Nurses play a crucial role in the promotion of optimum health and outcomes for the diverse populations that they serve. Nurses’ roles in healthcare include offering patient care, keeping up with evidence-based practices, and reassuring families and patients about the care that they receive. The diverse roles place nurses under immense pressure, which increases their turnover rates. Turnover among nurses is currently an issue in not only the United States, but also in most of the advanced nations, which threatens the delivery of high-quality, safe, and efficient care to all. Therefore, this essay describes the issue of turnover among nurses, its impacts, a possible solution, and leadership styles and theories that can be adopted to address it. It also explores nurses’ roles in addressing the issue of turnover among nurses.
Nursing turnover occurs when nurses leave their profession or their jobs. Nursing turnover is a crucial concern for the healthcare industry as it threatens the safety, quality, and efficiency of healthcare delivery systems. Most countries, including the United States, are experiencing shortages of qualified nurses because of a high turnover rate among them. According to statistics, the hospital turnover rates in the United States from 2016-2020 increased by 2.8%, leading to an 18.7% turnover rate in 2020 (An et al., 2022). During the COVID-19 period, the nurse turnover rate in the United States reached 27.65%, the highest rate ever reported in history (Bae, 2023). Nurses who have worked for less than a year have the highest rate of turnover rate compared to those with more than five years of experience (Bae, 2022). Factors such as high workload, violence, and family demands contribute to the high rate of turnover among nurses.
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Nurse turnover has detrimental effects on the quality of care in healthcare settings. An increase in the turnover rates among registered nurses leads to a high workload for the remaining nursing staff. High workload predisposes the remaining staff to adverse outcomes such as burnout, job dissatisfaction, and intention to leave their workplaces. A high nurse turnover rate also results in decreased patient outcomes. This can be seen from the increased rate of medical errors and delayed delivery of care services due to the high workload for the few staff. Studies have also linked occurrences such as pressure ulcers and hospital-acquired infections to increased turnover rates among registered nurses. Hospitals incur significant costs in hiring, training, and retaining new staff due to high turnover rates among registered nurses (An et al., 2022; Bae, 2022, 2023). Therefore, nurse turnover affects adversely patient, provider, and organizational outcomes.
An effective solution that hospitals can implement to prevent and reduce turnover among registered nurses is providing favorable working conditions for nurses. Most nurses who leave their jobs and profession attribute their decisions to poor or harsh working conditions. They report issues such as poor pay, violence, and limited autonomy as the factors that contribute to their decisions to leave their jobs and professions. Health organizations can retain their nursing staff by transforming their workplace environments. This can be achieved by ensuring that nurses get good pay, and flexibility in their work, be treated with respect, and ensure their autonomy is maintained (Lockhart, 2020). Paying nurses well will contribute to their job satisfaction, which lowers their intention to leave.
Providing nurses with flexible work arrangements will reduce their perceived workload, hence, lowering their intention to leave their employers. In addition, nurses should be treated as valuable members of the organization. Strategies such as valuing their contributions to the organizational success and being treated with respect by other healthcare providers minimize turnover rates among nurses. Nurses’ autonomy should be respected by ensuring that they practice as per their standards of practice. Creating a favorable environment has cost implications for health organizations (Perkins, 2021). For example, paying nurses well would mean that health organizations incur high operational costs to ensure increased workforce retention and the delivery of high-quality care that promotes sustainable outcomes.
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