Nurse Retention
Jennifer Voelkel
American Sentinel University
Sim 499- Capstone Project
December 13, 2020
Nurse Retention
Nursing retention is the aptitude of a healthcare facility to hold healthcare nurses after employment. Retaining the healthcare nurses helps the healthcare facility avoid turnover and, in turn, improves patients’ safety and the individual attention accorded. Nursing retention entails an institution being able to address the nurses’ individual welfare to avoid dissatisfaction and burnouts; an organization needs an in-depth understanding of factors that necessitates the nurses to stay within their premises and develop strategies to retain the nurses within the working environment.
Failure to address this pertinent issue may reduce the length of stay within the premises by the dissatisfied nurse, delayed attention, care and treatments. In addition to that, nurses will take time probing other avenues for survival. Nurses retention is a healthy and worthy practice if well used in a hospital environment. First and foremost, it improves job satisfaction and workers morale; this will escalate to service delivery and commitment.
Secondly, the retention of experienced nurses over a long period builds the organization’s image, enhances the quality of services and helps build relationships between the patient and the caregivers. It is also a strategy of building a stable workforce; new studies compare the cost of retaining a nurse to hiring. The latter is considerably higher; therefore, keeping nurses is significantly cheaper. Taking care of the nurses, you employ leads to nurse retention and job satisfaction.
Good leadership and enhanced nursing fraternity management is a vital role in strengthening the workforce, management that inspires, builds trust and loyalty in their force, inspires and positively influences their ability to make informed decisions to stay. Organization culture and leadership styles should be geared towards enhancing workforce and improvement of retention rates. When employees see the leadership team take strides in making a positive work environment and have open communication with staff helps retaining good team members.
Impact of Nurse Retention on Individual’s Nursing Profession
Nursing retention poses a significant effect in the nursing profession. Nursing retention especially resulting from the organization, greatly affects an individual caregiver’s profession. The impact of nursing retention on an individual generally reduces the quality of health service provided by the individual caregiver. Nurse retention may affect the nursing profession in one of the following ways:
Increased Workload
The most crucial factor with implication as a result of nurse retention is the increased workload to nurses. This is due to the increase in the number of patients seeking healthcare services compared to decreased staffing levels. The nurse’s experiences fatigue as a result of overwhelming healthcare services. This negatively affects the standards of healthcare services they provide.
Institution’s Climate
The employee’s feelings and perceptions are greatly influenced by the climate created in their working institution. Patients develop some perception in regards to the environment established by the nurses who serve them. On the other hand, the organization’s management and leadership staff greatly affect the nurses’ climate. Some factors, such as employees’ job satisfaction, the effectiveness of leadership, communication channels, and teamwork, influence the climate created in the institution. An idealistic working climate in an institution is created when job satisfaction, motivation and performance recognition are met. All these affect the quality of healthcare services nurses provide in an institution.
Institution’s Structure
The most important factor in any institutional structure is the communication’s channel. Nurses need to know who they are reporting to their roles and their operations in the organization. Relationships, communications, and knowing appropriate persons to whom an employee is answerable are crucial in an organization. This helps in avoiding miscommunications and increases performance in the nursing profession.
Professional Career Improvement
Some nurses prefer continuation with their education through attending part-time classes. Due to staff shortage, it becomes challenging to have in-service training and on-work practice for the nurses, especially for the newly employed nurses. Internally, the nursing shortage also poses a challenge in conducting orientation programs for the newly employed staff since this may result in patient’s complications as well as medicolegal occurrences.
Working Hours Schedules
Work schedule plans such as longer shifts forced extra working hours, and inflexible working hours affect nurses’ health standards and performance levels. Older nurses put under these tight working schedules may sense the strain and develop some health complication which may cause them to retire earlier than expected later. On the same note, younger nurses also get affected by the tight working schedules as they meddle around with their families and social life.
