Nursing is a great job for many reasons. Nurses can earn a good living while doing meaningful work, enjoy great job security, and have flexibility in their schedules.
Nurses can find jobs anywhere in the country doing anything from working at home on a computer to flying on a medical helicopter. They might work regular office hours, weekends, nights, or a combination of the three.
Unfortunately, there are staffing shortages all over the country, and many nurses are leaving their units or leaving bedside nursing altogether. Nurses are often burnt out due to staffing shortages, night shift schedules, difficult patient populations, and poor morale on the unit.
Because there are nursing shortages everywhere, it is easy for an unhappy nurse to move around from job to job. Nursing shortages and high turnover are expensive for a facility, dangerous for patients, and bad for unit morale.
This guide goes over nurse retention strategies to help keep both experienced and new staff from leaving your facility.
16 Nurse Retention Strategies to Keep Your Staff Happy
Retaining nurses is becoming a huge challenge for many healthcare facilities. Research shows that 1 in 3 nurses will leave their first job within 2 years of starting employment, which is both expensive and frustrating for everyone involved.
On average, it costs between $40,300 and $64,000 to replace a single nurse, so spending time and money on retention is a worthwhile investment.
Here are some strategies to retain nurses at your healthcare facility:
1) Communicate Expectations During the Hiring Process
Be clear in your job posting about responsibilities, patient population, and schedule requirements. During an interview, answer all candidate questions honestly and tell them about challenges they may face in your facility.
By being upfront about all aspects of your unit or facility, you help new employees have realistic expectations.
Be clear about pay structure, raises, scheduling seniority, and the types of patients typically seen in your unit. Make sure to communicate staff meeting and education requirements, flexibility in scheduling, and who new nurses should go to when they need help.
2) Pay Them Competitive Salaries & Bonuses
While offering a high salary isn’t a cure-all for nurse burnout, it is an effective way to recruit new candidates. Offering a slightly higher salary than competitors or giving flashy sign-on bonuses are good ways to get nurses in the door, but it does not guarantee that they will stay.
A more effective strategy may be to offer loyal nurses a retention bonus. Paying experienced nurses to stick around can have a trickle effect. By increasing the number of experienced nurses in your unit, you make the unit environment feel safer and more secure—which also increases retention for newer nurses.
3) Offer Great Benefits
If you want to retain employees, you must offer at least basic benefits like health insurance and family medical leave. One study found that the type of benefits you offer can help you attract a certain type of employee.
For example, offering future planning benefits like retirement plans and health savings accounts may help you attract more risk-averse employees who are less likely to jump from job to job.
Some benefits you might offer include:
- Health Insurance
- Paid Time Off
- Maternity and Paternity Leave
- Flexible Scheduling
- Flexible Vacation time
- Free Mental Health Support and Counseling Services
- Legal Benefits
- Health Savings Accounts
- 401(k) Matching
- Free Financial Advice
- Social Support Like Employee Clubs or Recreational Sports Teams
- Tuition Reimbursement
- Tax Services
4) Offer Continuing Education and Training
Continuing education and training courses are great opportunities for employers to improve the skills of their workforce while improving retention.
Employees who are constantly learning and improving are more likely to feel empowered at work and avoid burnout. And as an employer, you are developing your staff’s skills, making it a win-win proposition.
5) Provide Opportunities for Growth
Like education and training, opportunities for growth or advancement keep employees from getting bored and seeking change. Performing meaningful work that avoids too much repetition and allows for changes in routine helps nurses stay engaged and committed to their organization.
Humans thrive on stretching to meet a goal or challenge. It is easy for a nurse to get discouraged when they feel stuck or that they’ve reached the peak of their career with years to go before retirement.
Creating shared leadership positions or giving seasoned nurses more responsibility helps keep experienced nurses inspired and excited about their work.
6) Create a Mentorship Program
Nurse mentorship programs can help an organization in several different ways.
New nurses who participate in formal mentorship programs have a 25% higher retention rate than those who are not assigned a peer mentor. Having a mentor gives the new nurse continuity in their training, helps them build confidence, and lets them feel safe seeking help when they need to.
Mentorship programs are also beneficial for the nurse doing the teaching. Becoming an official peer mentor is a source of pride for many nurses, giving them an opportunity for growth, learning, purpose, and potential pay increases.
While peer mentoring is rewarding, it also creates extra work for the experienced nurse. Offering a small differential or raise can help mentors feel appreciated for their important contributions in training new team members.
7) Avoid Nursing Shortages
While it is easier said than done, avoiding nursing shortages is a crucial part of improving staff retention. In 2021, a survey of nurses showed that over 50% were considering leaving their jobs. The most common cause of dissatisfaction was being short-staffed.
Nurses aren’t just complaining about working hard. Nurses are concerned about safe staffing ratios, with strikes against staffing problems becoming more common. Many nurses who leave the profession don’t do so because they are tired of working hard, they leave because they are worried that they will harm a patient due to unsafe staff-to-patient ratios.
Whether a facility has to bring in agency nurses, offer lucrative incentives for picking up shifts, or encourage nurse managers to work a shift or two on the floor, it is absolutely essential to have adequate staffing to help nurses feel supported and safe.
