Nurse Retention Strategies: Ways to Retain Nurse Talent

The nurse turnover rate surged by over 30% between 2018 and 2022, as highlighted by a recent nurse staffing report . The uptick underscores a persistent issue in nurse retention, with far-reaching consequences for patient care and the overall stability of health care institutions.

A complex interplay of factors has contributed to nurses leaving their positions or even leaving the profession entirely. Addressing the challenges demands a comprehensive approach. Through adept nurse retention strategies, health care leaders can not only tackle pressing turnover challenges but also enhance patient care quality.

The Nurse Turnover Challenge

High nurse turnover creates serious challenges for the health care industry. The challenges go well beyond staffing shortages — threatening patient care quality and organizational stability.

When nurses leave, the remaining nurses often find themselves overburdened. This can lead to burnout, higher turnover, and a cascading effect on nurse staffing levels and the overall quality of patient care.

Consider several consequences of high nurse turnover:

• Understaffing: High nurse turnover can create gaps in staffing. Studies have linked low staffing levels to higher rates of in-hospital mortality, increased risk of infections, and longer hospital stays.
• Increased Nurse Workload: As the remaining nurses take on additional tasks to cover for vacant positions, their workload can increase significantly. This can result in excessive stress and decreased job satisfaction among staff.
• Quality of Care: Understaffing can compromise the quality of patient care because nurses spend less time with each patient.
• Overtime: Nurses may be asked to work overtime or extra shifts. This can disrupt their work-life balance and lead to fatigue and lowered morale.
• Recruitment Challenges: High nurse turnover rates may discourage candidates from accepting job offers. This only perpetuates staffing shortages.
• Additional Costs: Constantly recruiting and training new nurses to replace those who leave costs health care organizations time and money.

Nurse Turnover Statistics

Findings in a recent NSI National Health Care Retention and RN Staffing Report speak to the far-reaching implications of high nurse turnover:

• Though hospitals managed to regain some of the talent lost during the Great Resignation, increasing registered nurse (RN) staffing by 4.17%, nurses are still leaving their jobs at a rate of 22.5%.
• On average, health care organizations must spend an extra $52,350 for each nurse lost.
• The average hospital spends or saves approximately $380,600 a year for each percentage point change in RN turnover.
• Nationally, almost 16% of RN positions in the health care industry are vacant or unfilled.
• Over 75.4% of health care institutions report a vacancy rate exceeding 10%.
• The RN Recruitment Difficulty Index shows that it takes more than three months to recruit an experienced RN.

Factors Contributing to High Nurse Turnover

Addressing nurse turnover requires health care leaders to understand the factors contributing to it. This understanding can provide the insights needed to tackle the challenge head-on.

What drives nurse turnover ? A combination of issues contribute to the issue.

Workload and Burnout

Long shifts and high patient-to-nurse ratios frequently lead to nurse burnout. Strenuous patient loads, extended hours at the bedside, intricate documentation, and the emotional demands of nursing can leave nurses feeling physically exhausted and emotionally fatigued, prompting them to seek opportunities elsewhere.

Job Dissatisfaction

Job dissatisfaction can stem from inadequate recognition and lack of autonomy. Feeling underappreciated can lead to job dissatisfaction and result in nurses becoming disheartened and disengaged.

During a nursing shortage, additional stress and heavier workloads can intensify the impact of feeling underappreciated, potentially leading to even higher levels of job dissatisfaction. This sense of dissatisfaction often affects nurses’ commitment.

Lack of Professional Development

Nurses thrive on opportunities to grow professionally and develop their skills. Nurses in organizations that don’t offer professional development can feel stymied.

For example, specialized training workshops in advanced cardiac care or pediatric critical care can equip nurses with the expertise to provide specialized care to patients in critical condition.

Such opportunities not only enhance nurses’ clinical competency but also boost their confidence in tackling complex cases. A lack of educational and advancement opportunities can hinder nurses’ career advancement and diminish their loyalty to an employer.

Inadequate Communication

Open and effective communication supports a harmonious workplace for nurses. However, when nurses feel left out of the loop about important decisions, changes in policies, or patient care plans, their morale can suffer. Lack of communication can also lead to confusion and frustration, which erodes job satisfaction.

