Creative Plan for Addressing the Registered Nurses Turnover, Essay Example

In 2005, nursing shortage projected to reach over 25,000 RNs by the year 2020 in United States unless proper measures were in place within the shortest time possible (Heather, 2006).  Nursing leaders worked in collaboration with Washington State Legislators to facilitate the passing of SB 5599 in an attempt to provide a necessary grant to a nursing resource center within the state but failed in the process (Eliot, 2006). Based on RCW 18.79.202, the Health Department grant N 14191 to the Center for Nursing in Washington (WCN) proclaimed a need to evaluate “the effectiveness of education for nurses and articulation among the many introduced programs to help increase access to education for the nurses and enhance their career mobility.” The step was excellent as it provoked many hospitals to plan and incorporate friendly environments for the nursing practice (Heather, 2006).

The average cost of filling a vacant position in nursing is approximately $62,480, according to reports by the U.S. Bureau of Labor Statistics. The acknowledgement is a true indication that any turn over from the nursing, profession needs to be taken seriously and it needs to be handled with care to prevent it from happening (Roberts, 2006). Turnover brings in negative impacts on the patient care quality as well as continuity of care, strains physician relationships, lowers work unit morale and increases the patient risk (Bowles & Candela, 2005).

From the high numbers of nurse turn over, a lesson is learned, one that could spell a solution to this big menace, which is facing the nursing practice. Most of the nurses who declined their positions on nursing job offers claimed to be denied opportunities to further their education (Heather, 2006). It is apparent that these nurses want to develop their career and the hospital has to support their claim and deliver in time what would be the best approach in aiding them to start learning and advancing their skills in the nursing field (Friedrich, 2008). Furthermore, it will be to the advantage of the hospital when the nurses further their skills in nursing or any other medical field. With the closet nursing school being 75 miles away, it is impractical for the nurses to enroll in the institution and still serve in the hospitals because of the distance barrier (Heather, 2006).

The best possible plan is to start a program and engage the community college A.D.N. program within the hospital. The program is ideal in facilitating learning for the nurses in the field of interest as they work within the field of nursing in the hospital (Centrella, 2004). It will be ideal for the institution for the nurses to access the Associate Degree in Nursing Program. It prepares nurses in the provision of services and management of client care in a better way (Eliot, 2006). It does not only provide the three intrinsic roles of a nurse but adds to the list other necessary components in the profession including professional behaviors, clinical decision making, nursing process, communication, care interventions, collaboration, teaching/learning, and managing care (Friedrich, 2008). The program’s history is enormous with a history to create stable healthcare community since its inception in 1964. Having being approved by the Kentucky Board and given credit by the nursing accrediting commission, it is apparent that the program is the best in approaching the situation and sustaining the nurses within the hospital (Elaine, 2006).

Healthcare employees in the United States, often cite the stressful work environment being the main reason why they quit. The nurses do not have a union to query for them and present their grievances in the institutions therefore compelling pressure on individual who try to fight for their rights. A nurse union is ideal in the current situation in the hospital that poses major risks and increases the turn over. The union guarantees nurses full representation of their grievances to the board of directors in the hospital. Even though the institution will grant not everything of their wish, at least there will be a light of representation in the management level (Bowles & Candela, 2005). The representation is enough for the nurses and a positive effect can be felt immediately following a comfortable environment within the nursing profession. In fact, it can only be through nurses comfort ability that the profession stands and maintains its position within the institution (Eliot, 2006).

Many are the times when the nurses have to work for long hours and meet demanding patients contributing to the emotional and physical stress when working in the nursing field (Greene, 2005). Quality of patient care in this case decreases and leads to a higher turnover rate. There is a need for the hospital to take note of the demands of the nurses (Heather, 2006). Working hours need to stipulate the code of workers as per every organization’s requirement (Butler, 2005). A worker in every profession is mandated to work for six hours in a day within the country. He or she has a right to compensation on any extra hours worked as overtime. This is what the hospital needs to adopt to reduce the high number of Registered Nurses Turnover (Roberts, 2006). There is need to develop a schedule for the nurses and input their working hours preferably in shifts to avoid exploitation and a feeling of abuse in the nursing profession and guarantee the hospital quality services from the comfortable nurses (Elaine, 2006).

Registered Nurses Turn over is a situation rampant in many hospitals current. There is a statue, which nurses demand, and many hospitals are unable to meet their demands therefore increasing the rate of turn over (Friedrich, 2008). Ensuring nurse job satisfaction currently is necessary and the only step good for providing an immediate and necessary impact on the future of health care and financial viability. One thing about the current nursing professional practices is diversity (Butler, 2005). This has been a consequence of nurse shortage forcing institutions to take care and keep the available nurses to their service. Measures are important to keep any available qualified nurse and appreciate the services they offer (Centrella, 2004).

