Professional Documents
Culture Documents
STRATEGY: NURSE
RETENTION
Presented by: Nina Favor, Jody French-Sroka, Mary
Hefferan & Amy Herrington
Introduction
Improving Retention of Nurses
Literature Support
Nurse Retention Strategies
Kurt Lewin s Change Theory
Overview of Issue
Nursing shortage
Retention of nurses
Significant number of graduate nurses leaving the profession
Demographics of Population
Population is living longer
Demographics of Nursing
The average age of a practicing nurse is 45 years old
55% of surveyed nurses reported their intention to retire between 2011 and 2020
RNs will have the greatest job growth through 2020
495,500 replacements needed by 2020
(2013).
Staffing
Improper staffing levels
Unorganized units
Imbalanced assignments
Personal Reasons
Compassion fatigue
Glass ceiling
Punke, H. (2013).
Hillman, L., & Foster, R. (2011). The impact of a nursing transitions programme on retention and cost savings. Journal of Nursing Management, 19(1), 50-56.
http://0-dx.doi.org.libcat.ferris.edu/10.1111/j.1365-2834.2010.01187.x
Mills, J., & Mullins, A. (2008). The California Nurse Mentor Project: Every Nurse Deserves a Mentor. Nursing Economics , 310-315.
Orsini, C. (2005). A Nurse Transition Program for Orthopaedics. Orthopaedic Nursing , 240-246.
New Environment
Fear
Apprehension
Insecurity
Inadequate Support
Preceptors
Nurse Educators
Managers
Role Adjustment
Student to Professional
Cottingham, S., DiBartolo, M. C., Battistoni, S., & Brown, T. (2011). Partners in nursing: A mentoring initiative to enhance nurse retention. Nursing Education Perspectives, 32(4), 250-255. http://0dx.doi.org.libcat.ferris.edu/10.5480/1536-5026-32.4.250
Nelson, J. L., Arjes, M., Bushman, K., Carlson, M., Czaplewski, L., Derby, K., Godman, K., Horton, D., Stansfield, T., & Tan, H. P. (2012). Correlating novice nurses perceptions of nursing orientation
and first-year support with direct preceptor interventions. Journal of Continuing Education in Nursing, 43(2), 59-64.
Welding, N. M. (2011). Creating a nursing residency: Decrease turnover and increase clinical competence. Medsurg Nursing, 20(1), 37-40.
Time
Human Resources
Management
Staff Nurse Preceptors
Mills, J., & Mullins, A. (2008). The California Nurse Mentor Project: Every Nurse Deserves a Mentor. Nursing Economics , 310-315.
American Association of Colleges of Nursing. (2013). Nursing Shortage. Retrieved from http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-shortage
Wood, D. (2009). Why have nurses left the profession? AMN Healthcare. Retrieved from http://www.nursezone.com/nursing-news-events/more-news/Why-Have
Nurses-Left-the-Profession_29118.aspx
Marshall, E.S. (2011). Transformational leadership in nursing: From expert clinician to influential leader. (1st ed.). New York: Springer Publishing Company.
References
American Association of Colleges of Nursing. (2013). Nursing Shortage. Retrieved from http://www.aacn.nche.edu/media-relations/factsheets/nursing-shortage
Cottingham, S., DiBartolo, M. C., Battistoni, S., & Brown, T. (2011). Partners in nursing: A mentoring initiative to enhance nurse retention. Nursing
Education Perspectives, 32(4), 250-255. http://0-dx.doi.org.libcat.ferris.edu/10.5480/1536-5026-32.4.250
Hillman, L., & Foster, R. (2011). The impact of a nursing transitions programme on retention and cost savings. Journal of Nursing
Management, 19(1), 50-56. http://0-dx.doi.org.libcat.ferris.edu/10.1111/j.1365-2834.2010.01187.x
Marshall, E.S. (2011). Transformational leadership in nursing: From expert clinician to influential leader. (1st ed.). New York: Springer Publishing
Company.
