The Reason of Nursing Turnover - Essay Example

?Executive Summary: One of the unfortunate realities of the current system is that nursing turnover is proving to be highly costly to a number of hospitals and healthcare institutions around the nation. In effect, the nursing profession, and the healthcare profession in general, requires a stable, highly trained base of employees/nurses that can interact with and engage the patients under their care with a high level of healthcare provision and service. Yet, due to the fact that such a high rate of nursing turnover is evidenced within the current environment, this necessarily reduces the overall quality of care, increases the costs of seeking to fill unfilled positions, places the strain upon the remainder of nursing professionals, and drives up the average cost of healthcare for each and every individual in the system. Naturally, this has a trickle-down effect of increasing other medical staff turnover, increasing in overall level of absenteeism, increasing staffing costs, and decreasing patient quality of care as well as the potential loss of patients in the long run. Due to such a vast and intricately interwoven network of impacts that nursing retention within the current system effect, this brief analysis will consider and discuss the means by which will one particular hospital, Renfrey Memorial Hospital, can seek to ameliorate this nursing turnover by implementing a series of five steps; each of which has proven to increase overall personnel retention within other hospitals around the nation. Further, it is the hope of this author that through such an analysis and discussion, the author and stakeholders within the medical community can come to a more appreciable understanding with regards to the impact that nursing turnover has with regards to overall health care quality of care that is presented within the system. Introduction: Prior to delving directly into some of the prescriptions for maximizing the level of nursing retention within the hospital in question, it must be understood that the root cause of nursing turnover is necessarily with regards to the fact that a level of job expectation is not being met. Although a great deal of job satisfaction is contingent to the employer and the situational realities that they can provide, it must also be realized and engaged with that the extraordinarily high demand for nursing within the current system places a limitation upon the overall level to which the hospital or health care entity can improve the situational realities find the nursing profession (Jones & Gates, 2007). What is meant by this is that the demand is currently so high and so you nurses are able to fill these positions that they are invariably overworked and experienced a rapid level of burnout regards to the job which they engage. Within such an understanding, the reader can and should be intimately aware of the fact that although environmental factors can be tweaked and key levels of satisfaction likely met, straining realities of the nursing profession in its current form denote that there is a clear limitation to what can be done to increase employee satisfaction within this might work. 1 From a literature review and analysis of the means by which several hospitals around the nation have sought to increase employee/nurse satisfaction with that their institutions, it was determined that one of the most effective means that can be engaged is with regards to an increase level of flexibility and autonomy with regards to the scheduling process. Although this may seem as something rather trivial, the fact of the matter is that nurses are highly trained and highly educated nationals. In such a way, being manipulated and moved around like near ponds with regards to their schedule and the oversight thereof necessarily derives the individual stakeholders of a feeling of inclusion and importance within the healthcare industry as a whole. Within such an understanding, it has been proven that a farce. Method of stakeholder inclusion and appreciation is to create a system whereby a level of Democratic process and free will are able to direct and manipulate the way in which opened shifts can be filled and allotted to the respective stakeholders. One of the means that this can be equitably affected regards to utilizing a web-based staffing management solution that would allow for certain levels of preference and consideration be given to those nurses that display a level of seniority within the hospital. However, regardless of the unique metrics which could be used to define and constrain subsystem, allowing for web-based sign-up and application for cheap opened shifts allows for the individual nurses to determine the overall level of hours that they feel working and provide further level of equity as a whole (Knudson, 2013). Although it may be seen in such an approach will allow for two-number of shifts to go uncovered, the same supply and demand economics that define the rest of the economy were also exhibited with those hospitals that utilize such an approach. What is meant by this is the fact that the desire to take more shift and the desire to be off during certain times reached an equilibrium that allowed for the same level of work output with the exception of a far increase level of satisfaction job appreciation among the stakeholders involved. 