8) Give Reasonable Breaks
Every nurse understands that there will be busy shifts with sick patients, and sometimes a long break just isn’t going to happen. However, when this becomes the rule rather than an occasional occurrence, staff is likely to burn out quickly.
Any employee working a 12-hour shift should be able to expect a meal break and at least two additional rest breaks. Going above and beyond this is a good way to make sure nurses aren’t burnt out and perform well day to day.
Adequate staffing helps nurses feel safe leaving a teammate to watch their patients while they take a break. Some facilities even choose to bring in an extra nurse during lunch hours to ensure that each employee gets time to rest at some point during the day.
Having a charge nurse assign nurses to leave the unit at specific times for lunch also helps encourage regular breaks.
9) Have Strategies to Deal with Bullying & Other Conflicts
In 2013, 57% of nurses said that they had been yelled at, cursed at, or verbally threatened by a physician on the job. The Joint Commission states that workplace bullying is still a major problem in most healthcare facilities.
Bullying doesn't just cause problems with turnover. It is a patient safety hazard and decreases productivity across the entire organization.
Having a zero-tolerance policy for bullying and being willing to follow through on consequences is a huge step forward in helping nurses feel protected at work.
Have your employees, especially those in positions of power, take a course on workplace bullying and be firm in your policies against it.
10) Promote Workplace Safety
Nurses aren’t just at risk of peer-to-peer bullying. Every day in the United States, about 57 nurses are physically assaulted by patients on the job. Nurses in the emergency department and psychiatric units are at the highest risk.
Providing de-escalation training for all staff members, having a strong policy against aggression towards nurses, hiring enough security staff, and supporting staff members who become victims of aggression all promote workplace safety.
In addition, having supportive administration makes a big difference in nurses' feelings of safety and security. If a nurse expresses concern about patient or visitor behavior, take their report seriously and make staff safety a priority over patient satisfaction scores.
11) Keep up with Technology
Nurses spend about 33% of their time caring for patients and 25% of their time documenting that care.
While nurses’ priorities are to provide direct patient care, they usually spend a large portion of their day dealing with monitoring equipment, imaging devices, computer software, and office supplies.
If advancements come out that can make a nurse’s job easier, implementing these can help with burnout. Nurses perform approximately 72 tasks per hour and dealing with out-of-date or broken equipment can cause a ripple effect throughout an entire day.
Routinely look around your unit for malfunctioning equipment and pay close attention to items that are used the most frequently. If staff is constantly fighting for the one bladder scanner or ultrasound machine, it might be worth purchasing a second one.
12) Offer Flexible Working Opportunities
Flexible working opportunities can give people a break from the parts of a job that they find challenging. Some flexible options might include:
- Part-time or PRN schedule options
- Flexibility with night and weekend requirements
- Combination of bedside and administrative responsibilities
- Ability to work out of different locations
- Ability to cross-train to different units
13) Recognize Those Doing Well
As a busy manager, it can be easy to spend all of your time correcting low performers.
While you may feel confident that your high-performing employees can manage without guidance or intervention, statistics show that these employees tend to be less engaged and more likely to leave an organization than low-performing employees.
Employees that are doing well start to feel ignored and unimportant if they are not given frequent feedback and praise.
Employee recognition can decrease turnover by as much as 57%. Even subtle things like an employee shout-out board or a thank-you note can go a long way in helping your high performers feel appreciated.
Positive feedback helps employees feel more connected to the organization and makes them not only more likely to stick around but also encourages them to keep giving their best effort each day.
14) Build a Strong Company Culture
The culture of an organization is strongly correlated with turnover rates. A collaborative and inclusive culture decreases turnover, while a hierarchical culture increases it. Building a strong company culture requires leaders to set a strong example for their teams.
A manager who is willing to pitch in when things get busy shows that teamwork is a valued trait within an organization, while a manager who complains and criticizes will quickly spread negativity.
In addition, managers should be picky when hiring new employees. It is better to hire a teachable and likable novice than an arrogant expert. If new employees display signs of poor attitude or chronic complaining, do your best to correct the behavior right away.
Having a large group of nurses who are solution-focused and collaborative discourages negativity from new hires.
15) Ask Nurses for Feedback
As you work to build a culture of teamwork, you must create an environment where it is safe to ask questions and voice concerns. If every employee's complaint is met with dismissal or even punishment, employees will eventually stop asking for change—they will simply leave instead.
Being a team leader will require you to have difficult conversations and be open to the opinions of others. Drop your defenses when asking for feedback and try hard to understand the perspective of the nurse.
Then, give your nurses wins wherever you can. While you may not be able to give everyone the day off on Christmas, you might be able to replace the printer that has been giving everyone trouble.
16) Use Exit Interviews to Learn More
Like asking current nurses for feedback, exit interviews are a good way to look for areas of improvement. An employee may be more willing to be more honest during an exit interview and can give you valuable insight into the strengths and weaknesses of your organization.
Getting an employee to come in for an exit interview can be difficult. Consider a low-pressure phone conversation or an email survey to make things easier for an employee who may be stressed out with big life changes.