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5 Ways to Reduce Nursing Turnover in Year One

John Commins, for HealthLeaders Media, February 7, 2011

2. Build relationships with nursing schools and a robust nurse resident program.

Hospitals with nurse resident programs swear by them.  Nurses hired from these programs are generally strong performers because the systems assess their clinical performance before hiring them. These nurses are also less likely to leave because they are familiar with the culture. One health system fills most of its nursing slots from its nurse resident program, which pays for participants' tuition. The program begins after the first quarter of school and offers flexible hours. New nurses attend orientation and are partnered with preceptors. Another system offers outreach to nursing graduates, including a forum for nurse graduates to network and stay connected as they look for jobs. The system beats competitors by strengthening its pipeline of potential candidates and developing its employer brand.  

3. Conduct extensive orientation followed by employee feedback.

New nurses are encouraged to maintain contact with and provide feedback to human resources staff through orientation programs that last up to a full year.  Orientation may be customized by department/unit, and touch points typically occur after 30/45 and 90 days, six months, and a year. One system offers a week of orientation and follow-up with the same group of employees at 45 days and 90 days. At 45 days, nurses complete a satisfaction questionnaire. Another system conducts "re-interviews" at three and 10 months to ensure nurse satisfaction and fit. One system hosts reunions for recent hires at four months and a year and offers off-site retreats by nursing unit. Another system has recent hires lunch with the hospital president after one month and one year.

4. Implement new hire support programs.

Systems link new nurses to non-supervisor "buddies" who provide confidential support and guidance. One system offers a nurse retention contact on HR staff who provides a "safe haven" where employees can air concerns.

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6 comments on "5 Ways to Reduce Nursing Turnover in Year One"


vdutton (3/4/2011 at 2:53 PM)
This is just more Hogwash! - The main problem with retaining nurses, patient safety, drug errors and nurses leaving the bedside (Hospitals do not hire enough nurses to safely take care of the patients)Hospitals are the biggest obstacle to improved healthcare.

Beth Boynton, RN, MS (2/12/2011 at 12:51 PM)
Great article! I especially like that you are including "employee feedback" in #3. I would add, "look for ways to invite and integrate input from staff for any problem solvin". It increases buy-in, role models collaboration, increases creative options, enhances outcome success, and builds assertiveness! Beth Boynton, RN, MS, author of "Confident Voices: The Nurses' Guide to Improving Communication & Creating Positive Workplaces"

Christina M. Guillen-Cook, MBA,BS, RN (2/8/2011 at 5:40 PM)
The key point that was not mentioned, was how hospital administrators[INVALID]managers, directors, CNOs, CEOs, etc.[INVALID]need to actually engage in practices that let nurses know how valued and respected all nurses are, new and seasoned, if they want to retain them. As I nurse of over 30 years, I continue to witness the chronic mismanagement of our profession. What nursing needs is actual leaders. Leaders who care about each other and the profession. Leaders who advocate for the profession. Leaders who can inspire and bring out the best in all nurses. I'm tired of nursing managers who cares only about themselves, their next job or the next rung on the professinal ladder. The current behavior among to many nursing managers is killing our profession. We need nurses who care about the profession, nurses and can advocate for our value in the workplace. Until we have that kind of leadership, we will continue to have nursing leave the profession and who can blame them.