National Nurse Survey: The Cost of Nurse Retention

The Big Story: The cost of nurse turnover

“Over the past three years, average nursing turnover rates nationwide have trended back toward 2019 levels. However, many health systems, hospitals and departments still have not returned to pre-pandemic turnover performance.”

From Crisis Band-Aids to Long-Term Solutions

By Isaac Squyres and Courtney Kelsey

2-minute read

The cost of engagement requires the most expensive thing you have – your time. Your attention. Your devotion to developing relationships.

In our latest annual national nurse survey, we unpack how best to spend your time (and to create time for leaders) to strengthen your organization’s mission-critical relationship with your nurses. Think of it as recommendations for your workforce investment strategy.

You know the dollars at stake. The numbers, of course, speak for themselves. The average cost to replace one full-time RN ranges from $51,000 to $72,000, according to a recent Chartis report. Retention pays.

There’s good news, though. Nurse turnover has improved since the pandemic. And satisfaction seems to have stabilized. But the highly applaudable efforts that got us here from the low points of the pandemic crisis – the unrelenting heroic efforts and the crippling burnout that ensued – won’t get us where we need to go today.

You should want a better ROI.

It takes more than crisis Band-Aids and immediate tactical changes to instill a sense of belonging in the long game of a career in nursing. Assuming you’re compensating nurses fairly and staffing your floors appropriately – belonging and being engaged as part of an important mission is what matters most.

Our third-annual nurse survey of 800 RNs goes into the weeds to identify what nurses are really concerned about today and what we need to do to be better. The strategies that they point to aren’t one-offs. They require time and deep communication. Healthcare is a big boat, after all. It takes time to turn. And inside that boat are plenty of points of contention.

Ask yourself: What’s more important than your clinicians?

Going from good to great – to borrow from Jim Collins’ signature workplace management oeuvre – means saying no to a lot of other things. The opportunity for you to have a gold-standard workforce is high. But it’s not a layup.

The survey’s core message? While there are encouraging signs, ongoing work is needed regarding trust, satisfaction, communications and technology. Translation: It’s time now to get off the safe plateau that’s been achieved post-pandemic and resume the climb to gain lasting, high-caliber engagement. The work is deep and strategic and requires renewed commitment and investments of leaders’ time and organizations’ budgets. Because, as a recent Harvard Business review article points out, “Managing the employee experience for maximum benefit requires leaders to know what employees are seeing, feeling, and wanting—and then respond judiciously.” And that knowing takes work.

One takeaway: Trust and loyalty are fragile.

We asked the nurses, how much loyalty they feel towards different people and groups within their organization. We also asked how much they trust the leaders of their organization on different measures.

Their responses indicated a high level of loyalty to their department. But just over half feel very loyal to their team lead or organization. And less than 40 percent express a great deal or fair amount of trust in executives and believe that their leaders are making good operational and financial decisions. Only a third have a great deal or fair amount of trust that executives are honest and transparent.