Retention of Staff is One of the Biggest Challenges for Nurses


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Retention of Staff is One of the Biggest Challenges for Nurses

Nursing is one of the most versatile professions, and yet if you ask a disgruntled nurse why s/he is thinking about leaving nursing instead of changing specialties, the answer will more than likely be that s/he feels stuck.

In the midst of a severe nursing shortage, retention is one of the biggest challenges the nursing profession faces. In 2000, for example, it is estimated that 500,000 nurses in the U.S. were not working as nurses. They were either staying home raising children or working in other fields such as real estate, retail sales and education. If all of those nurses had been working as nurses, there would have been no shortage of nurses.

The advent of managed care in the nineties brought about so many drastic cuts and changes that resulted in some of the worst working conditions for nurses in the history of the profession.

Studies proving high nurse-to-patient ratios negatively impact patient safety and outcomes also helped convince insurance companies and facility administrators that work conditions had to improve. The unionization of the nursing workforce, helped to improve many of these situations, but much more has yet to be done.

Now Medicare has implemented stringent rules for not paying for additional patient expenses related to specific medical errors. This should be driving the point home even further that nurses need better working conditions if the quality of patient care is to improve.

The financial downturn in the past couple of years has brought many nurses back into the field, but with a shortage of over 800,000 nurses in the U.S. being predicted by 2020, retention of nurses is more important than ever.

Helping nurses to transition to new fields when they are burned out or no longer physically or emotionally capable of working in a particular area is one of the ways we can and must work to help to solve the nursing shortage.

Using older, retiring nurses as mentors for new nurses for example will keep the masses of Baby Boomers ready to retire from leaving the profession all together. The valuable resources from the wealth of knowledge and experience these nurses have to share should not be lost.

Most new grad nurses are encouraged to spend a year in basic med/surg nursing before seeking out a specialty. This helps to provide them with a broad background of experience and confidence in their skills.

However, in recent years, many more nurses have chosen (and been allowed) to go straight into a specialty. This can be very stressful for the new grad, but many times they would prefer the stress to being “bored” with a more mundane experience. A few years down the road they may live to regret this decision. More often than not, these nurses seem to be the ones who feel stuck because they are too specialized.

Some specialties naturally lend themselves to others better than others, but if you want out of the high stress of the ICU, moving into the ER isn’t necessarily going to reduce your stress. The hospital may only allow this transition however because of the skill levels involved. They may frown on losing such a technically skilled nurse to the Labor and Delivery team. And so instead of retaining the nurse, s/he decides to move on or leave nursing all together in order to reduce the amount of job related stress.

Stress is relevant, and each field of nursing has varying levels of stress. Being able to transition to another department, or to move into another field such as public health, home health or forensic nursing can afford nurses the opportunity to remain a nurse, while making the lifestyle changes necessary for their own physical and emotional health.

The nursing profession has to learn not only to think, but to live, outside the box in order to retain the nursing workforce we have as well as to attract new nurses to the profession.

By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book and is the author/owner of

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