The Dollars and Cents of Nurse Turnover
Conventional wisdom asserts that nurse turnover is a “bad” thing, resulting in increased costs (the need to recruit new nurses) as well as the cost of losing an experienced nurse’s medical knowledge and skills as well as his or her knowledge of the “way things are done” at a particular medical facility.
It seems to point to the following benefits of retaining nurses for the long-term:
- Reduction in advertisement and recruitment costs
- Fewer vacancies and reduction in vacancy costs
- Fewer new hires and reduction in hiring costs
- Reduced orientation and training costs
- Maintained or increased productivity
- Fewer terminations and reduction in termination costs
- Decreased patient errors and increased quality of care
- Improved work environment and culture, increased satisfaction, increased trust and accountability
- Preserve organizational knowledge, trade secrets
- Easier nurse recruitment
- Becoming the nursing “employer of choice”
But is conventional wisdom correct?
A 2007 article in the Online Journal of Issues in Nursing by Cheryl Bland Jones, RN, PhD, FAAN and Michael Gates, RN, PhD, noted that [t]here is fairly substantial evidence to support the position that nurse turnover is costly.” There are some benefits to turnover, the authors note, including:
- Reductions in salaries and benefits for newly hired nurses vs. departing nurses
- Savings from bonuses not paid to outgoing nurses
- Replacement nurses bring new ideas, creativity, and innovations as well as knowledge of competitors
- Elimination of poor performers and disgruntled employees
Some aspects of nurse turnover benefits are extremely easy to quantify – for example, the reductions in salaries and bonuses are easily quantifiable. However, how can new ideas be quantified? What exactly are the productivity gains that the organization may experience because disgruntled employees leave?
So what is the answer? Is nurse turnover a “bad thing” or a “good thing”. The answer – like most things in life – probably lies somewhere in the middle. It can be a good thing to bring in new nurses for their competitive knowledge and expertise, maintain a cadre of experienced nurses to your staff who fully understand your policies and procedures, preserve organizational knowledge and can serve as mentors to newly hired staff can be invaluable.
What about your own experience? Have you noticed the quality of care diminishing in your facility when staff turnover is high, and care rise when turnover is low? Or is it something in between? Let us know your thoughts on nursing and other medical staff turnover issues here.
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