Nurse turnover among new graduate nurses is a recurring problem for healthcare organizations. The turnover among new nurses is often higher than that among senior nurses
(Beecroft, Dorey, & Wenten, 2008). Nurse turnover in the first year of practice ranges between
35% and 60% (Halfer, Graf, & Sullivan, 2008). Nurse retention, particularly retention of new nurses, should closely focus on preventing nurse turnover and developing effective retention strategies. Concerns regarding registered nurse (RN) turnover are heightened during times of nurse shortages. These concerns originate from both economic and non-economic sources
(Jones, 2007). Regarding the economic sources, there are concerns about the costs of turnover including the loss of nursing
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As a whole, high nurse turnover and vacancy rates negatively affect health care access, patient care quality, and nurse job satisfaction (Jones, 2007). There are significant costs and consequences of nursing turnover to healthcare organizations. The profit margin of numerous healthcare organizations are remarkably affected by high nurse turnover. The cost associated with filling a nursing vacancy includes posting the position, filling the vacancy with nurses working overtime or nurses from staffing agencies, interviewing potential candidates, and orientating new employees. For these reasons, retention of nurses is essential for high quality patient care and outcomes in today’s health care industry; moreover, a high retention rate decreases costs for health care organizations.
According to the 2016 National Healthcare and RN Retention Report, in 2015, the national turnover rate for bedside RNs increased from 16.4% to 17.2%, while RN vacancies continue to trend negatively with a third (32.9%) of the hospitals reporting a vacancy rate of
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Like many hospitals the University of Miami Hospital (UMH) has faced the problem of retaining nurses especially new graduate nurses. According to the University of Miami
Hospital’s Human Resources Retention 2010-2016 Data about 50% of new graduate nurses within each annual residency (fall and spring residencies), resigned before the end of their two year employment contract Based on exit interview recorded responses, many of the new graduate nurses resigned due to lack of support, unfair patient load, lack of an effective electronic medical record system, and bullying from experienced nurses. With an average of 21.0% turnover rate over the past ten years among new nurses, the University of Miami Hospital’s bottom line has been significantly impacted. The University of Miami Hospital reported a high vacancy rate of
25.14% the first quarter (January 2017-March 2017 which can negatively affect patient care, nursing workload, productivity, and revenue. When healthcare organizations were sorted by for-profit versus non-profit ownership, RN vacancy rate at for-profit-acute care hospitals experienced the highest vacancy rate and exceeded the national average with a vacancy rate
There are many possibilities to consider when looking for a cause of this problem. Typically work force problems are looked at as an issue of supply and demand (Dauphinee, 2005). Workforce numbers in Canada as a whole are monitored from several databases (Dauphinee, 2005). But when predicting future trends its hard to account for everything (Dauphinee, 2005). The population continues to increase (“New Incentive,” 2013). As of January 1, 2014 there are 1, 117, 503 people in Saskatchewan, which is an increase of 20,056 from the previous year (“New Incentive,” 2013). More people means more medical care. This can cause a strain on the current medical professionals (“New Incentive,” 2013).
This article is a comprehensive look at staffing on hospital units. It used a survey to look at characteristics of how the units were staffed – not just ratio, but the experience and education level of the nurses. It evaluated several different categories of hospital facilities – public versus private, academic medical centers versus HMO-affiliated medical centers, and city versus rural. It is a good source because it shows what some of the staffing levels were before the status quo of the ratio legislation passed in California. It’s main limitation as a source is that it doesn’t supply any information about patient outcomes.
Nevidjon, B., & Erickson, J. (31 January, 2001). The Nursing Shortage: Solutions for the Short
The shortage of registered nurses (RNs) in the United States has been a cyclical topic dating back to the 1960s. Only recently have employers in certain regions of the nation stated a decline in the demand for RNs. Consequently, according to the American Association of Colleges of Nursing’s (American Association of Colleges of Nursing [AACN], 2014) report on 2012-2013 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, American nursing schools denied admission to 79,659 qualified applicants from baccalaureate and graduate nursing programs in 2012. The reported decrease in job availability and rejected admissions has left many individuals to question if the nursing shortage still exists. On the other hand, some experts project that the United States will be short more than one million RNs by 2020 (Dolan, 2011). Although some parts of the country are in less of a demand than others, it is undeniable that there is a national shortage of RNs.
What causes the problem? The problem is caused by finances. Hospitals claim they face declining reimbursements, and have chosen to cut nursing staff to lower their expenses. Has anyone tried to do anything about it? If so, why haven’t they succeeded?