How to Successfully Retain Nurses

Nurse leaders play a pivotal role in creating supportive, fulfilling environments that not only retain experienced nurses but also enhance patient care. By implementing effective nurse retention strategies, health care organizations can quell rising nurse turnover rates and lessen the negative impact that this problem has on the nursing profession.

The nurse retention strategies below apply to various aspects of nursing workplace culture.

Boost Nurse Morale and Job Satisfaction

High morale and job satisfaction make nursing staff more likely to stay with their organization. Positive feelings tend to increase motivation among nurses and foster a sense of loyalty and commitment. This, in turn, leads to higher retention rates and a more stable and skilled nursing workforce.

Nurse leaders can employ various methods to boost nurse morale and job satisfaction .

Education Support for Professional Growth

The nursing profession is constantly evolving. Health care organizations should therefore empower nurses by offering pathways for professional growth . These opportunities equip nurses with the tools and knowledge needed to excel and send a clear message that their aspirations and contributions are valued. Providing support for their professional growth can enrich the quality of patient care and serve as a catalyst for nurse satisfaction and long-term commitment.

Nurse leaders can offer comprehensive education support and avenues for professional advancement through:

• Tuition Reimbursement Programs: Financial assistance for nurses pursuing higher education or advanced degrees, fostering a culture of lifelong learning
• Continuing Education Opportunities: Ongoing training and workshops to enhance clinical skills and keep nurses up to date with the latest medical advancements, specific medical topics, new treatment methods, or evolving health care technologies

Effective Communication and Feedback

Effective communication and feedback create collaborative work environments in which nurses feel heard. Nurses who receive clear communication and constructive feedback can better understand their roles, what’s expected of them, and areas for improvement.

This can reduce misunderstandings and promote a sense of belonging within nursing teams that, in turn, can boost morale and reduce the likelihood of turnover. Additionally, open communication allows nurses to voice their concerns, leading to a timely resolution of issues and a stronger sense of investment in their roles.

The following nurse retention strategies can help bolster internal communication with nursing staff :

• Open Channels of Dialogue: Creating a safe space for nurses to express concerns, ideas, and suggestions, such as:
  • Nurse huddles
  • Employee suggestion boxes
  • Roundtable discussions
• Regular Recognition and Feedback Mechanisms: Reinforcing nurses’ value to the organization by implementing systems that acknowledge nurses’ accomplishments and provide constructive feedback, such as:
  • Monthly awards
  • Feedback sessions
  • Performance incentives

Fostering a Culture of Respect and Empowerment

A workplace culture rooted in respect and empowerment often gives nurses a greater sense of ownership and pride in their work.

Empowered nurses are more likely to stay in their roles, as they feel supported and recognized for their contributions. This strategy also promotes collaboration and teamwork, leading to improved patient care and overall team performance.

Ways to foster cultures of respect and empowerment include the following:

• Empowering Nurses in Decision-Making: Involving nurses in important decisions related to patient care and unit management by inviting them to participate in:
  • Quality improvement projects
  • Policy review and development
  • Clinical research
• Embracing Diversity and Inclusion: Encouraging an inclusive environment through:
  • Diverse hiring practices
  • Review of policies and procedures to ensure inclusion and unbiasedness
  • Establishment of employee resource groups in which nurses from underrepresented backgrounds can share experiences, offer support, and advocate for inclusive policies

Competitive Compensation and Benefits

Compensation reflects the value that health care organizations place on their employees’ work. Comprehensive benefits, such as health care coverage, retirement plans, and wellness programs, can also enhance a nurse’s well-being and job satisfaction.

Fairly compensated nurses are more likely to remain loyal. Additionally, competitive compensation and benefits packages help health care organizations attract and retain top talent .

Competitive compensation packages should include the following:

• Fair Salary Structures: Compensating nurses appropriately based on their skills, experience, and responsibilities, as well as ensuring transparent salary structures competitive with the job market and aligned with the value of the work
• Comprehensive Health and Wellness Benefits: Offering robust health care plans, mental health support, and wellness initiatives to enhance overall well-being

Resources for Boosting Nurse Morale and Job Satisfaction

The following resources provide valuable insights and practical nurse retention strategies for nurse leaders working to enhance nurse morale and job satisfaction. The resources delve deeper into the various aspects of creating a supportive and engaging work environment for nursing staff, ultimately contributing to improved retention rates and better patient care.

