Please stay

Q My organization and my unit are experiencing high turnover rates for nurses and various other positions. What tips do you have for promoting retention? First, let me emphasize why retaining staff is so important. According to Becker's Hospital Review, the average cost to replace a nurse is $52,000, including the recruitment and training of the newly hired nurse.1 The cost for ancillary nursing staff will be significantly less based on salary but can be costly if the turnover rate is high. Many times, we focus on the financial component of turnover, but there's a noneconomic impact on patient outcomes and staff morale as well.2 Now let's talk about your turnover and identify some techniques you can implement to improve your retention, especially during the first year. Analyzing your unit's turnover data is a must to begin the change process. In this analysis, look closely at the when, what, and why related to turnover, asking questions such as: When are employees leaving: 3, 6, or 9 months? What's their job classification and FTE (full-time equivalent) status? What's their tenure in healthcare? Why and what are the reported reasons they're leaving? Collecting this information will assist you in deciding what techniques to implement. Your initiatives for retention will start before the employee arrives to orientation. Review applications and résumés thoroughly for work history. Then focus on your interviewing style. Behavioral event interviewing (BEI) will identify if the person has the competencies you're looking for and can also provide insight on adaptability based on the questions asked. Here's a resource to assist you in conducting an interview using the BEI technique: www.linkedin.com/pulse/six-steps-conducting-behavioral-event-interview-edward-cripe.3 During the interview, you need to clearly communicate about the culture and the work done on your unit and the typical workload in your work area. As part of your BEI questions, ask the potential employee to share their experiences in a setting similar to your unit. Once your new employee is onboarded, the real work begins: keeping them. Retaining good employees is highly associated with how engaged they are in the unit and organization.4 Building good relationships with and among employees contributes to increasing their engagement. Connecting new employees with mentors, preceptors, and/or a general buddy on the unit fosters these collegial relationships and helps the new employee become part of the team. This technique can be used to decrease turnover during the first 3 to 6 months of employment. Inclusion in the unit is a good start, but continued engagement is what strengthens employee retention. Techniques that contribute to this ongoing engagement include routine, one-on-one meetings asking for feedback and ways to improve the unit, work flexibility (if possible), and expressing appreciation for the work being done. These last practices impact retention well past the first-year mark. All of these techniques can support retention, but if the reason people aren't staying is because of a toxic environment, you need to investigate this further. It may be that you have one (or more) employee(s) sabotaging the unit. In circumstances like this, you have to address the issue(s) with those employees. Neglecting to deal with situations involving difficult or poorly performing employees may be leading to some of the unit turnover. Realigning the culture and addressing the behavior of others can take some time, but it's worth it for all involved. Once you know at what point in time you're experiencing the turnover and why, start your game plan to decrease turnover and increase long-term retention.