Recent literature reports that there is a nursing shortage and it is continually increasing. Data released by the American Association of Colleges of Nursing (2011) projects that the shortage, would increase to 260,000 by the year 2025. AACN (2011) also reported that 13% of newly registered nurses changed jobs and 37% were ready to change within a year. A study conducted reports that there is a correlation between higher nursing workloads and nurse burnout, retention rates, job dissatisfaction and adverse patient outcomes (Vahey & Aiken, 2004). Among the nurses surveyed in the study, over 40% stated that they were suffering from burnout while 1 in 5 nurses intended
Clark, P., Leddy, K., Drain, M., Kaldenberg, D. (2007). State nursing shortages and patient satisfaction
"Toward a Method for Identifying Facilities and Communities with Shortages of Nurses." Health Resourses and Services Administration. 2004. U.S. Department of Health and Human Services. 5 Dec. 2012 .
However, upon securing a job, they find that things on the ground are not as they had expected them to be and this results in some of them deciding to leave the profession early. Research shows that turnovers within the nursing fraternity target person below the age of 30 (Erickson & Grove, 2011). The high turnover within the nursing fraternity results in a massive nurse shortage. This means that the nurses who decide to stay have to work for many hours resulting in exhaustion. A significant percent of nurses quitting their job sites exhaustion and discouragement as the reason that contributed to their decision. In one of the studies conducted on the issue of nurse turnover, 50% of the nurses leaving the profession argued that they felt saddened and discouraged by what they were unable to do for their patients (Erickson & Grove, 2011). When a nurse witness his/her patients suffering but cannot do anything because of the prevailing conditions he/she feels as if he/she is not realizing the reason that prompted him/her to join the nursing profession. The higher rate of nursing turnover is also affecting the quality of care nurses provide to
Thousands of nurses throughout the nation are exhausted and overwhelmed due to their heavy workload. The administrators do not staff the units properly; therefore, they give each nurse more patients to care for to compensate for the lack of staff. There are several reasons to why
In spite of the shortage among nurses, there are number of options and recommendations that can better help to maintain an adequate staff level and provide greater strategies needed to increase nursing. The choices open to cover for insufficient staff range from reallocating and postponing work, relocating staff within unit or from other units, to employing temporary additional nurses according to Buchan and Seccombe (1995). In health care, some of these options may not be available because ...
The prolonged shortage of skilled nursing personnel has been a serious concern to the healthcare industry, and this shortage has impacted the quality of care delivery. In addition, nursing turnover has also exacerbated the problem of nursing shortage. Nursing shortage has been blamed on many nurses retiring and less younger nurses joining the occupation. There is also an increase in life expectancy (baby boomers) leading an increase in both physical and mental ailment with subsequent demand in nursing care. Nurses are also leaving nursing profession because of inadequate staffing, tense work environment, negative press about the profession, and inflexible work schedules. Even though nursing is a promising career and offers job security, the
Bedside nurses want to change staffing levels to assure that they have enough time to both keep up with the constantly evolving health care and to provide safe patient care. Yet, healthcare employers consider that reducing nurse patient ratio is an unnecessary expense that has not been proven to improve quality of patient care (Unruh, 2008). Employers emphasize that raising nursing staffing level is not cost-effective. In fact, in accordance with ANA’s report (2013), a study, in the Journal of Health Care Finance, confirmed that reducing patient-nurse ratios increased hospital costs, but did not lower their profitability. Higher hospital costs were attributed to wages and benefits allocated to newly hired nurses. Yet, according to Cimiotti et.al (20112), it is more costly for hospitals to not invest money on nursing.
In addition to concerns about the adequacy of the supply of nurses the financial impact of high turnover was startling. According to Jones (2005) Using the updated Nursing Turnover Cost Calculation Methodology, the per RN true cost of nurse turnover is calculated to be 1.2–1.3 times the RN annual salary. That estimate is derived from a retrospective, descriptive study of external RN turnover cost data at an acute care hospital with over 600 beds. The findings indicate that the three highest cost categories were vacancy, orientation and training and newly hired RN productivity. (as cited in Kooker & Kamikawa, C. 2011). For example, At the Queen’s Medical Center, the annual salary of an experienced RN is currently $91,520. Therefore, using the
As the forthcoming nursing shortage threatens the United States, organizations must be knowledgeable in the recruitment and retention of nurses. The challenge facing health care organizations will be to retain sufficient numbers of nurses to provide safe, efficient, quality care to patients. Organizations will look to recruit and attract quality nurses to fill vacancies. As turnover in nursing is a recurring problem, health care organizations will look for strategies to reduce turnover. The rate of turnover for bedside nurses in 2013 ranged from 4.4 to 44.6% (American Nurses Association, 2013). Nurse retention focuses on keeping nurses in the organization and preventing turnover. The purpose of this paper is to discuss the significance of recruitment and retention of nurses, review the literature, and explore how recruitment and retention apply to nursing.