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The High Cost of Nurse Turnover on Your Patients, Your System, and The Health Ecosystem and Three Strategies for Mitigating the Risk

by TLD Group

There’s a reason the American Nurses Association calls nurses the “backbone of healthcare provision in the United States.” Nurses provide critical health care services, are often a patient’s first or primary point of contact throughout their care journey, and help promote overall health and wellness in the communities they serve through education and practice. 

Given the massive contributions of nurses to the patient experience and overall health and wellness, high turnover is a critical and costly issue for hospital leaders. The turnover of Registered Nurses (RNs) has increased over the past five years, with the turnover rate of all staff RNs increasing from 17.2% in 2018, to 22.5% in 2022, according to the 2023 Nursing Solutions, Inc (NSI) National Health Care Retention and RN Staffing Report. 

As a health ecosystem talent development firm, TLD Group has recently supported nurse development that has led to positive impacts on retention and engagement at health systems across the country. We’ve seen the impact of nurse attrition up close. Through work with our clients, we’ve learned how to engage nurses and therefore enhance retention through focused development. Through this blog we’re focusing on the impact of nurse attrition on: 

  1. Patients, who rely on nurses for high-touch and high-impact care. 
  2. Health Systems, which when faced with significant nurse attrition, suffer poor patient outcomes and higher costs for nurse alternatives. 
  3. The Health Ecosystem, which relies on nurses even more as the population in the United States continues to age.  

And, we’re providing tactical solutions to curb nurse burnout and attrition.  

1. Impact on Patients.

In addition to providing essential healthcare services, nurses also provide emotional support and care by developing positive relationships with patients and their families in clinics and hospitals. 

Researchers conducted a three-year study to assess the effects of nurse staffing levels and skill mix on patient care costs, length of stay, and adverse events in a three-year study. The study found that increases in nurse staffing levels were related to reductions in nursing-sensitive adverse events and length of stay. 

Another study on the effect of variation in patient-to-nurse staffing on adverse outcomes also shows the correlation between lower patient-to-nurse ratios and patient outcomes. According to data on nurse staffing in 116 acute care general hospitals in New York, higher ratios of patients to nurses adversely affect patients. In this study, researchers estimated that 4,370 lives would be saved by staffing hospitals at a 4:1 patient-to-nurse ratio. 

2. Impact on Health Systems.

The financial cost of nurse turnover is also massive for health systems. The same report from NSI found that the average cost of turnover for a staff RN is $52,350 — more than half of the median pay for RNs in the United States in 2021.

The study on patient-to-nurse ratios also revealed the high cost for hospitals and health systems of not maintaining a large enough nursing staff. Researchers estimated that $720 million would be saved in a two-year period through the shorter lengths of stay and avoided readmissions that accompanied an appropriate patient-to-nurse ratio. 

High nurse attrition can also lead to a lack or loss of services in hospitals. When the COVID-19 pandemic led to vacancies in nursing staff in hospitals around the country, some hospitals had to triage procedures and postpone surgeries for non-life-threatening conditions. These vacancies clearly come at a cost to patients, as well as to those working other positions in the hospitals. Medical technicians, doctors, and therapists of various kinds face longer, more stressful work days when there aren’t enough front-line nurses to provide services to patients. 

3. Impact on the Health Ecosystem.

As the population continues to age, the need for health services, specifically nursing, will continue to increase. The United States has a higher number of Americans over the age of 65 than any other time in history. According to research on nursing shortages from the National Library of Medicine, in 2029, when the youngest members of the baby boom generation reach retirement age, there will be a 73% increase in Americans 65 years or older, compared to 41 million in 2011 and 71 million in 2019. 

Sectors across the health ecosystem will continue to be taxed to meet the needs of the aging population, with providers in hospitals and clinics likely to bear the brunt of caring for the aging population. 

The need to retain nurses is clear. The question is, are you prepared for the task? 

We know that engaged nurses are more likely to stay within their organizations. TLD Group offers a variety of ways to define and execute strategies for engaging and retaining your nursing staff including: 

  • Assessment and Coaching: Assessments reveal personality and behavioral insights, allowing individuals to identify strengths and areas of improvement, while coaching focuses on developing knowledge, skills, and abilities required for the job. Leadership development that includes both an assessment and individual coaching results in improvements in nurse leadership competencies and sustains performance over time. 

  • Mentoring: Mentoring has a significant impact on retaining nurses. Nurses who are new to the profession often face numerous challenges as they navigate the complexities of the healthcare environment. A mentor provides guidance, support, and advice to help the new nurse develop their skills and knowledge, build confidence, and become a successful practitioner.

    The mentor also acts as an advocate for the nurse, helping them to navigate the complexities of the healthcare system and providing them with networking opportunities. By providing mentorship, healthcare organizations can help new nurses develop a sense of belonging, which is crucial for job satisfaction and retention. Research has also demonstrated that nurses who participate in mentoring programs are more likely to remain in their positions for longer periods than those who do not. 

  • Group Leadership Development: A well-defined group development program, built around the composite needs of nursing staff can also increase retention, improve patient and staff satisfaction, and enhance retention. Additionally, targeted group development has been identified as an effective way to build and maintain comradery among staff, and may help support the development of skills necessary for high performance and organizational engagement. 

Contact us today to learn more about strategies for retaining nurse leaders. 

Topics: Leadership Development, Healthcare Ecosystem, Executive Coaching

TLD Group

Written by TLD Group