Mills, J., & Mullins, A. (2008). The California Nurse Mentor Project: Every Nurse Deserves a Mentor. Nursing Economics , 310-315.
Nelson, J. L., Arjes, M., Bushman, K., Carlson, M., Czaplewski, L., Derby, K., Godman, K., Horton, D., Stansfield, T., & Tan, H. P. (2012). Correlating
novice nurses perceptions of nursing orientation and first-year support with direct preceptor interventions. Journal of Continuing Education in
Nursing, 43(2), 59-64.
Orsini, C. (2005). A Nurse Transition Program for Orthopaedics. Orthopaedic Nursing , 240-246.
Punke, H. (2013). 3 biggest causes of nurse turnover. Beckers Hospital Review.
Welding, N. M. (2011). Creating a nursing residency: Decrease turnover and increase clinical competence. Medsurg Nursing, 20(1), 37-40.
Wold, G.H. (2012). Basic Geriatric Nursing (5th ed.).
Wood, D. (2009). Why have nurses left the profession? AMN Healthcare. Retrieved from http://www.nursezone.com/nursing-news-events/morenews/Why-Have-Nurses-Left-the-Profession_29118.aspx
Administrator Role
Financial
Safety
Outcomes
Nurse retention
Estimated that 55% of nurses plan to retire between 2011-2020
(3)
(1)
Strategy
Kurt Lewins Change Theory
3 stages
Unfreezing
Moving to new level or Changing
Refreezing
Unfreeze
Shifts
Benefits
Staffing
Schedules
Education
Work-life balance
Governance
Change
Flexible shifts
Variable benefits
Flexible schedules
Staffing ratios (acuity systems)
Refreeze
Improved morale
Improved communication
Culture of safety
Who
How
Barriers
Process
Support
Enactment
Compliance
References
intention to stay among Saudi nurses. Journal of Nursing
Abualrub, R., & Alghamdi, M. (2012). The impact of leadership styles on nurses' satisfaction and
Management, 20, 668-678. doi:
10.1111/j.1365-2834.01320.x
Brewer, C.S., Kovner, C.T., Greene, W., Tukov-Shuser, M., & Djukic, M. (2012). Predictors of actual
turnover in a national sample of newly licensed registered
nurses employed in hospitals.
Journal of Advanced Nursing, 68(3), 521538. doi: 10.1111/j.1365-2648.2011.05753.x
Bryant-Hampton, L., Carroll, T., Walton, A., & Strickler, L. (2010). Recognition: A Key Retention
Collins-McNeil, J., Sharpe, D., & Benbow, D. (2012). Performance potential. Aging workforce: retaining
from CINHAL
Cowden, T., Cummings, G., & Profetto-McGrath (2011). Leadership practices and staff nurses intent
19(1), 461-477.
Force, M.V. (2005). The relationship between effective nurse managers and nursing retention. Journal
Furtado, L., Batista, M., & Silva, F. (2011). Leadership's impact in turnover and career abandonment
intention: The Azorean hospital nurses case, Hospital Topics,
89(3), 51-58. Retrieved from
ttps://fsulearn.ferris.edu/courses/1/XLIST_10370.201301/groups/_6497_1//_244103_1/a
zorean.pdf
Hirschkorn, C.A., Wes, T.B., Hill, K.S., Cleary, B.L., & Hewlett, P.O. (2010). Experienced Nurse Retention
Organizations. The Journal of Nursing
Administration, 40 (11) 463-467.
