4 Steps to Hire and Retain Your Best Nurses

If you are feeling the burden of healthcare workforce crisis happening in the United States, you are not alone. Not only is a large portion of our healthcare workforce nearing retirement age, but our general population is aging as well, prompting an increased need for geriatric care. This, coupled with the abysmal retention rates for most nurses or client-facing support professionals may make you wonder –  how can I gain control of the changing landscape within my organization? In this blog, we will take you through the 4 steps you need to take in order to hire and retain your best nurses and staff.

Workforce Crisis in America

The workforce crisis is a real phenomenon and the issues are expected to get worse throughout the next decade. To help paint the picture, studies and surveys from the past five years indicate that between 40 to 55 percent of the Registered Nursing (RN) workforce is 50 years or older, with projections that 1 million RNs will retire in the next 10 to 15 years.. On top of that, almost 18 percent of new RNs turnover within their first year.

In 2012, the Center for American Progress (CAP) found that, on average, it costs 21.4 percent of an employee’s salary to replace them in the event of turnover. That amounts to $6,420 for an employee making $30,000 annually (someone like a Direct Support Professional), and $14,552 for an employee making $68,000 annually, such as an RN. When you consider these costs in conjunction with the high turnover rates, it’s easy to see what a powerful impact turnover has on your organization’s bottom line.

There are so many issues that account for staff burnout and lack of engagement leading to turnover, such as insufficient staffing, lack of experience, patient demographics, and inconsistencies in salaries. The problem is exacerbated when you consider that this group of crucial healthcare professions is projected to grow over the next decade between 15.3 and 23.6 percent (with specific professions projected to grow anywhere from 36 to 47 percent). Now you can begin to understand the extent of the issues facing healthcare professionals across the country over the next couple of decades.

How to Hire and Retain Your Best Nurses and Staff

Organizations across the continuum of care are inevitably looking for solutions to identify the risk of burnout and turnover, find and retain employees who will be successful in their role, and creatively implement solutions. These solutions must not only address the problem, but sustain the turbulence of the years to come, during which demographics will further curb the availability of competent healthcare professionals.

If you’re reading or searching for information like this, you’re already concerned about investing in your human capital. Let’s walk through the 4 steps to hire and retain your best nurses and staff:

oneHire the right person

Nothing will likely provide your organization with a greater return on investment than selecting the right employee for the right job and ensuring they have the right competencies, knowledge, skills, and characteristics to be successful in that job. One versatile solution that healthcare organizations can leverage to improve their hiring and selection process is a personnel assessment. The U.S. Office of Personnel Management (OPM) defines a personnel assessment as “any method of collecting information on individuals for the purpose of making a selection decision… [which] include, but are not limited to, hiring, placement, promotion, referral, retention, and entry into programs leading to advancement.”

As professionals, we possess “hard skills,” or measurable knowledge that contributes to successful job performance. In addition, our personality characteristics, tendencies, preferences, communication style, personal experience, and the like, all contribute to the formula that makes each person a unique individual. Identifying these key aspects early on within your staff can help ensure you find the right role fit for the right person. That is why it is important to utilize an assessment tool that evaluate the entire person without bias.

twoTailor onboarding to the individual

Even if your organization has an onboarding process, it may not be as effective in preparing new employees for the job as you expect. A recent survey of 350 HR leaders found that onboarding programs fall short of effectively onboarding new hires at a staggering 76 percent of organizations. Supporting this claim, exit survey data from a study examining annual hospital turnover showed that only about half of new RNs believed that their onboarding process provided information they deemed necessary for successful employment.

nurse and doctor team
Are you onboarding your nurses efficiently and effectively?

Because onboarding programs often fall short of new employee expectations and do not adequately prepare them for success in their new role, there is a need to identify an employee’s unique strengths and areas of improvement, and then craft an individualized onboarding plan to train in those specified areas.

For instance, if a brand-new CNA has little clinical knowledge, you may wish to provide a more in-depth review of these concepts during the onboarding phase. On the other hand, an RN with years of experience and a solid understanding of clinical knowledge would not need this same training. This personalized approach has been found to significantly reduce onboarding costs. In fact, in one study of using assessments to individualize preceptor onboarding for ICU and Medical/ Surgical RNs, onboarding time was decreased by nearly 2.5 weeks, resulting in an estimated $85,000 worth of savings across six months (Relias, 2016).

threeEvaluate and enhance ongoing competency

Once the position has been filled, it is important to continually evaluate and improve clinical competency. With increasing complex diagnoses, higher acuity and the need for treating the whole person, clinical knowledge needs to be accurate and up to date with current information. This can be achieved by utilizing course learning and assessments as developmental tools. Ongoing developmental assessments help you better understand your current human capital by identifying areas of strength and improvement that are important to the job role. Then, specific courses focused on knowledge gaps can be assigned to that person.

As an example, the professional practice of nursing continuously evolves for each practitioner. A recent nursing program graduate will have a large body of knowledge on various healthcare specialties. After that nurse has been employed for several years of focused practice, assessments can be used to identify knowledge areas to improve upon. This can set up a personalized path of learning specific to that employee.

fourDevelop residing and emerging leaders

An important aspect of retaining the best nurses and staff is identifying strong leaders within your organization. Direct supervisors have a powerful impact on job satisfaction in frontline service employment. To develop the next leaders for your organization, you must first identify which members of your staff have the necessary propensities that you look for in a leader. Then, you must build on their skillset. Offering continuing education courses to current and future leaders in the areas where there may be gaps in their leadership style is a great way to foster this group’s growth.


With national nurse turnover at 17% and the cost of replacing a single nurse estimated to be $37–58K, hospitals need innovative ways to build and retain a stronger nurse workforce. Relias offers a suite of assessment and learning solutions to reduce nurse turnover, improve onboarding programs, evaluate competency, and develop the next generation of nurse leaders.

Justin Hess

Product Manager for Assessments, Relias

Justin received his Masters of Science in Industrial/Organizational Psychology from Alliant International University and is currently pursuing his doctorate in the same discipline. He has almost 10 years of experience in working with organizations for the purposes of assessment, selection, training, organizational and leadership development, and project management. In these roles, he has directly hired and developed over 85 internal personnel, while also acting as a liaison and directing projects for over 100 external personnel. In the realm of learning, Justin has taught university courses on talent, staffing, and selection, and he has reviewed, managed, or written content for over 400 eLearning courses. Justin is currently the Product Manager for Assessments at Relias.

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