned with nursing retention? Studies show that the loss of one nurse costs anywhere between $22,000 to $64,000 (Jones & Gates, 2007). When one considers the average turnover percentage of nurses, hospitals can suffer millions of dollars lost to recruiting replacements, advertising vacancies, loss of experience, training, and most of all, patient care.

High turnover rates have been attributed to a number of things within the healthcare field. The top complaints for job dissatisfaction include burnout and high nurse to patient ratios, high workloads, increased paperwork, lack of acknowledgement and appreciation, and lack of decision-making opportunities. These issues play a large role in the culture of an organization and have adverse effects on the patient care and quality of care. If career dissatisfaction continues, it could very well affect the outlook of potential nurses in the future which could further exacerbate the nursing shortage.

The top complaints for job dissatisfaction include burnout and high nurse to patient ratios, high workloads, increased paperwork, lack of acknowledgement and appreciation, and lack of decision-making opportunities.

Human resources can employ several tactics to deter nurses from leaving and assess the discrepancies that nurses in their specific hospital experience. Decreasing the amount of turnover in turn decreases the amount of money spent on recruitment, increases the organization’s productivity, increases patient safety and health outcomes, and also improves the work environment and satisfaction of all workers.

Here are some of the possible strategies recommended to reduce nursing turnover:

  1. New Hire Check-ins – Identifying concerning issues early on can decrease the likelihood of new nurses leaving. The percentage of first-year nurses that changed jobs peaked at 13% (Nursing Solutions, 2015).
  2. Employee Satisfaction Surveys and Assessments – Directly engaging employees about their satisfaction with their job will allow HR to improve the working environment and work to solve issues that plague the nursing staff. Interviewing current employees also allows employers to develop compensation packages that deter employee departure.
  3. Exit Interviews – Every HR department should conduct exit interviews to assess why the employee departed organization. This allows the HR department to gather data on issues that cause nurses to leave.
  4. Job Analysis – HR departments should conduct a periodic job analysis of nursing positions to assess the positives and negatives of the job. Is the job satisfying, does the job allow the employee to exercise all their skills, and do the activities of the job fit the compensation package?

Developing an efficient retention plan for nursing positions could increase the financial outcomes and quality of care in hospitals. Conducting interviews for currently employed nurses and employee satisfaction surveys can allow HR departments the resources and data to better retain nurses. Nurse dissatisfaction has shown to produce more clinical mistakes and adverse patient outcomes. High burnout rates and patient overloading have contributed to increasing turnover rates within the nursing field. The effects that nurse vacancies and shortages have on patient outcomes and safety also affect health expenditures which are also on the rise. HR can effectively play a role in retaining nurses which can in turn allow hospitals to invest financial resources in other areas to increase satisfaction for customers, nurses, and the healthcare organization overall.


Jones, C., Gates, M., (September 30, 2007)  “The Costs and Benefits of Nurse Turnover: A Business Case for Nurse Retention” OJIN: The Online Journal of Issues in Nursing. Vol. 12 No. 3.

Beaulieu-Volk, D. (2014, October 27). Nurse retention strategies: Keys to empowerment, ownership and support. Retrieved February 26, 2017, from

Writer, L. S. (2016, January 22). Nursing Shortage Statistics. Retrieved February 26, 2017, from


3 thoughts on “Nursing Retention in Healthcare

  1. Your blog makes me reflect back on the Nurse Sabbatical program. Hopefully, over time administrators will realize that nurses need periodic time away from work in order to recharge and capitalize on the educational opportunity offered in such programs. Bisk (2017) refers to several solutions that administration can implement for nurse retention including recognizing great work, being available, rewarding loyalty and mentorship, focusing on orientation and encouraging career development. As you mentioned this issue needs to be addressed and swiftly. I am twenty years your senior, I hope that there are some competent and compassionate nurses left to take care of me in the future. Hopefully, Julius and the rest of my cohort will have this issue resolved by the time I am in need.

    Bisk. Keeping Nurses: Strategies for Nurse Retention. (n.d.). Retrieved February 27, 2017, from


  2. Julius,
    The nursing shortage is a major issue. One that we, as health administrators, will be dealing with once we are working. The aging population and the rise of chronic diseases are creating a driving demand for nurses. Nursing is a hot career to go in right now, and most that graduate with their BSN have a job before graduating. The main cause of the nursing shortage is while there may be a need for nurses, there are not enough spots in nursing programs because there are not enough professors, that is why it is so competitive to get into these programs. More nurses isn’t the solution, however. It’s retainment. There are reasons why nurses change careers or move into higher positions. Burnout, high patient loads, and long working hours all contributed to dissatisfied nurses. I can’t wait to discuss this issue with my group in class!


  3. Julius, this is a great topic that is very critical to St. Julius University Hospital. As a teaching hospital, we need to strive to not only create a beneficial educational experience for our residents but also to retain our current nurses. The nursing shortage is a very serious thing that creates problems within the organization and can create many financial losses. I think the recommendations for nursing retention are very good in determining a solution for our hospital as well. One thing I feel would be a great idea is to learn why a newly hired nurse left her/his previous position and what they expect out of their new job. We need to strive to keep our nurses happy because without them our organization would crumble. We need to find out exactly how many nurses are needed for each floor in order to keep the workforce running smoothly and also to make sure they know they are appreciated. Nurses choose their profession because they care about the lives that they are taking care of so it is imperative that we continue to keep that fire alive in our hospital.


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