Nurse turnover refers to an objectionable voluntary or involuntary tendency of nurses to leave their jobs. Nurses leave their job due to aspiration for change or promotion, expression of job dissatisfaction, proceeding for further studies, personal issues, and the desire to change to a different profession (Dewanto & Wardhani, 2018). Thus, nurse turnover forces healthcare facilities to recruit new nurses to fill the vacant positions (Dewanto & Wardhani, 2018). Nursing turnover has various job-related implications, including disruption of hospital services, staffing problems, managerial process disorientation, and financial issues.
The chief financial implication of nursing turnover is the reduction in hospital revenue collection and increased peripheral costs. When old and established nurses leave the facility, it may take time to recruit other nurses and healthcare personnel to fill the vacant positions (Dewanto & Wardhani, 2018). The window period between the departure of the old staff and the newly recruited ones may lower the patients’ satisfaction levels, causing mistrust among the clients regarding the facility’s service delivery. Dewanto and Wardhani (2018) observed that up to 20% of patients might miss healthcare services during such periods, influencing other patients to avoid the affected hospital. The patients may switch their preference and allegiance to another hospital, leading to fewer patients visiting the facility, resulting in loss of revenue by at least 20% (Dewanto & Wardhani, 2018; Ruiz et al., 2016). Like in any other business, the number of patients visiting a facility is often directly proportional to the revenues earned at the facility (Bai & Anderson, 2016). Moreover, Ruiz et al. (2016) point out that the cost of advertising for vacant positions, interviewing, recruiting, orientating, and training new staff is about $856 million annually. Thus, nurse turnover erodes the financial accounts of an affected hospital.
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Solving the financial consequences arising from nursing turnover requires proper planning and preparation by the strategic management team. First, there should be an established policy that presses hospitals to offer flexible working schedules to the nurses. In this regard, hospitals should prioritize onboarding and on-the-job training of the already employed staff, endorse significant acknowledgment of service delivery through appreciation, promote nursing career development, and introduce continuing education to the existing workforce (Dewanto & Wardhani, 2018). These intervention measures significantly reduce nurse turnover, saving the extra costs involved when nurses exit the facility.
The intervention measures need a valid policy and procedure to implement. First, every hospital’s strategic management team should convene meetings and reprogram the working hours to accord every health worker social flexibility. Secondly, the strategic management teams should introduce on-the-job training programs, workshops, and benchmarking activities (Jeoung & Kim, 2016). Additionally, the long-serving nurses should be promoted and appreciated for their service and experience (Stephens et al., 2017). When these three recommendations are implemented and adhered to, nurses’ job satisfaction levels will greatly improve, thus mitigating the financial implications of nurse turnover.
References
Bai, G., & Anderson, G. F. (2016). A More Detailed Understanding Of Factors Associated With Hospital Profitability. Health Affairs , 35 (5), 889–897. https://doi.org/10.1377/hlthaff.2015.1193
Dewanto, A., & Wardhani, V. (2018). Nurse turnover and perceived causes and consequences: a preliminary study at private hospitals in Indonesia. BMC Nursing , 17 (S2). https://doi.org/10.1186/s12912-018-0317-8
Jeoung, H. Y., & Kim, S. Y. (2016). Effects of Nursing Professionalism and Job Involvement on Turnover Intention among New Graduate Nurses. Journal of Korean Academy of Nursing Administration , 22 (5), 531. https://doi.org/10.11111/jkana.2016.22.5.531
Ruiz, P. B. de O., Perroca, M. G., & Jericó, M. de C. (2016). Cost of nursing turnover in a Teaching Hospital. Revista Da Escola de Enfermagem Da USP , 50 (1), 101–108. https://doi.org/10.1590/s0080-623420160000100014
Stephens, T. M., Smith, P., & Cherry, C. (2017). Promoting Resilience in New Perioperative Nurses. AORN Journal , 105 (3), 276–284. https://doi.org/10.1016/j.aorn.2016.12.019