Motivating and retaining employees start at orientation and recruitment (Eliot, 2006). It is necessary for the hospital to get qualified team players to operate in the nursing field (Greene, 2005). Because of the difficult times that a nurse faces after recruitment, a better approach rather than on-job training is better to handle the problem and provide a better solution (Bednash, 2000). From the reports on why there is a high turnover rate in the hospital, it is evident that the institutions fails in facilitating an orientation program for the new arrivals and with time they face difficulties in the profession thereby quitting the hospital without further consultations (Heather, 2006). To prevent the new comers from giving up and leaving the institution, case studies, team building exercises, and case reviews are essential and of major help in addressing communication breakdowns that happen between the managers, staff and the overall healthcare team (Friedrich, 2008). Mostly, it is through breakdowns that there is a felt effect on the plan of a patient therefore compromising their service delivery. Handling these issues through the proposed means is a better approach and an ideal probability of providing a solution to the menace (Bowles & Candela, 2005).

Healthcare organizations need to employ a streamlined and detailed on-boarding survey used in measuring items with the most impact to ensure immediate contribution and stabilization of new employees (Eliot, 2006). Successful surveys include reasons for joining the institution, demographic coding, closed-ended items predicting stable contributors as well as open-ended items on reasons for joining the respective organization, realistic job preview, feelings about the job and effective orientation (Elaine, 2006). These are the virtues ideal to the organization and in betterment of keeping new employees in the profession and delivering better services to the patients (Centrella, 2004).

David Rowley, the research services vice president for Moorhead Associates, said recently that any employee survey as well as research regarding why employs turn over, should now shift their focus and direct it to why they stay. This way, the institutions can learn from what they do well to the employees that make them stay for longer so that they uphold the good morals (Bednash, 2000).

Strict Quality Assurance Program is a blow to nurse retention in the hospital setting. Even after the inception of the quality assurance program, the hospital needs to take care of the nurses and give them space in their profession (Butler, 2005). Quality assurance cannot work in compelling employees to work under pressure because they cannot deliver. The administration should involve nurses in such quality assurance approaches for them to appreciate and accept the set standards of quality service in their profession (Heather, 2006). Out of involvement, the nurses feel appreciated and welcomed in the institution therefore boosting their performance. In fact, an institution does not need quality assurance if it upholds a perfect involvement of all parties in any decision making process to make everyone comfortable with the outcomes and run the nursing profession without difficulties and very minimal is any (Eliot, 2006).

From the many researches done on employee’s turn over, there is an evident coloration between workforce engagement and goals and challenges within healthcare organizations. From the reports on the hospital turn over of nurses, it is apparent that nurses let go their jobs with a minimal reason of not being engaged in the hospital operations to make decisions within the institution (Butler, 2005). Workforce engagement has a major impact to any organization and it improves its performance, patient safety, clinical outcomes, physician engagement, financial performance and market penetration. This is what the hospital needs to handle and input within the organization to help maintain the employees and attract more to serve in the nursing positions within the hospital (Elaine, 2006).

Research indicates that majority of nurses leave their jobs blaming neutral or positive events as the major cause, for instance unsolicited offers on other jobs or spouse relocation. Therefore, it is up to institution to insulate valued employees and guard them from the events that would distract their service delivery in patient care (Heather, 2006). It is mandatory that the hospitals make connections between established groups and individuals in the institution and the new employees to facilitate a comfortable and compatible work environment all employees and reduce turn over rates (Greene, 2005). This approach is good to necessitate psychological benefits accumulating overtime and creating a situation where employees will not desire to forfeit the respective gains by attempting to leave their job positions (Eliot, 2006).

References

Elaine, G. (2006). Graduate Nurse Perceptions of the Work Experience. Jannetti Publications, 24(3):150-155, from http://www.medscape.com/viewarticle/541778?rss

Eliot, F. (2006). Professional dominance: the social structure of medical care. Transaction publishers, New Jersey.

Bednash, G. (2007). Decreasing Supply of   Registered Nurses: Inevitable Future or Call to Action? Journal of American Medical Association, vol. 283, p. 2985-2987.

Bowles, C., & Candela, L. (2005). First job experiences of recent RN graduates. Journal of Nursing Administration, 35(3), 130-137.

Butler, A.S. (2005). Best Place to Work. Executive Excellence, vol. 17, pp. 4-5.

Centrella, H. (2004). Oklahoma Heart Hospital Maintains 98 Percent Retention Rate. The Journal Record, Oct 11, pp. 12-15. Retrieved from, http://www. journalrecord.com/

Friedrich, B. (2008). Staying Power: First Line Managers Keep Nurses Satisfied with Their Jobs. Nursing Management, vol. 32, pp. 26-28.

Greene, J. (2005). What nurses want: Different generations, different expectations. Hospitals and Health Networks, 79(3), 34-42.

Heather, K. (2006). ‘The Impact of Nursing Work Environments on Patient Safety Outcomes: The Mediating Role of Burnout Engagement.’ Journal of Nursing Administration, 36(5) 259-267

Roberts, B. (2006). Job satisfaction of new baccalaureate nurses. Journal of Nursing Administration, 34(9), 428-435.