6 Strategies to Boost Nurse Retention

By Clean Hands - Safe Hands

Nurse retention is key to meeting clinical demand in an era of pervasive workforce shortages.

Nursing schools are not producing enough new nurses to replace the tens of thousands of nurses leaving the practice – and it will be years before schools can dramatically increase production, as they’re limited by a lack of faculty members and clinical space. Retaining the nurses you have on staff is not only more efficient and cost-effective than hiring new-to-you nurses; in some cases, it may be the only realistic option. 

Of course, it takes deliberate effort and sustained attention to improve nurse retention. As noted by Gallup, the analytics and advisory company, “Remedying nurse turnover is no easy feat – it requires a holistic approach and continual commitment from leaders.”

Start now with these six strategies: 

  1. Identify and correct workflow inefficiencies

Hospital nurses spend up to 20% of their work time, on average, on non-nursing activities, including activities that “should not be necessary in the delivery of patient care.” That waste of time, talent, and expertise frustrates nurses who want to make a positive difference in their patients’ lives. Identifying and correcting workflow inefficiencies can improve care, patient outcomes, and nurse satisfaction, which, in turn, boosts nurse retention. 

Most workflow inefficiencies are systemic, and many are easier to address than you may think. For instance, supplies that are stashed too far away from patient rooms add steps (and time) to routine tasks. Moving commonly needed supplies closer to the point of care increases efficiency. Similarly, scheduling Monday morning imaging scans and lab tests for all patients admitted over the weekend may cause unnecessary workflow challenges that could be simply resolved by scheduling tests throughout the day.

Automated technology, including electronic hand hygiene monitoring systems, make it easier to detect workflow inefficiencies, providing you the opportunity to introduce corrections. 

  1. Emphasize positive reinforcement

Negative reinforcement can quickly depress morale. Science has repeatedly shown that focusing on human weaknesses is rarely effective, even if the intent is to build skills and therefore minimize those weaknesses. Dwelling on weakness or issuing consequences in response to less-than-desired behavior can lead to anxiety, withdrawal and disengagement, even if the consequences are intended to motivate. 

It’s much more productive to recognize and reward desired activity. Nurses like to work in systems that cultivate their strengths and celebrate their achievements, and research shows that positive work environments can increase nurse retention

  1. Don’t complicate clinical care

Occasionally, well-meaning hospital leaders will introduce technology or processes that are intended to improve performance or clinical outcomes. Sometimes, however, these “solutions” require extra work that interferes with clinicians’ ability to efficiently provide care. Anything that unnecessarily complicates clinical care is likely to increase nurses’ stress levels, and persistent stress coupled with a perceived lack of administrative interest in the realities of clinical work can drive nurses from the bedside.

Look for ways to make clinical care easier, not more onerous. In a recent interview with Healthcare IT News, Shawn Sefton, RN, chief nursing officer and vice-president of client services of Hospital IQ, said “The core goal of hospital and health IT leaders right now should be to elevate and optimize nurses’ abilities and day-to-day experience through the use of technology.”

  1. Prioritize skill development

New graduate nurses and experienced clinicians crave ongoing professional development that fits into their schedule. When ongoing skills development is not provided, nurses often decide to go elsewhere.

If you don’t already have a robust nurse orientation and onboarding program, develop and implement one. (Your existing staff likely have lots of ideas about your current onboarding process!). Consider establishing a nurse mentorship program and be sure that skills development opportunities are available to nurses on all shifts. 

  1. Provide staffing support

Overwhelmed nurses need help. Hiring additional nurses and support staff can be cost efficient, as additional staff may decrease nurse turnover, thereby reducing the financial burden of finding and onboarding new nursing staff. 

If it’s not possible to hire more staff, get creative. Technology that allows you to detect unusual workflow patterns can indicate a critical need for just-in-time staffing support. (We’ve found, for  instance, that staff enter and exit a room more frequently when patient health is deteriorating.) Nurse managers who step in to help overwhelmed nurses are invaluable. 

  1. Listen to nurses

Nurses know what they need and want. If you’re serious about boosting nurse retention, talk to your nurses and listen carefully to their responses. Implement as many of their suggestions as you can. Nurses are more likely to remain with an employer who values their opinion and acts on their input.


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