2 Perhaps the most obvious complement of seeking to make a job more attractive and thereby maximize return is with regards to increasing compensation for such jobs. This is a contentious topic due to the fact that many hospital administrations and financial oversight committees are highly represent to increase levels of pay the fact they believe that this will undercut the overall profitability that the firm is able to enjoy. However, aspect of economics must be engaged with in order to understand the irony of the fact that this is indeed not true. It has been estimated that nursing turnovers within a hospital cost an average of 300 house and dollars per turnover. Naturally, this is a staggering sum of money that, when counted next to a 15 to 20% pay increase for a salary that averages between $80,000-$120,000, is but a drop in the bucket. Naturally, in order to engage the decision-making stakeholders within a hospital with regards to this eventuality, a level of data analysis and a careful cost breakdown must be presented (Chafin & Biddle, 2013). However, no matter what way this issue is discussed were analyzed, the understanding that is necessarily engaged is that an increase in salary is one of the single leaf expensive and most effective means by which nursing retention can be maximized. 3 Although the two approaches which have been discussed previously exhibit a clear and definitive level of expenditures that must be engaged with by the hospital and/or entity the third recommendation which will be discussed does not require much if any direct investment in order to increase the overall level of nursing retention. Based upon studies and the application of this approach within hospitals around the nation, it was determined that merely seeking to engage stakeholder that with regards way in which satisfaction and utility/efficiency could be maximized was extraordinarily useful in increasing the overall rates of nursing retention (Koen et al, 2013). Naturally, there is no tried and proven method by which this can be affected. However, for the sake of argument, holding monthly committee meetings, engaging in symposium, soliciting feedback in various forms, and a litany of other approaches are all extraordinarily useful in integrating with the nursing staff and understanding that they are truly appreciate their input with regards to improving the process and maximizing their own satisfaction, as well as the efficiency of the firm, is a primary priority. 4 Another cost effective approach that has been engaged in hospitals around the nation is with regards to seeking to screen out those nursing applicants that do not “it” into the culture of the hospital. Although somewhat obvious, this approach is oftentimes ignored due to fact that such a clear and definitive level of shortage necessarily demands that any and all resources be put forward to fill these vacancies. However, in the long run, such an approach is not useful due to the fact that incurs a higher level of cost and presents the hospital with an ineffective and culturally unharmonious approach to health care provision (Thomas et al, 2013). 5 The fifth and final approach which will be discussed within this analysis is contingent upon the level and degree to which hospitals around the nation have begun instituting programs of stress reduction and counseling with regards to the tension and pressures that nursing staff necessarily integrate. One of the primary reasons for such a high rate of turnover within the nursing action cannot be said to be contingent upon a cultural mismatch, or even necessarily unhappiness the job in question. Rather, one of the primary reasons for such a high rate of nursing turnover the current environment is contingent upon the fact that nurses, perhaps more than any other profession, are becoming emotionally burned out (Tillot et al, 2013). As a means of ameliorating this emotional burn out, many hospitals have begun instituting programs specifically designed to engage with these nurses provide them with actionable tools to impact upon their emotional well-being prior to point in time that emotional burnout is fully realized and irreversible. Naturally, such an approach is not cheap; however, it is been proven that the cost engaging within such programs are measurably much less than with regards to merely allowing the realities of the nursing profession to continue to play out within the workforce. Discussion and Centralization of Two Key Responses: Although each of the approaches which a been discussed with likely help to affect an overall improvement in the situation at Renfrey Memorial Hospital, it is the understanding of this analyst that two of the above approaches specifically would help to affect the greatest level of nursing retention. As will be discussed, these two approaches are as follows: instigating a further level of stress reduction and counseling programs within the hospital for key stakeholders and increasing compensation as a means of encouraging further employment by nurses. Part of the reason that these two approaches have been selected is due to the fact that they provide a minimal level of impact with regards to the five stakeholders that must always be considered when a hospital or health care provider creates a change of any sort: patients, hospital administration, accounting, human resources, marketing, and third-party payers (Ellenbecker & Cushman, 2012). With regard to these five stakeholders, the first approach mentioned, that of engaging in a higher level of counseling and stress reduction programs, would affect the patient and the fact that she/she would necessarily need to pay and nominally higher level of money in