Impact of Nurse Retention on the Nursing Profession
Nurses shortage is increasing every day due to the increasing number of patients who seek health care services. Hence, there is a need to retain professional nurses. However, retaining these professional nurses possess some effect in the nursing profession. The following are some of the effects of nurse retention in the nursing profession:
Attracting professionally retired nurses to join high managerial positions in the Nursing profession may affect professional standards. The retired nurses indeed have immense experience concerning management and practice. However, the worry is their ability to apply the experiences they have in the real nursing situation. Old nurses’ experiences may be outdated due to some reasons, such as improved technology and modern tools and equipment used by the nursing team. A conflict would arise in a scenario where a young nurse tries to explain a concept to the old nurse due to such improvements in technology. On the same note, old nurses would get it challenging, adapting the tight work schedules due to nurse shortages.
The effect of values in different age groups within the nursing profession affects nurses’ behaviours towards work, authorities, and patients. In a nutshell, values influence nurses’ perception of ranks, requirements and commitments to the institution. The old nurse’s value authority, responsibility, and age while the young nurses are more attracted to how fast the work is done. The old nurses take nursing as a calling and strictly follow the old school norms while the young nurses are more industrious and complete tasks.
Another factor that affects the nursing profession as a result of nurse retention is the nursing, public image. The 2007 nursing strikes in South Africa rendered nurses very heartless as patients were in dire need of their service. This engraved the negative public image depicted in South African Media. The issue of nurses striking is very common in various Countries. The South African media depicted nurses as after money rather than after the healthcare of patients. Striking cases reported by the South African media showed forms of nurse’s carelessness, abuse of patient’s as well as the absence of professionalism in their practice.
Work relationship within an institution also affects the professional standards of the nurses. Verbal abuse between the nurses, cravings for high ranks among other practices lowers the professional nursing standards. The USA’s Nursing Organization Alliance, (NOA), established policies that aim at improving the working environments within the healthcare facilities.
Lastly, professional development within any sector is improved by developing employees’ educational standards. Due to nurses’ shortage, the latter cannot continue with their part-time education as the patients will be endangered. This also applies to the implementation of orientation programs within the institutions for the newly employed nurses. The number of skilled nurses to implement the programs is less than the number of patients they are required to attend.
LITERATURE REVIEW
Attracting and retaining nurses is a significant problem experienced in most healthcare facilities. Many factors affect the retention of nurses, Cangelos, Markham &Bounds (2008) indicate that work schedule, job-related stress and nurse’s salaries or benefits affect nurse retention in most healthcare facilities. Nurses face personal and job-related stressors, such as working for long hours at different schedules with no substantial compensation, therefore increasing stress levels that contribute to nurses leaving the profession. The work schedule problem has also been emphasized by Buffinton et al. (2012), who stressed the unfavourable nurse to patient ratio. An unfavourable nurse to patient ratio means that the nurses have limited time between one shift to another, which hinders them from performing their personal life. It is essential to give nurses a flexible work schedule to balance their job and personal needs (Cangelos, Markham and Bounds,2008). Tight schedules have been associated with the dissatisfaction witnessed in the nursing profession.
Leadership and management skills are essential in most healthcare settings because they support nursing practice. Leadership and management skill mostly contribute to low retention in some organization. According to Perez (2014), applying management skills and power to nurses has been a factor that has contributed to reduced nurse retention in the most healthcare organization.
Nurses are the primary care providers, and therefore they should be considered when developing policies that affect them. According to Gess (2008), eliminating employee-related issues such as job exit institutions needs to seek feedback from the employees (nurses). According to Perez (2014), low retention of nurses is because of nurses’ lack of engagement in decisions that affect nurses, especially compensation and work schedule. It is crucial to mobilize healthcare towards unitary goals rather than the individualizing of nurses roles. Individualizing of the nurse’s roles has caused frustration among the nurses, which contributes to resignation. The organization needs to engage nurses in decisions that affect their well-being and operationalization since it helps the organization understand the motivators for exit from the profession.
Clinical Problem
Nurses play an essential role in healthcare facilities by providing care services to patients through evidence-based practice. The healthcare system is continuously changing due to the growing diversity of the patient population in the United States. Healthcare providers are expected to provide culturally competent and patient-centred care to their patients, but there has been an institutional problem in that those skilled nurses exit the profession. According to ANA (2014), nurses quitting their jobs create a shortage of critical skills and experience needed by the diverse patient population. According to Neese(2008), low retention rates have a substantial adverse effect on patients and the hospital’s health. Nurse shortage in the healthcare system in the United States has been associated with a lot of factors. Still, nurse retention is a significant problem since it robs hospitals of the nurses’ required skills and experiences leaving the profession (Darkwa et al.2015). Every organization has different approaches to the retention of healthcare providers, and therefore 84.8% of healthcare organizations recognize that an effective retention strategy is essential in the profession (Neese, 2014; Colosi, 2018).
