Nurses are quitting in droves. According to research by McKinsey in November 2021, 32% of RNs in the US said they may leave their current direct patient care role. Of those looking to leave, only 29% plan to stay in a direct care role, which may contribute significantly to the growing nurse shortage.
The nursing shortage is happening for a variety of reasons: there is an increase in demand because of the aging population, there is a shortage of nursing school faculty which limits nursing school enrollment, many nurses are retiring, and others are quitting. Nurses are leaving patient care roles because of insufficient staffing levels, low pay, a lack of support at work, and the emotional toll of the job. Additionally, 44% of nurses surveyed said burnout and a high-stress environment are why they are considering leaving their job.
So, how can we help keep nurses happy and thriving in their work? We have some organizational suggestions:
1. Improve Pay and Benefits
As mentioned above, low pay (and the opportunity to make more money at a different job) is one of the top reasons nurses are considering leaving their current position. Compensation is such a concern now because of the pay difference that travel nurses receive compared to nurses at a regular position. Travel nurses do not have the same stability and job benefits that a regular nurse does, but it can still be difficult for nurses to work with a travel nurse that, since the pandemic has started, may be getting paid significantly more than the regular nurse.
Good pay is important for retaining nurses. Organizations should pay their nurses well, because healthcare would not work without them. In addition to good initial pay, organizations can offer scheduled raises to compensate nurses for their commitment to the organization and for their experience. Tuition reimbursement can also help retain nurses, especially recent graduates.
Benefits are equally important to compensation. When RNs were asked how they’d like to get a break, they said they want options to take more time off. Offering ample PTO, paid sick leave, paid parental leave, and flexible work options can help employees live their best lives at and outside of work.
2. Prevent Workplace Violence
Improving workplace safety is incredibly important in healthcare. The American Nurses Association has found that one in four nurses are assaulted in the workplace, and only 20%-60% of incidents are reported. While the incident rate of workplace violence for healthcare workers has been increasing even prior to the pandemic, 65% of nurses surveyed had been verbally or physically assaulted by a patient or patients’ family member in the last year. Nurses are doing life-saving work. They should not have to worry about their safety when they are just doing their job to help patients.
Workplace violence prevention programs can help to reduce violence in the short and long term. The plan prepares staff to handle violence situations, and has leadership identify risks and implement plans to mitigate these risks. Additionally, violence prevention programs create plans for what to do if an incident does occur. Organizations should offer support for workers following a workplace violence incident, including counseling, leave, and assistance for return to work.
To make violence prevention programs effective, it’s important to increase reporting of incidents since so many go unreported. One suggestion for increasing reporting is to create an electronic database that allows employees to anonymously report workplace violence. Another is to create and uphold a policy that ensures that people who report incidents do not face repercussions and that victims receive the help they need.
3. Improve Teamwork and Communication
Nurses’ daily work and environment impacts their decision to stay at or leave a job. Nurses are highly skilled, but their skills are not always utilized to the fullest extent. 30% of nurses who report spending five or more hours doing duplicative or unproductive charting per week say they are likely to leave their organization in the next two years. Nurses do not want to sit around and do repetitive tasks that are not helping patients. Healthcare is better when the entire team is working together on patient care. For example, involving nurses in interdisciplinary team rounds improved communication, quality and safety of care, and nurse satisfaction (which is an important marker of retention).
There are many ways to improve the work environment. One is to ensure that everyone on the healthcare team is respected and involved in the care plan. By collaborating, clinicians can each share their knowledge and skills to create the best treatment plan they can for the patient. Another way to improve the work environment is to recognize and celebrate good work. The celebrations do not need to be huge and expensive, but it is a great feeling to have your hard work acknowledged. Finally, addressing problems in the work environment – such as using tech to eliminate duplicative work – can reduce stress and frustration, and give clinicians more time to care for patients.
4. Increase Staffing Levels
Improving staffing is crucial for retaining nurses. One of the main reasons that nurses are leaving the field is insufficient staffing levels. While there have been problems with staffing levels in the past, this has been exacerbated by COVID-19. With low staffing levels, nurses may be required to take on the responsibilities of multiple nurses and work long hours and extra shifts. This is exhausting, and it is unsustainable to expect one nurse to do the work of two or three nurses. Additionally, research has shown that hospitals see better patient outcomes when they have adequate nurse ratios.
Some may argue that it is not this simple, and that hiring this many nurses is too expensive. I would say, so is relying on travel nurses when full-time nurses quit because they are not respected. Nurses are valuable to healthcare, and it is time that they are given respect and credit for the work they do.
Thank you to all the nurses for your hard work and dedication to patients!