5 Strategies to Improve Nurse Retention

For many healthcare organizations, retaining nursing staff is a constant challenge. Organizations struggle to meet ever-increasing employee expectations, maintain a worker-centered culture, and ensure a flexible scheduling practice that mitigates stress.

Without the right processes and tools for support, an organization’s healthcare operations suffer; and so does the ability to provide a desirable work environment for nurses. This contributes to a vicious cycle. Dissatisfied nurses quit and the remaining staff must take up more shifts, higher case loads, and more challenging cases in their absence. Then, those nurses get burned out prematurely, which hinders worker productivity, decreases quality of care, diminishes patient satisfaction, and, ultimately, leads to even higher employee turnover rates. 

The COVID-19 pandemic has only exacerbated this problem, as more than one-third of nurses say they’re likely to leave their jobs in the next few years. Healthcare organizations who fail to adapt processes and leverage intelligent tools to bolster their workforce will struggle to maintain their viability. 

To remain ahead of the curve, attract the right staff, and reduce turnover, healthcare companies need the right processes and tools to meet (or exceed) employee expectations, improve nurse scheduling, and empower their workers to succeed. 

The Main Drivers of High Nursing Turnover

It’s true that the recent pandemic has intensified the operational factors that drive nursing turnover, but retention isn’t a completely new issue in the healthcare industry. Turnover in home health care nursing, in particular, has been growing, with rates reaching 22.18% in 2020. 

Home health agencies must work quickly to find, hire, and retain adequate nursing staff to maintain operations. This high demand has led to more employment options than ever for nurses. With industry-wide staffing shortages placing nurses in an ideal bargaining position, they are no longer fearful of leaving a stressful or unsatisfying job and are able to be more discerning about potential employees.

In fact, some nurses are leaving the healthcare field altogether, as industries like retail, financial services, and business corporations offer greater scheduling visibility and flexibility, better development opportunities, and less stressful working environments. 

For every type of healthcare organization, high turnover is directly tied to the negative outcomes born out of several common challenges:

• High stress – 44% of nurses who plan to leave their jobs cite a high-stress working environment as their key motivator. Nurses consistently face both quantitative (number of hours worked, number of weekend and night shifts, etc.) and qualitative stressors (working with immobile patients, caring for patients with violent behavior tendencies, etc.), and organizations often don’t have clear insights into these details. Without sophisticated processes and tools, operations teams simply don’t have the information required to serve as a proxy for the amount of stress that certain jobs or patients create for workers—which limits their ability to schedule in a way that alleviates some of that stress.
• Lack of visibility – Equity and balance requires total visibility into all work, and many healthcare organizations lack that context. Outdated scheduling processes and manual tools (like spreadsheets, email, static calendars, etc.) make it difficult to understand who’s working and where, who’s available, and where there’s demand. Nurses have little to no control over their schedules by way of availability or preferences, so their satisfaction and autonomy suffer.
• Schedule volatility – Schedule volatility is a pesky reality in healthcare: Patients cancel, don’t show up, or book appointments at the last minute. The unpredictable nature of the work means appointments invariably run over time. Home health care providers are directly impacted by these abrupt changes, as they typically strive to get 40 hours of work per week from a single employer. But when an organization doesn’t have the processes and tools in place to accurately track and manage appointment statuses in real-time, schedulers simply scramble to ameliorate the problem. The result is a haphazardly scheduled nursing workforce that lacks predictability and stability throughout the week. 
• Long shifts – Long shifts are yet another reality for nurses, as they tend to work for more hours over several days, then take a few days off. But because of staff shortages and tools that only offer a limited view into worker availability, preferences, hours worked, and individuals’ work patterns, healthcare schedulers struggle to align their nurse’s schedules with business demands. So while organizations offer flexible shifts to ensure they meet patient demand, they often also fail to establish shift-based schedules that actually reflect their nurses’ needs. 

Crucial Strategies to Improve Nurse Retention 

Improving nurse retention starts by optimizing your healthcare operations. With the right strategy, processes, and tools, your team can reduce and even eliminate the frustrating and productivity-hindering factors that drive nurses to seek other employment. 

Here are 5 effective strategies for getting started:

1. Focus on Culture

Everyone wants to feel appreciated for their work, and nurses are no exception. Providing patient care is often a difficult, tiresome task, but one that can be incredibly rewarding with the right employer. When employees feel recognized, they’re 4.6 times more inclined to perform at their best. That’s why it’s crucial to build a people-first culture that proves how much your organization values its employees. 

By implementing a meaningful rewards and incentives program, healthcare organizations can demonstrate their appreciation of their nurses’ efforts. Depending on your budget, you can find creative ways to reward those who have high patient satisfaction ratings, take on more shifts, or consistently show up to their appointments on time. A gift card, extra time off, or a public display of recognition (like a team-wide “thank you” email that highlights a high-performing individual) can go a long way in keeping nurses satisfied and engaged in their work. 

A strong program shouldn’t simply offer rewards based on performance, though. It should also mean taking the time to recognize what’s going on in the schedule. If, for example, the schedule shows that Kevin has worked every Saturday for the last three months, try asking him if he’d prefer the next few weekends off. It’s a proactive approach that allows nurses to switch up their schedules, maintain a healthy work-life balance, and avoid burnout. 

Your recruiting and onboarding processes are a great place to establish your healthy culture, too. For instance, by facilitating “ride-alongs” prior to hiring, nurses can see first-hand the types of areas, homes, and environments in which they’ll be working. That way, they’ll be well prepared for the work and understand the patient cases they’ll be handling before they commit to the job. 