Proposed Solutions
Improvement of the various turnover causes is one way to solve the nurse retention problem. Employee turnover positively or negatively influences their psychological imprints hence influence their choice to stay in an institution or not (Hughes, 2017). By identifying various issues, the leaders can put in place a measure that alleviates the problem.
An improvement in leadership quality also helps in solving retention. A leader who trusts in his or her workers portrays allegiance, supports the workers, and inspires their workers’ self-confidence. This positively influences the workers decided to stay in the institution (Hughes, 2017). Scholars have found relationships between nurse leadership and the nurse’s perception of staying (Hughes, 2017). Most health facilities should therefore employ qualified leaders to help fix out these challenges.
The retention rates can also be reduced by changing the institution’s culture. For instance, an organization’s working hours include changing extra working hours from a mandatory habit to an exception. Workers who work 12 hours or more are likely to experience burnouts compared to those who work fewer hours (Dall’ora et al., 2015). Reduction of shift hours helps reduce burnouts as well as job dissatisfaction.
Another way to improve the rate of retention is the employee’s motivations. Workers get encouraged in doing their work when they are recognized and motivated. According to a 2016 study by Peterson, 55% of nurses were willing to resign from their work and join an organization that gives financial bonuses to its employees for good work (Peterson, 2016).
Nurse Retention Strategies
Appreciation of Good Work
To increase the rate of nurse retention, the recognition of workers efforts is very critical. Hard-working nurses can be motivated by bonuses, or any other type of appreciation deemed best by the organization. When employees feel valued, the work culture will promote a positive workplace.
Provide Orientation to New Employees
Conducting orientations should be extended to meet the personal needs of the new nurses. The new nurses should be oriented on the various institutional activities as well as professional roles. During the orientation process, more time should be taken with the newly hired experts to help them feel comfortable and accommodated within the institution.
Career Development Encouragement
Nurses who wish to pursue advanced education should be given tuition reimbursement to motivate them to continue education. They should also be given time to attend the training. Having several dates and allowing the nurse to plan alleviates stress between the work-life balance.
Improving Floating and Scheduling Problems
Floating and schedule can be done successfully to accommodate full-time speciality nurses. The formation of a floating pool of nurses educated in various sectors to work in a number of healthcare units can help reduce retention rate. On the other hand, floating can be made easier by providing manuals that show the procedures and expectations when working in various healthcare units.
In conclusion,n nurse retention is a significant problem that affects healthcare providers and patients’ well-being. Many factors influence nurse retention, and therefore a lot of strategies have been implemented in most healthcare facilities to stop this trend.
References
Dall’ora, C, Griffiths, P, Ball, J, Simon, M, and Aiken, L. (2015). Association of 12-hour
shifts and nurses’ job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries. BMJ, Vol 5(9), pp.1-7. http://dx.doi.org/10.1136/bmjopen-2015-008331
Darkwa, E. K., Newman, M. S., Kawkab, M., & Chowdhury, M. E. (2015). A qualitative study of factors influencing the retention of doctors and nurses at rural healthcare facilities in Bangladesh. BMC health services research, 15(1), 344.
Gess, E. (2008). An evidence-based protocol for nurse retention. The Journal of Nursing Administration, 38(10):441-7.
Hughes, V. (2017). Leadership Strategies to Promote Nurse Retention. Scientific Journal
Nursing Practice, Vol 1(1), pp.001-005.
https://www.newenglandcollegeonline.com/resources/healthcare-administration/keeping-nurses-strategies-for-nurse-retention/
Peterson, K. (2016). Recognition: Is It Just a Bunch of Fluff, or Is It the Right Stuff?
Journal of Pediatric Nursing, Vol 31(2), pp.228-229.
Neese, B. (2014). Nurse retention strategies. Alvernia University. Retrieved from https://online.alvernia.edu/nurse-retention-strategies/