Kleinman, C. (2004). The relationship between managerial leadership behaviors and staff nurse
Healthcare, 82(4). Retrieved from
http://business.ollusa.edu/leadership/LEAD9310/MLQ2.pdf
References (cont)
Marshall, E.S. (2011). Transformational leadership in nursing: From expert clinician to influential
Publishing Company, LLC
Michigan Center for Nursing Survey of Nurses. (2012). Survey instrumental and response frequencies for
registered nurses employed
in Michigan. Retrieved from
http://www.michigancenterfornursing.org/docs/Report%20on%20Survey%20of%20Nurses%22012%
20FINAL%2010-12-12%20(2).pdf
Spence Laschinger, H. K., Wong, C. A., & Grau, A. L. (2012). Authentic leadership, empowerment and burnout:
a comparison in
new graduates and experienced nurses. Journal of Nursing Management. Advanced online publication. doi:10.1111/j.13652834.2012.01375.x
Wallis, A., & Kennedy, K. I. (2012). Leadership training to improve nurse retention. Journal of Nursing
online publication. doi: 10.1111/j.1365-2834.2012.01443.x
Management. Advanced
Weberg, D. (2010). Transformational leadership and staff retention. Nursing Administration Quarterly, 34(3), 246-258.
Wieck, K. L., Dols, J., & Landrum, P. (2010). Retention priorities for the intergenerational nurse workforce.
Salt, J., Cummings, G. G., & Profetto-McGrath, J. (2008). Increasing retention of new graduate nurses. The
Administration, 38(6), 287-296.
Journal of Nursing
Stroth, C. (2010). Job embeddedness as a nurse retention strategy for rural hospitals. The Journal of Nursing
40 (1) 32-35
Wong, C., Cummings, G., & Ducharme (2013). The relationship between nursing leadership and patient
review update. Journal of Nursing Management. 21 (5). 709-724
Administration,
outcomes: a systematic
INTRODUCTION
Nursing Educators have facilitated staff adaptation to new or changing roles with
strategies such as
Preceptor models
Mentoring programs
Internship courses
NURSE RESIDENCEY PROGRAMS
These strategies have been effective in ensuring that new grad nurses as well as
experienced nurses possess the attitude, skills, and knowledge needed to embark
on a new journey into the health organization.
(Lampe, Stratton & Welsh, 2011)
RESEARCH
Research has shown that individual needs such as
Cognitive learning
Stressor perception
Coping styles
Self-esteem
Socialization
spectrumcenter.umich.edu
Translationsolutions.org
STEP 1
STEP 2
Use Change Theory-Informed Behaviour Change to identify the pathway(s) of change and to
address possible barriers
Burnout (Laschinger et al., 2012)
Use qualitative methods to identify barriers and enhance nurse retention in regards to behavior
change
Harming patients; Teamwork , quality care, liking the job, relationship with colleagues = decreased
turnover (Goode et al., 2013)
STEP 2 continues
Using a Theoretical Framework
blog.girishm.in
Flexible shifts
Variable benefits
Flexible schedules
Staffing ratios (acuity systems)
Increased educational offerings
Advancement
Accountability and ownership
stdavids.com
Evidenced-based project
Simulations inter- professional exercises
(Goode et al., 2013)
STEP 3
STEP 4
convertunitsnow.com
The Casey-Fink
Quantitative scoring
Identify mediators of change to investigate the proposed pathways of change
Transformational Leaders
Select appropriate outcome measures
Determine feasibility of outcomes to be measured
(Goode et al., 2013)
REFERENCES
French, S. D., Green, S. E., OConnor, D. A., McKenzie, J. E., Francis, J. J., Michie, S., ... &
Grimshaw, J. M. (2012). Developing theory-informed behaviour change interventions to
implement evidence into practice: a systematic approach using the theoretical domains
framework. Implementation Science, 7(1), 38. doi:10.1186/1748-5908-7-38
Goode, C., Lynn, M., McElroy, D. (2013). Lessons learned from 10 years of research on a postbaccalaureate nurse residency program. The Journal of Nursing Administration, 43(2), 73-79.
doi: 10.1097/NNA.0b013e31827f205c
Guthrie, K., Tyrna, J., & Giannuzzi, D. (2013). Transitional orientation: A cost-effective
alternative to traditional RN residency program. Nursing Economic$, 31(4) 172-175.
Jacobson, S. & Sherrod, D. (2012). Transformational mentorship models for nurse educators.
