Nurses have one of the most in-demand roles in healthcare, and with a 6% projected job growth rate through 2031, the demand for nurses to fill both vacancies and new roles is only increasing. Given the current and future need for nurses, healthcare organizations must focus on recruiting new nurses, but perhaps more importantly — keeping their nursing staff engaged in clinical practice. Maximizing nurse recruitment and retention is a challenge nearly every healthcare organization across the country is facing.
Healthcare leaders will need to get creative to find innovative strategies to retain nurses. New graduate nurse retention statistics suggest that up to a third of new nurses leave during their first two years of practice. With the average cost of turnover per nurse between $33,900-$58,300, healthcare organizations can’t afford to lose the nurses they have.
Focus your retention efforts with these 7 retention strategies:
Be strategic during recruitment.
Establish a nurse residency program.
Make career development a top priority.
Promote a culture of learning.
Offer a flexible work schedule.
Provide competitive compensation and benefits.
Recognize and reward your nurses.
See our Nurse Engagement, Satisfaction, and Retention Resource Kit for more strategies.
1. Be strategic during recruitment
The first step in developing a successful nurse retention plan includes a strategic recruitment initiative. With new graduate nurses making up a large percentage of overall nursing turnover, attracting the best-fitting nurses from the start will make retaining them that much easier.
Engage from the first touch
Just as nurse candidates aim to make a solid first impression, so should organizations and recruiters themselves. Given the demand for nurses, it’s likely that candidates will have their choice between different healthcare organizations and positions. A seamless interview process that includes clear directions and maintains a high level of professionalism can help HR teams make a great first impression.
Set and meet a hiring standard
While a candidate’s application will provide an overview of their clinical practice knowledge and skill set, it’s less likely to include their behavioral competencies, which are telling signs of how well they’ll fit within an organization. Ensuring alignment of values between an organization and a nursing candidate using robust onboarding and assessment tools promotes compatibility from the start. Personal attributes such as accountability, honesty, and conscientiousness can help determine a candidate’s behavioral characteristics and likelihood for success within a specific role.
2. Establish a nurse residency program
Research shows a direct link between nurse residency programs and retention. Participants reported higher satisfaction with orientation and onboarding compared to those without a formal nurse residency program. Organizations with a nurse residency program provide new nurses with additional support while also engaging experienced nurses as preceptors — fostering new connections and a healthy, collaborative culture. In addition to improving nurse retention, nurse residency programs instill a sense of community and confidence in new nurses.
Emphasize leadership and clinical skills
Early-career development for nurses requires an emphasis on clinical skills, but leadership and critical thinking skills are also important so that new nurses receive solid guidance for decision-making and the application of their knowledge.
Consider a cohort structure
When developing your program, grouping new nurses into cohorts can help build relationships, provide learning partners, and boost job satisfaction through shared experiences and camaraderie with peers. Upon completing residency, a celebration for each cohort can provide recognition and satisfaction.
3. Make career development a top priority
The nurse leader role is gaining importance, and more nurses are pursuing advanced degrees in preparation to take on leadership roles. To support nurses on their career journeys, organizations must establish a culture that promotes professional development. Not only will additional resources improve nurses’ ability to care for their patients with greater skill, continuing education and clinical training will help them see themselves as an instrumental part of the healthcare industry.
Provide career pathways
Nurses at all points in their careers are interested in their future opportunities. Some may have goals to advance, others may be interested in their earnings potential, and still others may want to learn about ways they can grow into new areas or specialties. Provide your nurses with ways to advance so that you don’t lose them to opportunities elsewhere. Look at the variety of roles you offer and map out potential career journeys for new nurses to build a pipeline for advancement within your organization.
Another way to help retain your nursing staff is taking a moment to celebrate nurses on their work anniversaries for their dedication and loyalty to the organization. Recognizing service milestones can be especially important for younger nurse retention, as these nurses may be more likely to leave their practice or an organization than older generations.
4. Promote a culture of learning
Providing nurses with ongoing opportunities for lifelong learning is a worthy investment. In addition to improving their overall clinical practice knowledge, an investment in learning also contributes to organizational excellence. It shows nurses they’re valued beyond their direct contributions to their units and patients. Ensuring nurses feel valued is the key to retention.
Open and transparent communication is of the utmost importance to healthcare staff. As part of learning and knowledge sharing, it ensures that everyone has the same mission, vision, and mental models to enable nurses to work well together and achieve common goals. Learning can’t occur unless everyone has access to the necessary information. Transparency also increases trust.
Create a positive work environment
Open communication and a culture of learning go hand in hand with a positive work environment. A good work environment with quality leadership is high on the list of factors that determine whether nurses stay in their roles. Look to the transformational leadership style as an example of how to engage and retain nurses by inspiring them, providing opportunities and independence, and encouraging creativity and innovation.
