Improving Nursing Retention and keeping them within the doors

Staffing, balancing fiscal responsibility and providing quality care are complex and multifaced issues facing nursing. I truly believe one of the biggest issues in nursing is staffing. Staffing has always been a problem since I have started nursing and I sure it existed before I was a nurse as well. It is difficult to predict patient census at times, especially in the emergency Department. Most hospital I believe have some form of a staffing matrix that they follow, however, I do not think that it is effective. We know it is not effective because there has been such a high turnover rate in nursing.?

Research supports that when we do not have nurses working it is associated with poor patient outcomes and increased mortality (Needleman et al, 2020). However, I am pretty sure anyone can figure that out without having to do a study. It is a cyclical deep-rooted issue, most nurses leave the bedside because of poor staffing or unsafe working conditions. Approximately 1 in 5 new graduate nurses leave their job within 1 year which cost an average for $52,100 (Kester et al, 2020).

I think having a larger float pool of nurses may help alleviate some of the staffing issues because nurses that are cross-trained and competent to work in various areas in the hospital can deliver safe quality care (Larson et al, 2012). The float pool can be flexible and fill in the gaps and vacancies that are needed and cost less than hiring agency nurses. There needs to be a more forward-thinking approach and collaboration between hiring managers and human resources. Historical data can serve as a way to prepare to hire in advance before staff turnover. Furthermore “The Prospective Hiring Equation may help nurse managers improve accuracy when evaluating hiring needs (Kesler et al, 2022, p. 343). There is no one answer to solve the staffing issues, however it will take a multidisciplinary approach and creative thinking. However one that is certain we do have to create a health work environment and provide appropriate compensation for nurses as well.?Let's stop the revolving door syndrome and keep our nurses within the doors.?We need to treat all our nurses with respect and be supportive, especially to our new graduate nurses so we can retain them!

Farah Laurent?MSN, RN, CPXP, NEA-BC, NPD-BC, TCRN, CPEN, CEN

International Nurse Coach

References:?

Larson, N., Sendelbach, S., Missal, B., Fliss, J., & Gaillard, P. (2012). Staffing Patterns of Scheduled Unit Staff Nurses vs. Float Pool Nurses: A Pilot Study.?MEDSURG Nursing,?21(1), 27–39.

Needleman, J., Jianfang Liu, Jinjing Shang, Larson, E. L., & Stone, P. W. (2020). Association of registered nurse and nursing support staffing with inpatient hospital mortality.?BMJ Quality & Safety,?29(1), 10–18. https://doi-org.ezproxy.monmouth.edu/10.1136/bmjqs-2018-009219

Kester, K. M., Lindsay, M., & Granger, B. (2020). Development and evaluation of a prospective staffing model to improve retention.?Journal of Nursing Management (John Wiley & Sons, Inc.),?28(2), 425–432. https://doi-org.ezproxy.monmouth.edu/10.1111/jonm.12945

Kester, K. M., Engel, J., Fuchs, M. A., Alston, S., Thompson, J. A., & Granger, B. B. (2022). Evaluation of a proactive hiring model to achieve workforce stability in the intensive care unit.?Journal of Nursing Management (John Wiley & Sons, Inc.),?30(1), 336–344. https://doi-org.ezproxy.monmouth.edu/10.1111/jonm.13465