Nursing Science Quarterly, 25(3) 279-284. doi: 10.1177/0894318412447565
Lampe, K., Stratton, K., & Welsh, J. (2011). Evaluating orientation preferences of the generation Y
new graduate nurse. Journal for Nurses in Staff Development, 27(4) E6-E-9. doi:
10.1097/NND.0b013e182236646
Laschinger, H., Wong, C., & Grau, A. (2013). Authentic leadership, empowerment and burnout: A
comparison in new graduates and experienced nurses. Journal of Nursing Management, 21, 541552. doi: 10.1111/j.1365-2834.2012.01375.x
Laschinger, H., Wong, C., & Regan, S. (2013). Workplace incivility and new graduate nurses mental
health. Journal of Nursing Administration, 47(7/8), 415-421.
doi: 10.1097/NNA.0b013e31829d61c6
PICTURE REFERENCES
Slide 3
spectrumcenter.umich.edu
Slide 4
Translationsolutions.org
Slide 5
gapevologicconcepts.com
Slide 7
blog.girishm.in
Slide 8
stdavids.com
Slide 10
convertunitsnow.com
Objectives
Objectives
Explain how credibility contributes to a
change process
Nursing roles contributing to change
Professional Nursing
Hoffart and Woods (1996) Professional Practice Model for Nursing
Professional Nursing
Hoffart and Woods (1996) Professional Practice Model for Nursing
Professional Nursing
Hoffart and Woods (1996) Professional Practice Model for Nursing
Transformational Leadership
Source:
http://www.developmentsolutions.org.uk/images/tr
ansformational_leadership_table_3.gif
Nursing Leaders
Nurse Administrator (Jody)
Financial incentive
Conflict resolution skills
Balancing staffing concerns
Nursing Leaders
Nurse Practitioner (Amy)
Committed to patient safety and quality patient
care
Advanced knowledge
Conclusion
Nursing Profession
Many aspects to understand to facilitate change
Transformational Leadership
Better commitment to change
Nursing Leaders
Utilize strengths of nursing leaders within the organization
Nursing retention
Lewins Change Theory: Unfreezing, change, refreeze
References
Carroll, L. T. (2005). Leadership skills and attributes of women and nurse executives: Challenges for
Nursing Administration Quarterly, 29(2), 146-153.
the 21 st century.
Chiu, L. Y., Chung, G. R., Wu, S. C., & Ho, H. C. (2009). The effects of job demands, control, and social support on hospital clinical
nurses intention to turn over. Applied Nursing Research, 22, 258-263. Retrieved from:
http://www.medscape.com/viewarticle/714327
Herold, M. D., Fedor, B. D., Caldwell, S., & Liu, Y. (2008). The effects of transformational and change leadership on employees
commitment to change: A multilevel study. Journal of Applied Psychology, 93(2), p. 346-357. doi: 10.1037/0021-9010.93.2.346
Hoffart, N. & Woods, Q. C. (1996). Elements of a nursing professional practice model. Journal of Professional Nursing, 12(6), 354364. Retrieved from: http://dx.doi.org/10.1016/S8755-7223(96)80083-4
Jones, B. C. & Gates, M. (2007). The costs and benefits of nurse turnover: A business case for nurse retention. The Online Journal
of Issues in Nursing, 12(3). doi: 10.3912/OJIN.Vol12No03Man04
Marshall, E. S. (2011). Transformational leadership in nursing: From expert clinician to influential leader. New York, NY: Springer.
National League for Nursing. (2012). The scope of practice for academic nurse educators. New York, NY: National League for
Nursing.
Twibell, R., St. Pierre, J., Johnson, D., Barton, D., Davis, C., Kidd, M., & Rook, G. (2012). Tripping over the welcome mat: Why new
nurses dont stay and what the evidence says we can do about it. American Nurse Today, 7(6). Retrieved from:
http://www.americannursetoday.com/article.aspx?id=9168