5. Offer a flexible work schedule
Promoting a healthy work-life balance is an important key to improving nursing staff retention. Nurses endure long, physically and emotionally demanding shifts. Especially important for new nurse retention, organizations should create a culture that encourages time away from work to recharge.
Reduce overtime work
Nurses that consistently work overtime shifts experience more burnout, reducing their engagement and satisfaction. By limiting overtime work, organizations promote the health of their nurses versus only focusing on the organization’s immediate operational needs — ultimately benefiting both in the long run. During staffing shortages, allow nurses to opt in or out of overtime, or consider other staffing strategies to mitigate the shortage.
Consider a shared governance approach to scheduling
Nurses that have input into their schedules are more likely to feel empowered and in control of their work. While a new nurse likely understands that working weekends and holidays is part of the job, having a say about which ones can make them feel less dissatisfied about it. As an outside-the-box solution to staffing, nurse managers might implement a shared governance approach, allowing nurses to sign up for shifts instead of being assigned a set schedule.
6. Provide competitive compensation and benefits
Our Nurse Salary Research Report reported on a survey of over 2,500 nurses and found that — not surprisingly — compensation and benefits are primary retention factors. Even though nurse salaries have continued to increase, the pandemic underscored the risks and challenges of the profession while also causing many to leave. Hospitals and health systems learned quickly that salaries need to stay competitive to recruit and retain nurses from a shrinking pool of candidates.
Keep pace with demands
At the very least, your salary ranges should keep pace with your region. To attract candidates from beyond your region, you might have to offer even more. If increasing salaries is not feasible, consider other benefits, such as sign-on bonuses, relocation packages, loan or tuition assistance, incentives for career development milestones, childcare discounts, or upgraded retirement plans.
Examine pay equity
Compare compensation rates for each level and role to ensure equity. If nurses become aware of inequities, that could harm your retention strategy. For example, what do you offer travel nurses compared to what you offer your permanent staff? The COVID-19 pandemic gave rise to a surge in the use of travel nurses to keep up with demand. In some cases, inequities emerged due to the high salaries paid to travel nurses. Unfair treatment can cause dissatisfaction and eventual attrition.
7. Recognize and reward your nurses
Lastly, are you communicating the value you place in your nursing staff? As you work to make your organization more attractive to new nurses and grads, make sure existing staff knows you value them. As experienced, knowledgeable team members, they are the lifeblood of your organization. And remember, rewards don’t need to be large to be significant.
Even small gestures can make an impact if they are intentional and meaningful. A personal note of thanks, ordering food, or an informal verbal shout-out can effectively convey appreciation and even help prevent burnout. Formal recognitions, such as a DAISY Award, can have a major impact on the career of a nurse with lifetime benefits through the DAISY Foundation.
Make it a process
To be effective, your recognition program should be ongoing and visible so that everyone knows about it. Awareness can motivate aspiring recipients and instill pride and satisfaction in past honorees. Supported recognitions can also be connected to outside organizations, such as national nursing awards from the American Nurses Association and the American Association of Critical-Care Nurses. External awards also have the benefit of elevating the reputation of your organization.
Relias Vitals+Vision Podcast
Lora Sparkman has been a nurse and healthcare authority for nearly 40 years. Listen as she explores the connections between nurse education, high competency, and retention. She discusses a wide range of topics — from taking action on maternal mortality to incorporating blended learning modalities into nurse training.
Interested in learning more about nurse retention?
Read 4 Steps To Hire and Retain Your Best Nurses for more recommendations.
Recruitment and retention resources
Relias Assessments empowers nurse leaders to make informed hiring and placement decisions for better long-term success, satisfaction, and retention of their nurses. Assessment data helps identify developmental areas, measure competencies, and cultivate future leaders.
Additionally, Relias offers a broad range of continuing education for nurse managers on management and leadership education, including:
100+ courses specific to management and leadership training for nurses, such as Developing Your Leadership Potential and Coaching: An Essential Skill for Nurses
Certification review courses on nursing’s most popular topics to help nurse managers self-prepare for certification exams, prepare for recertification, and earn CE hours while increasing knowledge
Our Focused CE Series on Nursing Preceptor Specialty Practice maximizes nurses’ knowledge. Topics include boundaries between preceptor and preceptee, critical thinking, time management, competency evaluation, goal-writing, constructive feedback, patient/family engagement, HCAHPS, NDNQI, and more.
Nurse Engagement, Satisfaction, and Retention Resource Kit
Nurse shortages, challenging work environments, and a lack of professional development contribute to high nurse turnover rates. High turnover adversely impacts the quality of care and is costly for organizations. To help your organization increase nurse engagement, satisfaction, and retention, Relias provides a resource kit that includes white papers, webinars, guides, and more.
Download the Toolkit →