• “Leadership Styles and Nurses’ Job Satisfaction. A Systematic Review” explores how various approaches to leadership can affect how nurses feel about their jobs. This offers key insights into which leadership styles can best promote job satisfaction.
• The Importance of Education in Nurse Retention explores the role of education and professional development in addressing the nursing shortage crisis and increasing nurse retention rates. The article discusses the high success rate of these education initiatives compared with other nurse retention strategies.
• “Effective Communication: Get the Nursing Team on the Right Track” delivers actionable strategies that nurse leaders can use to boost communication, along with ways to avoid counterproductive approaches to communication.
• “Connection Is Retention: Lessons From Leaders With Unusually High Nurse Retention” offers insight into which practices meant to reduce turnover achieve their intended goals and which don’t. It also sheds light on how nurse leaders who focus on help, care, and growth improve nurse retention.
• “Creating Empowering Conditions for Nurses With Workplace Autonomy and Agency: How Healthcare Leaders Could Be Guided by Strengths-Based Nursing and Healthcare Leadership” explores how the leadership framework helps empower nurses to reach their full potential, resulting in greater job satisfaction and retention.

Address Nurse Burnout

The term “nurse burnout” refers to the physical, emotional, and mental exhaustion caused by chronic workplace stress. Burnout among nurses often results from high demands, inadequate resources, and a lack of support.

Nurses who experience burnout become disillusioned with their jobs. They often have feelings of cynicism and reduced personal accomplishment, feelings that can interfere with their commitment to their jobs.

By addressing nurse burnout, health care organizations can create more supportive work environments. This in turn can positively affect nurse retention. Nurse leaders can implement several nurse retention strategies that tackle burnout, reducing stress and enhancing nurse well-being at the same time.

Adequate Staffing Levels

Maintaining adequate staffing levels ensures that nurses’ workloads are manageable. Heavy workloads and long hours due to understaffing can make nurses more susceptible to physical and emotional exhaustion — the hallmarks of burnout.

Sufficient staffing allows time for essential rest and recovery. When nurses don’t have a chance to recharge, their physical and mental resilience can erode, affecting their well-being and jeopardizing patient safety.

On the other hand, adequate staffing eases the pressure that nurses experience and lowers their stress levels, reducing the risk of burnout. To maintain adequate staffing levels, nurse leaders can implement various strategies, including the following:

• Effective Workforce Planning: Allocating resources efficiently and proactively addressing staffing gaps as well as using predictive scheduling technologies , when available, that can forecast:
  • Patient volume
  • Staff requirements
• Flexible Staffing Models: Adjusting staffing levels based on patient demand, fluctuations in workload, and nurse availability by using adaptable staffing strategies , such as:
  • Float pools (nurses trained to work in various units who can be deployed to units facing temporary shortages)
  • Part-time positions

Overtime Management

While overtime may offer a temporary solution to staffing shortages, excessive overtime can have negative consequences on both nurses and patients. Extended work hours can diminish nurses’ ability to perform their best.

The fatigue caused by excessive overtime can also increase nurses’ stress levels, disrupt sleep, and contribute to a decline in overall health. Ultimately, if not carefully managed, overtime can lead to nurse burnout.

Relying heavily on overtime can also create a negative workplace culture that normalizes overwork. This can discourage potential candidates from joining the workforce and drive away experienced nurses seeking a healthier work environment.

To prevent excessive overtime, nurse leaders can use the following nurse retention strategies:

• Overtime Monitoring: Keeping track of overtime hours and patterns to identify trends and areas that require intervention and requiring overtime approval protocols to prevent excessive overtime
• Balanced Workload Distribution: Assigning work evenly among nurses to prevent a few individuals from consistently bearing the brunt of overtime

Wellness Programs and Mental Health Support

Wellness programs and mental health support provide nurses with resources and tools to prioritize their well-being. These initiatives offer nurses a safe space to discuss their challenges and seek professional help, fostering emotional resilience. This can significantly reduce burnout risk.

