The subject of nurse retention and turnover came up during a recent conversation I was having with the HR director of a regional hospital system here in Florida. We were discussing the Florida Center for Nursing report that identified the median turnover rate for RN's was 20% in 2007. The HR director responded that prior to the recession they were running in the low to mid twenties, but it had dropped to just below twenty percent in the past two years. As he said this, a look of trepidation came upon his face, as if he was waiting for the other shoe to drop.
The director added, "I hate to
think what's about to happen once hospitals begin hiring again. The nursing
shortage didn't go away simply because the economy faded." Curious, I
asked him to confirm if the American Hospital Association estimate that it
costs an average of $64,000 to replace a single RN was realistic at his
institution. "Easily, and that doesn't account for the increased stress an
open position places on the remainder of the staff."
A little short math reveals that a
hospital with 200 nurses experiencing a 20% annual turnover rate is very likely
expending $2.5 million a year in hard dollar costs associated with this
phenomenon. Extrapolated across the nation, this endemic turnover challenge
may, in fact, be costing American hospitals more than $10 billion annually.
This doesn't take into account the additional costs associated with patient
length of stay, the risk for adverse events, cost at discharge, and
patient-perceived quality of care, all of which are negatively effected by
nursing staff shortages and exacerbated by nursing staff turnover.
A quick search of the peer-reviewed,
published research on the subject reveals many of the underlying causes of
endemic turnover in hospital nursing are rooted in the "soft skills"
of nursing, leadership, and organizational culture. Digging a bit deeper into
the literature identifies some innovative, evidence-based suggestions and
approaches to lowering costs and improving patient care as it relates to this
front-line challenge. More than two dozen studies document the positive role
emotional intelligence and the cultivation of emotional resiliency can deliver
in nursing and clinical leadership. Fortunately, these are learned skills and
competencies that can be developed over one's lifetime. The research clearly
reveals that emotional intelligence in nursing:
-Has a positive impact on nursing
team cohesiveness and patient/client outcomes.
-Minimizes the negative stress consequences of nursing.
-Reduces nurse burnout.
-Contributes to performance, career longevity, and job retention.
-Builds successful nursing leadership.
-Leads to more positive attitudes, greater adaptability, improved relationships, and increased orientation towards positive values.
-Enables the expression of empathy through healthy, professional boundaries.
-Minimizes the negative stress consequences of nursing.
-Reduces nurse burnout.
-Contributes to performance, career longevity, and job retention.
-Builds successful nursing leadership.
-Leads to more positive attitudes, greater adaptability, improved relationships, and increased orientation towards positive values.
-Enables the expression of empathy through healthy, professional boundaries.
Nurses capable of a self-reflective
process become aware of their own emotions. When nurses recognize their own
feelings they are more likely to manage them and communicate in appropriate
ways.
The nursing profession exemplifies
positive intention, a spirit of service, and compassionate behavior. The daily
interaction of nurses with their patients has a distinct impact on patient
satisfaction, especially the emotional needs of patients and their families.
Yet constantly evolving technologies, severe economic constraints, and the
chronic nursing shortage combine to challenge the ability of nurses to focus on
patient care. The very people that are in the position to have the most
positive impact on critical patient perceptions also bear the brunt of many of
today's challenges.
The fact is, healthcare is entering
a phase of unprecedented change, experiencing pressures from many sides
simultaneously. Like so many industries today, healthcare must adapt to a
rapidly shifting economics, demographics, and expectations. Investments in
technology will undoubtably help contain costs and improve efficiencies, but
technology can only go so far. Of all industries and endeavors, healthcare is
simply the most human. Investing in the human aspects of care, in developing
emotional intelligence, adaptability, engagement, and techniques in self-care
should be a key consideration as administrators seek innovative ways to
successfully lead their institutions through this period of uncertainty and
change.
Terry Murray is a professional coach
and business executive with twenty-five years of progressive experience in strategic
development, executive leadership, and the deployment of highly profitable
business teams. His executive leadership with Fortune 1000 and start-up
companies has directly contributed more than $1 billion in market
capitalization growth throughout his career.
Terry is the founder and Managing
Partner of Performance Transformation, LLC a Professional Coaching and
Strategic Development firm focused on igniting breakthrough performance through
the authentic engagement and development of human talent. The company's
evidence-based programs and philosophical approach employs their proprietary
Accretive Coaching Process™. The organization's engagements align the clients'
human capital with their strategic imperatives driving tangible results,
delivering a sustainable competitive advantage and an exceptional Return on
Investment. Terry is a graduate of The Whittemore School of Business,
University of New Hampshire and a veteran of U.S. Naval Intelligence. He has
just completed his first book, "The Law of Traction ~ A Practical Approach
to Engaging the Mind,Heart, & Spirit for Transformational
Performance".
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