Retainment & Recruitment High Turnover

Retainment & Recruitment High Turnover Rates of New RNs Complicates a Massive Nursing Shortage Hospitals and healthcare organizations are in for an arduous fight. Research shows that we are currently in the midst of a major nursing shortage, where a serious lack of capable RNs has been causing the quality of care in American hospitals to begin to decrease. Much of this shortage is caused by the high turnover rates seen in new nurses, caused by a lack of a supportive system in training.

However, it is also caused by the average age of RN being at around a retiring age. It is clear that hospitals must begin to recruit more nurses and begin implementing more in-depth and supportive on-the-job training. Turnover rates for nurses in modern health organizations are astounding. Massive droves of both new and retiring nurses have been leaving the workforce to pursue other areas or relax in retirement. The demographic of nurses who are leaving in the greatest numbers are brand new nurses, with very little experience under their belts.

According to a recent study conducted by the Los Angeles Times, "one in five newly licensed nurses quit within their first year of work," (New America Foundation 2009:1). That means that the cost of training one fifth of all nurses is a huge waste for healthcare organizations, who are already reeling from the effects of the recent recession. Some reports even estimate that hospitals have an 8.4% turnover rate for nurses in the first year of employment with the healthcare organization.

Other estimates from 200 place that number as high as 21.3% as a national average (American Organization of Nurse Executives 2002). If this continues at the same rate, the nurse shortage in the United States will reach a need of 500,000 nurses by the year 2025 (New America Foundation 2009). This shortage is the worst timing, for "The United States is in the midst of a nursing shortage that is expected to intensify as baby boomers age and the need or health care grows," (Rosseter 2009:1).

Thus, we are experiencing the greatest levels of shortages during a time where we need quality care the most. Hospitals and other health care organizations need to step back and look at the reasons why so many nurses would be leaving as a way to re-strategize effective changes. There are a wide variety of reasons for such large numbers of nurse turnover. Research suggests that "many nurses point to stress, lack of supervision, and poor-on-the-job training as their reasons for leaving the field," (New America Foundation 2009:1).

Many nurses actually receive little on-the-job training, especially in comparison to the residency programs necessary to complete higher level medical professions, like surgeons or physicians. Therefore, it is common for new nurses to feel as if they are not in a strong supportive environment, although their jobs could have the potential to affect the lives of their patients. When in need, many were lost. In fact, 41.8% in a 2007 survey of quitting RN nurses blamed poor management (Science Daily 2007:1). Such stress would definitely lead to poorer job performance and enjoyment.

Other reasons were listed as stressful working conditions at 37.2% and 34.1% of RNs "wanting to get experience in a different clinical area," (Science Daily 2007:1). The lack of support in hospitals today for new nurses poses a serious problem in the midst of a major nursing shortage. There are several negative consequences that come along with high turn over rates in hospitals and other healthcare organizations. High rates of nurse overturn can mean dramatically increased costs.

Such costs can be related to increased funding for the training of new nurses and staff development, "Such turnover levels represent substantial recruiting, training, and orientation costs," (American Organization of Nurse Executives 2002:4). When more and more new staff is being constantly brought in, a healthcare organization is forced to continuously place funds needed elsewhere into training. In act nurses themselves are a source of human capital, and high overturn rates signify loosing some capital.

According to research, recent studies of the costs of nurse turnover have reported results ranging from about $22,000 to over $64,000 per nurse turnover," (Jones & Gates 2007:1). Hospitals then have to pay for advertising fees and HR fees to get more new nurses on board. Even conservative estimates place the cost of recruiting new nurses at around $25,000 (Thomas Group 2009). Additionally, the quality of care in any given organization can decrease based on high overturn rates and large numbers of new or training nurses.

There are several concerns regarding nurse overturn, which are not tied to economic factors. Such critical elements include "retaining adequate numbers of RNS to appropriately provide safe care to patients," (Jones & Gates 2007:1). In this concept, the quality of care can be dramatically lowered, and the reputation of any given organization's care environment can be tarnished, leading to potential loss in future patient revenue.

Moreover, high turn over rates can lead to the "over-burdening existing staff with increased workloads and demands that may bring about more staff turnovers," (Jones & Gates 2007:1). This can then also serve to decrease the quality of care in any given organization based on current staff being overworked and therefore inefficient. There are several strategies a healthcare organization can implement in order to decrease rates of nurse turnover, and therefore rising costs of such turnovers. One major reason for turnover was poor on-the-job training.

Therefore, hospitals should implement better on-the-job training programs, where new nurses get real training on the medical floor. Some hospitals that have seen a decrease in turnover rates pair "up new nurses with more experienced nurses. At first, the new nurse will just observe as she completes a lengthy checklist of competence in vital skills," but will eventually begin taking on actual tasks necessary for providing care in a healthcare setting (New America Foundation 2009:1).

Additionally, research shows that maintaining high levels of morale is also key for keeping up a good staff environment, and therefore higher levels of nurse retention. According to this research, "The fact is, turnover rates are heavily dependent on staff morale, and high morale is dependent upon the strength of an institution's leadership and the degree of empowerment it provides its nurses," (Thomas Group 200:1). Thus, it is clear that hospitals must provide quality and positive environments for their nursing staff.

This also means providing a supportive environment, where new nurses feel like they can get the help they need when they encounter confusing situations. In addition to new nurses quitting, hospitals have problems with loosing older and more experienced nurses because of retirement. All nurses should have the option to retire, but the current workforce in the modern context shows alarming numbers of nurses close to that option.

This means that the nursing shortage will only continue to grow as more and more nurses begin to retire and leave healthcare right along their counterparts who are quitting. According to research, "With the average age of RNs projected to 44.5 years by 2012, nurses in their 50s are expected to become the largest segment of the nursing workforce, accounting for almost one quarter of the RN population," (Rosseter 2009:1).

This presents the alarming fact that more new nurses are going to be needed to take over the place of their more experienced counterparts. However, bringing on new nurses carries with it a greater potential rate of turnover. It is hard to recruit so many new nurses with so many leaving the workforce. With current shortage estimates, "a faculty with 400 RNs must develop a system to recruit and train up to 80 new RNs each year,".