2. Offer Appealing Benefits 

Increasing nurse salaries to adequately compensate them for their work can help your organization improve retention rates. Because of employee shortages, nurses have the freedom to evaluate employers based on their ability to provide a competitive salary. And while boosting wages might seem like an expensive approach, it’s a relatively small price to pay when you consider the alternative; as the cost of a single nurse turnover can be upwards of $100,000.

It’s also crucial to give your nurses ample time off to offset the stressful nature of their daily work. Make sure the tools your operations team and staff schedulers use offer insights into how many hours each individual is working, how many days they’ve taken off, and which types of patients they’re serving. Then, establish a fair PTO structure that takes into account the amount and complexity of work each nurse completes. 

Perhaps most importantly of all is your organization’s ability to ensure flexible work schedules. Nurses want their employers to consider their availability, preferences, and work history, and upcoming jobs as they create their shifts. Employers should measure their scheduling practices against several critical, competitive differentiators by asking themselves the following:

• How far in advance do you let your employees know about their schedules?
• How many hours on average do employees receive?
• How does that average align with employee expectations?
• How do you solve for exceptions?

Visibility into your workforce data can transform “flexibility” from a buzzword to something meaningful—so make sure you use it to your advantage. 

3. Improve Scheduling 

Delivering quality care is a wobbly balancing act if you don’t have the right scheduling processes and tools in place. Up to 43% of organizations still use paper-based tools or spreadsheets to schedule their nurses. But these outdated methods cause inefficient workflows, require time-consuming and repetitive tasks, and lead to scheduling errors; and nurses feel the pain. Plus, healthcare workers must adhere to compliance procedures, and physical paperwork makes it difficult to protect patient confidentiality. 

Competitive healthcare organizations have started investing in intelligent scheduling tools to eliminate those redundant tasks, eliminate workflow bottlenecks, and ensure accuracy. Some tools automatically assign the best healthcare provider for the patient (based on availability, location, preferences, certifications, and more), so nurses always arrive on time and fully prepared.

Smart scheduling systems offer user-friendly mobile apps, so nurses can send and receive updates throughout the day, seamlessly sync patient and job data to a centralized system, and access up-to-date routes in real time. And because healthcare is often time-sensitive, modern scheduling tools make it easy to accommodate last-minute changes, unusual patterns, and recurring appointments. 

4. Provide Training and Support 

In order to remain engaged, nurses need to feel as though their careers and skills are continuing to develop over time. And since a highly-engaged team can boost profitability by up to 21%, healthcare organizations should provide sufficient opportunities for their nurses to grow. 

One way to ensure development is by empowering nurses with better remote communication tools, so they can easily contact their presiding physicians or other nurses to ask questions. Even better if their tools enable video calls or a phone line for triage nurse support, which help nurses access live assistance and gain deeper expertise while on the job. Moreover, remote educational tools and compliance training programs can make it easier for nurses to keep up with constantly changing regulations; and for their supervisors to confirm they’re up-to-date. 

A buddy system or pre-scheduled time for nurses to meet with other nurses once a week can also build team cohesion and bolster knowledge-sharing. Non-billable work doesn’t mean non-valuable work. Opportunities for socialization, team problem solving, and peer-to-peer mentoring all contribute to indirect revenue generation. Happier, more satisfied employees stay longer with organizations and maintain better relationships with your client base. 

Some organizations have also implemented programs that help aides get their CNA (certified nursing assistant) certifications free of cost, so nurses can further develop their training and skill sets. When employers give their nurses convenient opportunities to increase their knowledge and experience, those employees are more likely to advance within that same organization—rather than looking elsewhere to hone their skills. 

5. Leverage Better Tools

If you’re operating a small group of healthcare providers, you might be able to get away with using manual, disjointed tools. But for competitive organizations who want to retain their top talent and provide excellent patient experiences, those makeshift solutions just won’t work.

To remain satisfied, fulfilled, and successful, nurses need tools that make their already-complex jobs easier. Modern healthcare scheduling tools, for example, make it easy to match the right provider to the right patient, update caregivers in real-time, reduce travel time, and increase efficiency—all in one, easily accessible place. 

These tools use intelligent automation to handle complicated schedules and support all types of dynamic work arrangements. They offer complete workforce visibility for operations teams and staff schedulers, who can use those insights to optimize their scheduling process. That means no more guesswork for schedulers, as they have seamless, up-to-date access to everyone’s skill sets, certifications, preferences, job history, location, and more.

Nurses have everything they need (from the fastest routes, to patient information, to communication tools, to vital documentation) in a single, mobile-friendly app, so they don’t need to waste precious time toggling from one tool to the next. They’re always in the know about the most up-to-date schedules and have flexible workloads that balance their autonomy with their supervisors’ authority. 

What’s more, the right healthcare scheduling tool enables nurses to collect patient and job data (like signatures, appointment details, health forms, etc.) in the field, then automatically syncs that information back to the central system. Nurses no longer need to spend time manually re-entering data into a separate database, and operations teams always have a real-time, accurate understanding of their workforce. 

Powerful Scheduling for Better Nurse Retention

Nurse turnover is a costly problem for many healthcare organizations, and insufficient tools and processes only exacerbate the issue. They often require superfluous time and effort from nurses whose time could be better spent focusing on their patients. Retaining your nurses means adapting your operations to improve scheduling, ensure a better employee experience, and become more human-centered. 

Skedulo’s home healthcare scheduling software helps organizations easily manage complex nursing schedules, with tools for intelligent job matching, route optimization, real-time communication, and more—all in one, mobile-friendly, HIPAA-compliant platform. Skedulo eliminates the manual tasks and scheduling issues that otherwise diminish nurse productivity and satisfaction. 

Learn more about how to decrease your home health workforce turnover, or book a demo today.