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Research literature on nurse retention
Literature review on effective strategies of nurse retention
Nursing turnover
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Recommended: Research literature on nurse retention
Nurse retention is a world-wide issue and should be one at the forefront of every nurse manager’s agenda as nursing shortages are being felt in numerous hospitals across the United States. According to Buffington, Zwink, Fink, DeVine and Sanders (2012) creating an organizational culture and environment that is committed to registered nurse (RN) retention is one strategy to reduce nurse turnover. Twigg and McCullough (2014) concur, as research reveals strategies promoting a positive work environment improves both nurse retention rates and quality of care for patients. Nurse leaders and managers play a critical role in developing this positive practice environment (Twigg & McCullough, 2014). Initiatives specifically aimed at empowering nurses within an organization through encouraging participation in hospital affairs, promoting autonomy, and valuing individual well-being, have all been linked to increased job satisfaction, consequently promoting a more positive work environment (Twigg & …show more content…
Thankfully several issues are currently being reviewed and addressed by the current ED manager, who has made it a personal goal to introduce new initiatives aimed at retention of personnel. In addition to hiring new staff, another initiative that has been introduced in our ED to help increase nurse satisfaction is instituting a mid-shift RN position (11 a.m. – 11 p.m.). Specifically this position allows the day and night shift the ability to take a lunch or dinner break while covering their patients. This intervention has proven successful at increasing job satisfaction for other hospitals, as not having a lunch break free from patient care or responsibility is wearing on a nurse and on their level of satisfaction within an organization (Buffington, Zwink, Fink, DeVine, & Sanders,
Talking about the change, reinforcing success and education upon hire are all part of creating a new culture. Continue to discuss ways to improve the meal break process and communication that occurs at that time. Communication and teamwork are necessary to ensure meal breaks occur; they are necessary in nursing practice to ensure patient and nurse safety. Units should talk about the difference meal breaks have made in their day. Patient satisfaction and patient safety such as fall occurrences should be trended to determine the effect of staff taking uninterrupted meal breaks. Ideally, patient satisfaction and patient safety trends should improve with nursing staff taking actual uninterrupted meal breaks. Trends should improve with the increased teamwork and communication resulting in answered call lights during breaks and awareness of where their nurse is when they do not see them or another nurse comes in to meet their needs. Upon hire, a routine of taking meal breaks should start from the very beginning and the expectation communicated with both the hire and their preceptor. Developing the routine during orientation should make it easier to keep the routine when practicing
Stevens, S. (2002, September-October). Nursing workforce retention: Challenging a bullying culture. Health Affairs, 21 (5), 189–193. http://dx.doi.org/10.1377/hlthaff.21.5.189
One of the problems that faces most health care facilities are being able to recruit and retain their nurses. Nursing shortage and turnover are a complex issue that is affecting healthcare delivery. Nurses form the majority in healthcare and mostly direct caregivers, its deficit poses a dangerous effect on the care of the sick and the disabled. Curbing the nursing shortage and turnover is important for facilities to hire and train their leaders and managers. A good leader or manager should be creative, effective, committed, initiative, motivated, and can handle stress (Huber,
In healthcare it is very important to have strong leaders, especially in the nursing profession. A nurse leader typically uses several styles of leadership depending on the situation presented; this is known as situational leadership. It is important that the professional nurse choose the right style of leadership for any given situation to ensure their employees are performing at their highest potential. Depending on which leadership style a nurse leader uses, it can affect staff retention and the morale of the employees as well as nurse job satisfaction (Azaare & Gross, 2011.) “Nursing leaders have the responsibility to create and maintain a work environment which not only promotes positive patient outcomes but also positively influences teams and individual nurses” (Malloy & Penprase, 2010.) Let’s explore two different leadership styles and discuss how they can enhance or diminish the nursing process.
Sherman, R. & Pross, E. (2010). Growing future nurse leaders to build and sustain healthy work
Due to the continuous nature of patient care, many areas of the nursing profession rely on shift work to maintain 24-hour staffing. According to the Institute for Work and Health, shift work has been defined as “employment with anything other than a regular daytime work schedule” (2012). While many nurses work one specific shift, such as days shifts or nights shifts, many work rotating shifts, in which nurses are scheduled to work a combination of day, evening, and night shifts (Walsh, 2013). They may work forward shift rotations, in which they work a day to night shifts in succession, or they may work reverse shift rotations, in which they transition from night to day shifts (Institute for Work and Health, 2012). A nurse working a shift rotation may transition between shifts over a period of days or a period of weeks. Although some areas still utilize eight hour shifts, most hospital systems have transitioned to 12-hour shifts over the past two decades . There has been concern that 12-hour shift rotations are contributing to burnout and nurse fatigue. Burnout is defined as extensive
The critiqued article, “Identifying the Key Predictors for Retention in Critical Care Nurses,” by Jo-Ann V. Sawatzky, Carol L. Enns, and Carole Legare, is a study of the key predictors in determining the retention of nurses who work in critical care areas. The abstract is complete, concise and comprehensible. The problem identified a shortage of nurses working in critical care areas, and the purpose of this study is to identify key factors leading to sparsity in critical care areas in hospitals. This is a significant problem, due to the shortage of critical care nurses being an ongoing issue, and reaching a crisis point throughout the world. (Sawatzky, Enns, & Legare, 2015).
