Targeting burnout and workplace violence can help CNOs lower nurse turnover, according to this CNO.
Nurse turnover rates have been high since the COVID-19 pandemic, and as the five-year anniversary passes, it's important for CNOs to reflect on what they can learn from that time.
During the pandemic, nurses were feeling burnt out, and according to Cheryl Reinking, CNO at El Camino Health, overburdened both emotionally and physically. Now, burnout is still a critical issue in nursing, along with heavy workloads, documentation burdens, and workplace violence.
"We're coming out of that," Reinking said. "We’re still challenged with continuing to address the needs of the workforce as it pertains to burnout."
Since the pandemic, there have been some positive changes in nursing. Despite the continued prevalence of workplace violence incidents, Reinking cited the increased focus on flexibility and work-life balance, which Reinking calls "work-life integration."
"I think [work-life integration] is a great new term because I'm not sure there's ever any balance," Reinking said."
However, turnover rates continue to be a significant issue for many health systems. While many CNOs are still working towards solutions, Reinking and the leadership at El Camino Health have found the path forward.
What happened at El Camino Health?
According to Reinking, El Camino Health had a turnover rate of less than 5% before the pandemic. That number increased to about 12.7%.
"That's the highest it's ever been, and I've been here for 37 years, and I've never seen it that high," Reinking said. "Now that's lower, in fact, than half of what the national rate was at the time. However, for us that was tremendous."
The health system's turnover rate has since dropped back to 5%.
El Camino is a relatively small to medium-sized organization, Reinking explained, so they wanted to understand the contributing factors and root causes of the spiking turnover rate. One of those factors was engagement and recognition.
"[We make sure] we have recognition programs in place to address those many important activities and care practices that nurses bring to patient care and to the bedside," Reinking said.
Workplace violence prevention is another critical piece of the strategy. Reinking also said they brought in a nurse retention specialist in 2024 to help build professional career development plans for nurses.
"What we found is that nurses want a trajectory of advancement…especially the Gen Z [nurses] who are now in our workforce, they want to know what's next," Reinking said. "We want to make sure we create a plan for them to know what's next in their career trajectory while staying at El Camino Health."
Improving retention
For CNOs who want to improve retention, Reinking believes the culture of recognition at the frontline is key. To help increase that effort, El Camino Health is leveraging Laudio's software platform so nurse managers can recognize individuals for their birthday, work anniversary, or for working an extra shift.
"That's been tremendously well-accepted and has really been seen as boosting our engagement of our nurses," Reinking said.
To combat burnout, the health system hired a licensed clinical social worker who is trained in mental health support. That way, when something traumatic happens to a nurse, there is someone on staff who can help them work through the incident.
"This employee support specialist can meet in the moment with our clinical staff and help to be that decompression that they need, and that person they need to talk to about what just happened during their shift," Reinking said.
To mitigate workplace violence incidents, El Camino Health also implemented the CALM team, to address patients who begin to escalate their behavior. The program brings in mental health professionals in a proactive way to help address any unmet needs the patient might have, which according to Reinking is usually the reason why patients begin to escalate.
"We can help make sure that we're providing that unmet need through that mental health support at the bedside," Reinking said.
Ultimately, Reinking believes it takes a combination of strategies to lower retention rates.
"I wish there was a magic bullet, but we've been trying to understand all the different things and what's made the biggest difference," Reinking said.
G Hatfield is the CNO editor for HealthLeaders.
KEY TAKEAWAYS
CNOs should recognize their frontline nurses for their hard work to make them feel valued as part of the organization and as a nurse.
To combat burnout and workplace violence, El Camino Health is leveraging mental health professionals to provide support to both the nurses and to patients who might begin escalating their behavior.