order to cover the expenses that such programs would incur. Similarly, with regards to hospital of ministration, approval of such a plan would require careful consideration and an overall change with regards to the way in which key decisions would be made (Mokoko et al, 2010). Likewise, with regards to accounting, this will necessarily have a profound impact due to the fact that an entirely new level of budgeting and costs must be allocated to integrating such a program into the hospital as a whole. Although it could be said that such an integrated program would have an impact upon marketing, it is the belief of this analysis that the only changes to marketing which could be affected is with respect to the way in which the nursing opportunities within the hospital are marketed to the nurses themselves; as something of a recruitment efforts/drive. Lastly, with respect to the way in which such a change would impact third-party payers, this is also with regards to price increases that would be passed along. Due to the fact that the cost of overall service would nominally be increased, third-party payers would also be required to absorbed some of this cost with respect to the reimbursements that they deal with on a daily basis. Similarly, the other approach which has been chosen to be the most viable for Renfrey Memorial Hospital is with respect to paying the nursing professionals at a more competitive rate. Naturally, many of the same impacts that were discussed with regards to the first option above will also be reflected within this particular option; albeit to a somewhat greater degree (Duffield et al, 2011). With respect to the patient, it will be calm a noticeable increase in the overall level of cost associated with health care provision. With respect to hospital administration, key approval and appreciation for the realization that increase in pay will actually help to bring down costs in the long run must be engaged. Likewise, with the accounting department, justification of such an increase must be appreciated and rectified within the budget and yearly operating expenses of the entity. Moreover, the human resources department must ensure that such an increase is reflected across the board among all stakeholders and that future employees are also offered the same (Brown et al, 2013). Likewise, the impact upon marketing would be much the same as was discussed with the previous option; specifically concentric upon the means by which hospital is able to integrate with prospective employees and promote themselves as differentiated and offering a better overall opportunity than the competition. Likewise, mirroring the same determinants which were discussed above, third-party payers would also be responsible for shouldering part of the financial burden that such a liberalized approach to employment compensation would engender. Final Approach Recommended: Based upon these two findings/recommendations, it is the understanding of this author, as a result of extensive research and analysis of the repercussions of such a decision, that the best approach of these two would be with regards to instituting a broad program of stress reduction and/or counseling to all available nursing staff. One of the first reasons for such a choice is necessarily with regards to the fact that such a program has definitively been proven to reduce the overall turnover ratio in a more efficient means than any of these other single determinants which is thus far been discussed. Naturally, a secondary level of this particular approach provides is with respect to the fact that order of magnitude left of the other approaches that it been engaged with during the course of this analysis. In a perfect world, each of the above determinants could be integrated with to a lesser or greater degree as a means of maximizing nursing retention within the hospital. However, due to the fact that a limited amount of resources constrain the overall approach that can be taken to such an issue, the most actionable and effective/efficient means of approach that can be engaged is necessarily with regards to maximize the level of counseling/stress reduction that the stakeholders have at their disposal. This will necessarily also have direct effects upon the overall well-being, happiness, longevity, and quality of care that can be engaged within the hospital. Accordingly, through careful planning and implementation, other aspects of the above recommendations can be included, to a small degree. What is meant by this is that a situation in which a level of counseling and stress reduction seminars could be engaged would also provide an opportunity stakeholder feedback, and perhaps even a discussion and appreciation for the way in which effective time management could also be used as a means of maximizing happiness and thereby increasing retention rates as well. References Brown, P., Fraser, K., Wong, C. A., Muise, M., & Cummings, G. (2013). Factors influencing intentions to stay and retention of nurse managers: a systematic review. Journal Of Nursing Management, 21(3), 459-472. doi:10.1111/j.1365-2834.2012.01352.x Chafin, W., & Biddle, W. L. (2013). Nurse Retention in a Correctional Facility: A Study of the Relationship Between the Nurses’ Perceived Barriers and Benefits. Journal Of Correctional Health Care, 19(2), 124-134. doi:10.1177/1078345812474643 Duffield, C., Roche, M., Blay, N., & Stasa, H. (2011). Nursing unit managers, staff retention and the work environment. 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