By Rose O. Sherman, EdD, RN, NEA-BC, FAAN
Nurse turnover in 2023 was down to 18.4%. Part of the reason for this decline in turnover is that health systems are rethinking antiquated employment practices that have led nurses to seek new positions. Nurse leaders are also rethinking how they should view turnover. A medical-surgical manager recently told me that she had 35% turnover in her unit last year, BUT it was “good turnover,” meaning none of her nurses left the organization. She noted, “I have changed the way I think about my role – I am a coach, and what I want is the best for the staff, my patients, and our organization. If this means a great nurse leaves me to go to another unit in our hospital, then so be it – I have done my job.”
The nursing job market is witnessing significant changes that are reshaping our understanding of unit turnover. These changes include:
- Nurse now see their career as a series of tours of duty. The term tours of duty , which is used to describe the phenomena we see today, was coined by Reed Hoffman, the founder of LinkedIn. Military careers are built on tours of duty – no one stays in any role for a long time. Moving on is an expectation and part of the employment contract.
- New graduates can find positions in their specialty areas of choice. Historically, new graduates were recruited to work on medical-surgical units. After several years of experience, they could apply for specialty areas. This dynamic is different today as new graduates can find employers willing to move them directly into a specialty area.
- Most employers no longer require one year on a unit before transferring to another area. Policies regarding transferring from unit to unit have become much less strict as hospitals work to retain staff.
- The cost of nurse onboarding is skyrocketing. Patient volumes and acuity are higher than ever in healthcare. At the same time, the experience level of nurses in acute care has declined. Fewer expert nurses are on units to orient new staff, so residency programs are expanding to teach basic skills BEFORE new graduates complete orientation. The investment in new staff is now so high that retaining them is essential.
- Experienced nurses remain in high demand. As nurses gain experience (even a year or two), their value increases because there are so few experienced candidates out. there. When nurses feel their needs are not being accommodated, they will leave and quickly.
When there are changes in how the workforce looks at their work, nurse leaders must also strategically think differently. Today instead of a metric on unit turnover, why not a metric on turnover at the hospital or even the health system level instead.
© emergingrnleader.com 2024
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