Programs may include the following:

• Stress reduction workshops
• Mindfulness training
• Fitness initiatives
• Access to wellness coaches

Nurse leaders can sustain these initiatives through:

• Collaboration With Mental Health Professionals: Partnering with mental health experts to design and deliver tailored programs that address the unique stressors nurses face in their roles
• Needs Assessments: Evaluating the specific stressors and challenges nursing staff face by:
  • Conducting surveys to gain insights into nurses’ concerns
  • Organizing focus groups to understand nurses’ preferences for support

Resources for Tackling Nurse Burnout

Explore the following resources for managing nurse burnout:

• The Looking After Your Team’s Health and Well-Being Guide is packed with practical insights, exercises, and resources that address the physical, mental, emotional, and social well-being of nurses. Based on input from health care professionals, the guide is a practical tool designed to foster well-being within teams.
• Healthy Nurse, Healthy Nation , an American Nurses Association (ANA) program, focuses on all aspects of nurses’ well-being, including physical, mental, emotional, and social health. Nurse leaders can find resources that address nurse burnout and offer strategies to enhance different dimensions of well-being.
• The SE Healthcare Burnout Prevention Program (free to ANA members) provides on-demand access to a collection of over 190 short video modules covering topics such as building a better day off, delegation, shared governance, and ethical dilemmas, all designed to identify and address nurse burnout issues.
• The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores the various issues that affect nurses’ well-being, including mental and social health, discrimination, and racism. It also includes some approaches to improving nurses’ well-being.

Strategies for Recruiting Nurses

Nurse recruitment and nurse retention are intrinsically linked. Effective nurse recruitment strategies play a critical role in building a strong and sustainable nursing workforce that, in turn, improves nurse retention.

Nurse leaders are pivotal in both attracting new nursing talent and ensuring that new recruits feel supported and valued. Consider some strategies that nurse leaders can use to recruit a thriving nursing workforce .

Leveraging Technology and Social Media

Technology and social media offer powerful tools for nurse recruitment. Nurse leaders can embrace these platforms to connect with potential candidates.

• Online Job Platforms: Using reputable online job platforms allows nurse leaders to advertise nursing positions to a wide audience. These platforms are popular with job seekers, making it easier for nurses to find and apply for positions that align with their skills and aspirations.
• Engaging Social Media Campaigns: Social media channels provide platforms to exhibit the organization’s culture, values, and success stories. Nurse leaders can create engaging content that highlights the positive aspects of working for their organization.

Collaboration With Nursing Schools and Programs

Building partnerships with nursing schools and programs is a strategic approach for recruiting promising nursing talent. Nurse leaders can establish connections that benefit both students and health care organizations.

• Internship and Residency Initiatives: Partnering with nursing schools to offer internships and residency programs can help bridge the gap between classroom and practical knowledge. Internships and residency programs provide students with hands-on experience, easing their transition into the nursing workforce and increasing the likelihood of considering employment within the organization.
• Mentorship and Preceptorship Programs: Nurse leaders can establish mentorship and preceptorship opportunities for new nurses. This support system helps them navigate the challenges of their initial nursing roles, making them more likely to remain with the organization that invested in their growth.

Resources to Assist With Nurse Recruitment

The following resources provide valuable insights and practical strategies for nurse leaders engaged in recruiting new nursing talent:

• The Nursing Workforce: Challenges and Solutions During the COVID Era , a report produced by the Organization of Nurse Leaders, gives an overview of the factors contributing to the current nursing shortage and explores potential solutions to recruitment and retention challenges.
• The Nurse Retention Tool Kit provides research-based tips for nurse leaders on nurse engagement, nurse education, burnout prevention, and work-life balance that can improve recruiting and retention efforts.
• Recruiting Nurses explores steps that health care organizations can take to attract nurse candidates. It focuses on ways to improve written job descriptions and expand the search criteria to maximize the potential of online hiring tools.
• How to Recruit Nurses serves as a guide for employers seeking to fill nurse positions. It offers sample job descriptions for a range of nursing roles, discusses ways to source quality candidates, and provides interview questions.
• Ten Recruiting Strategies to Attract Nurses offers creative ideas to bolster nurse recruitment efforts and respond more effectively to nurses’ needs for supportive work environments and incentives.

Build a Strong Nursing Workforce

Nurse retention strategies and effective recruitment are fundamental to addressing the challenges of turnover and nursing shortages. By implementing these strategies, nursing leaders can foster a more engaged and satisfied nursing workforce, leading to better health care for all.