Hospitals, medical centers and other healthcare organizations must implement strategies that help to keep more veteran nurses at patient bedsides, according to a new study.
The study, "Wisdom at Work: Retaining Experienced Nurses," finds that a number of healthcare organizations lowered turnover rates among experienced nurses by making a concerted effort to improve nurse morale and productivity.
Supported by the Robert Wood Johnson Foundation and coordinated by The Lewin Group, the study reveals that successful strategies included innovative approaches to staffing; employee health and wellness programs; and training and development opportunities for veteran nurses.
Ergonomic initiatives, such as teams and equipment to help nurses lift patients and other heavy items, did not contribute to an overall drop in turnover among experienced nurses; however, they did improve morale and cut expenses associated with work-related injuries, the study found.
"We know that there is no quick fix to the crisis in healthcare," said Susan B. Hassmiller, RWJF's senior adviser for nursing. "But the approaches explored in our 'Wisdom at Work' initiative are pieces of a larger puzzle that will help healthcare organizations keep experienced nurses from walking out the door - and taking their expertise with them - just when we need them most."
The new study includes seven in-depth case studies examining strategies used by healthcare and non-healthcare institutions that have received recognition for their success in retaining experienced workers, as well as findings from 13 separate research projects conducted from January 2007 to December 2008 to explore the impact of interventions aimed at retaining experienced nurses in hospitals.
It is a follow-up to the white paper, "Wisdom at Work: The Importance of the Older and Experienced Nurses in the Workplace," commissioned by RWJF in 2006.
The new "Wisdom at Work" report finds that companies that have successfully retained older workers cite the following reasons for their success: sustained commitments by corporate leadership; corporate cultures that value aging; and compensation packages that cater to older workers, offering benefits such as phased retirement options and flexible work arrangements.
"The evaluations demonstrate that there are ways to retain experienced nurses that ultimately are cost-effective," Hassmiller said. "With our nation's population aging and healthcare needs growing, we need to encourage more veteran nurses to stay in their jobs so we can benefit from the knowledge and wisdom they have gained over the years."
The average direct cost to replace a full-time registered nurse at the 13 hospitals in the study totaled $36,567, a sum reflecting expenses associated with termination payouts, filling temporary vacancies, additional overtime costs, and hiring and training new staff. The loss of experienced nurses is especially costly.
Strategies in the "Wisdom at Work" study offer suggestions to help healthcare systems address the issue. Although no single initiative lowered turnover rates at all the healthcare organizations evaluated in the study, several hospitals and medical centers improved nurse retention rates with programs that met nursing needs at their individual institutions.
In one example, Carondelet Health Network in Arizona improved retention by offering an on-site BSN education program that nurses requested when asked what the health network could do to retain them. Later, it signed an exclusive contract with Grand Canyon University to offer its nurses an MSN program, offered on a part-time schedule over 25 months.
The "Wisdom at Work" in-depth case studies of recognized top performing companies identified among the reasons for their success: a sustained commitment by company leaders to retain older workers; corporate cultures that value the experience of older employees; ongoing data collection and analysis to address concerns of senior employees; opportunities for older employees to transfer to less demanding roles; compensation packages that reward longevity; and benefits catering to older employees such as phased retirement options, flexible work arrangements and opportunities to receive in-home care for parents and spouses.
The strong practices at these companies include:
- building a "culture of aging" at Bon Secours health system in Richmond, Va., with flexible work and retirement arrangements, mentoring, and ergonomic programs;
- a "snow bird" program at Carondelet Health Network in Tucson, Ariz., that makes it easier for Carondelet to offer temporary R.N. assignments to licensed nurses from other Nurse Licensure Compact states; and
- comprehensive retention programs at Scripps Health in San Diego that include interactions with employees through trainings, orientations and communication that aim to consistently engage employees and provide them with relevant information.
"Wisdom at Work" also showcases successful retention initiatives at a number of healthcare systems including: Centra Health in Lynchburg, Va.; Mary Imogene Bassett Hospital in Cooperstown, N.Y.; Edward Hospital in Naperville, Ill.; and Hillcrest Memorial Hospital in Greenville, S.C.