Labor costs for healthcare systems account for upwards of 50% of their annual spending budget. In addition, Syntellis and the American Hospital Association reported that labor costs in hospitals have increased 258% from 2019 to 2022. One of the largest factors contributing to this trend is reliance on temporary workers to fill staffing gaps. These costs understandably increased during the pandemic with heightened care demand, however, an influx of labor spending is unsustainable for most healthcare systems. Developing a strategy to balance labor expenses is crucial in helping hospitals focus on providing quality patient care while improving profit margins, but how can organizations increase their retention rate to reduce their dependence on contract labor?

Reducing labor costs involves understanding the causes of high turnover and vacancy rates. Nurses report a lack of career advancement opportunities, poor leadership, and burnout as reasons for wanting to leave their positions. As hospitals focus on boosting retention, they, in turn, reduce turnover and vacancy rates creating a sustainable pipeline of workers. Let’s explore some innovative ways hospitals can improve the retention of their nursing workforce!

1) Implementing Resident Apprenticeship Programs in the First Year

As new grads enter their practice, they often struggle to manage the schedule, workload, and stress of their new role. Supporting individuals with first-year resident apprenticeship programs opens the door to refine clinical skill competencies, building patient care quality, and provide mentorship opportunities to nurture talent. Fostering resilience early in practice allows nurses to adjust to the stress of working in a hospital while reiterating their clinical education. As they adjust and their confidence expands, young nurses are able to combine their healthcare expertise with the caring nature that brought them to nursing to deliver quality patient-centered care. 

In improving a healthcare system’s retention rate, it is important to build the foundation in the first year with new graduate RNs. Gen Z nurses display lower job satisfaction, are less likely to recommend nursing as a career, and are exiting the profession within their first year at higher rates than previous generations. Utilizing transition programs aids hospitals in building a relationship with young RNs that is mutually beneficial while developing talent to the facility’s standards. Nurturing talent in their first year is integral to hospital staffing; it is the first step in creating synergy in retention between newly registered nurses and experienced nursing personnel. Hospitals are able to decrease the amount of time it takes for new hires to be productive in their role, increase RN retention, and establish a robust pipeline of workers.

2) Offering Flexible Schedules

Beyond a nurse's first year, their career expectations and work-life balance are important factors in strategies for nursing retention. The standard scheduling of nurses includes 12-hour shifts, rigid arrangements, and sharp turnover times. Hospitals can offer alternatives to their staff that maintain their scheduling needs while favoring retention efforts. Creating shifts with variable start times offers nurses flexibility in their call times to work with their personal responsibilities. Promoting shift self-governance allows RNs to build their own schedule, work collaboratively with their team, and foster a sense of autonomy in their work. Pioneering a self-governance program for scheduling becomes a great benefit to staff and allows hospitals more elasticity in shift planning. 

Giving more autonomy to staff, especially in scheduling, boosts job satisfaction and curbs feelings of burnout. Although there can be trouble with shift self-governance, many teams find it easier to collaborate on a schedule that works team-wide. Finding a way to balance hospital staffing needs and nurse work-life balance can be the key to long-term nurse retention strategies.

3) Nurse Burnout Prevention

Burnout is a leading cause of the nursing shortage. Nurse burnout is a condition caused by unmanaged excessive workplace stress that can ultimately result in individuals leaving their job or the profession altogether. There are a variety of factors that contribute to the condition in nurses, with top causes including overworking staff, inefficient care models, and poor communication throughout a facility. Developing and nurturing talent is important to a nurse’s practice, however, maintaining an open dialogue with RNs is crucial to retention strategies. 

Healthcare systems can fight burnout by understanding the unique needs of their nursing workforce and finding ways to balance care demand and provider well-being. Hospitals can achieve this through team-based care delivery and open feedback from bedside nurses to leadership. Championing more efficient communication helps to address unique staff concerns while hospitals gain teams using their strengths in providing care. In addition, encouraging an open dialogue aids in matching a nurse’s skills with responsibilities to increase job satisfaction and care quality.

4) Nurse Shared Governance Programs

Fostering a culture of open discussion in the workplace is a continuous practice. Hospital leadership must find ways of effective communication to encourage a collaborative environment for quality patient care. Nursing shared governance is a practice of bedside nurses and nurse leadership coming together for shared decision-making. This nurtures a way for nurses to have a broader impact while fostering empathy in their work. Implementing programs that promote a cohesive collaborative environment allow for better decision-making, teamwork, and patient outcomes. Shared governance programs also boost job satisfaction in nurses as they see the impact of their work throughout the organization. Being able to witness the impact nurses have beyond patient care, they are able to witness the effects of their care delivery on their healthcare community. Hospital’s see the results of shared governance programs through improved retention and patient outcomes. Although it can be difficult to initially implement such programs, proper self-evaluation helps to understand the best method for individual facilities.