Nurse managers who can exhibit a direct and favorable relationship with their staff may encourage them to tap into their intrinsic motivators to create a positive and engaging working environment. An efficient and reliable leader may consider steering away from her usual leadership style to aid in creating this environment. Staff members cannot be forced to make changes, but the use of positive psychology can help steer them in that direction. Ensuring healthy relationships in the workplace is another way of attempting to create an engaging environment. According to Manion (2011), positive psychology has revealed that a healthy relationship is built around positive-to-negative reactions. Other changes that could be implemented might be communicating expectations clearly to the staff and setting explicit performance goals and initiate an incentive plan to inspire them. When leaders strive to create healthy relationships, this shows the staff that they do care and are interested in their job
Notably, having higher proportions of nurses working shorter shifts—8–9 hours or 10–11 hours—resulted in decreases in patient dissatisfaction” (Stimpfel et al.). This is essentially saying that the longer the shift length, the more negative outcomes result. This study proves that eight to nine-hour shifts are more effective, and should, in turn, be worked more than longer shifts. This is a problem because hospitals are likely to continue to schedule nurses for twelve hours shifts out of
There are three significant characteristics related to nurses’ job satisfaction: intrapersonal relationships between nurses, the opportunity to provide quality patient care, and the organization of nursing work. (Houser et al. 2012) The following characteristics are pertinent to not only the nursing staff but also the patients under their care. The quality of care is the deciding factor if the patient will ever return to their institution again. The care the nurses provide needs to be exceptional. It needs to exceed or meet up to the needs of ones own expectation of care. Nurses who work together and help each other succeed in the time of a stressful situation, whether its on a day to day basis or if its long term, develop the greatest bonds with the best intrapersonal relationships. This could give the sense of acceptance and make the working environment not as stressful. Intrapersonal relationships are important in a working environment. They facilitate participation and discussions of concerns, improvements and praise amongst the nursing staff. Studies in the nursing literature have suggested relationships between formal shared governance structures and outcomes including work environment satisfaction, and financial implications. (Houser et al.
Nurses comprise the largest professional group within hospitals. Job burnout, lack of motivation, and dissatisfaction among nurses often contribute to costly labor disputes and turnover and increased risk to patients. Nursing research surveys found much higher job dissatisfaction and burnout among nurses who are engaged in direct patient care in hospitals and nursing homes when compared to those involved in other jobs or settings. Patients’ satisfaction levels tend to be lower in hospitals with more nurses who are dissatisfied or burnt out, a notable finding that signals serious concerns regarding the quality of nursing care. Consequently, improving nurses’ job satisfaction may improve patients’ satisfaction as well as the delivery
According to Breau and RÉAume (2014), some of the major reasons nurses are dissatisfied with their jobs is due to their salaries, work environment, and lack of educational and advancement opportunities. In fact, poor working conditions was a substantial predictor of a nurse’s intent to quit their job (p. 16). In addition, “unhealthy work environments are an important determinant of several work-related outcomes, including burnout, job dissatisfaction and turnover intent” (Breau & RÉAume, 2014, p. 17). Therefore, in order for nurses to overcome their dissatisfaction with work; nurse leaders need to create empowering environments that remove barriers to resources and information. In turn, nurses will then be able to share empowerment strategies,
... three public and two private hospitals. The response rate of this study was 79.6% out of 438. The findings of Mrayyan’s study showed that nurses reported that they were moderately satisfied with their jobs and had a neutral opinion about their retention. Nurses who worked in public hospitals reported lower levels of job satisfaction, and less of them had the intention to stay at their jobs than nurses in private hospitals. Al-Momani (2008) identified improved nurse retention in Jordanian public hospitals. The response rate was 92% out of 120. The conclusion of this study revealed ten key factors that influenced the respondents’ intention to leave their positions: salary, workload, autonomy in decision-making, caring environment, motivation system, job description, nurses’ welfare, growth opportunities, perception of fair leadership, and recognition for work done.
A Review on Nurse turnover in New Zealand: costs and relationships with staffing practices and patient outcome.
Singh and Loncar utilized information from two hundred registered nurses who are union members to gain insight upon the changes nursing and hospital management should make to reduce turnover among the nursing staff and gain the maximum benefit from their employee investment. Employees who become disproportionally dissatisfied with their employment fail to strive for the best possible output and instead perform to the bare minimum of standards. This may cause failure to meet service standards, leading to customer dissatisfaction.