Nursing turnover is a constant in healthcare and produces many challenges including a high cost because the cost to replace an individual nurse can range from $33,000 to $64,000 depending on the specialty area. When a nurse leaves their practice area, no matter what the reason, it is most often seen negatively.

The nurse manager or leader is asked why the nurse is leaving, where they are going, and may take it personally when a nurse chooses to move on to another practice area or profession. Despite the cost, I do not think that turnover is always negative. I see it as an opportunity for the individual and the organization.

Hopefully the individual is growing professionally and finding greater career fulfillment while the organization can hire someone new to train and mentor.

Employee turnover is expensive and occurs in all industries, with the cost estimated to be from one-half to two times a person’s salary which is in line with nursing’s cost of turnover. It seems like we hear a lot less about turnover (outside the Great Migration of the last couple of years) in industries outside of healthcare.

Perhaps since nurses are seen as a cost rather than a revenue generator in a health system, the cost of nursing turnover is discussed more frequently especially since patient care cannot be provided without nurses. Health systems need to be able to plan for and manage turnover rather than fight so hard against it.

It is not realistic to think a nurse will stay in the same job for their entire career, and health systems must create flexibility for nurses to enhance their experience throughout their nursing lifespan.

Of course, I wish that everyone who completed nursing school and passed the NCLEX would stay in nursing for their rest of their career. But that is not a practical view of a profession that allows for a career path with tremendous flexibility.  In addition, we don’t all pick the right career when we first enter the workforce.

Despite having the flexibility to have a wide variety of experiences along the way, nursing can be incredibly tough on the individual especially if one is practicing in a sub-par work environment. We must repair the healthcare system, so it includes care for the caregivers and has systems that make the work easier not harder or more dangerous.

Improving the environment and implementing solutions that use technology or other mechanisms to ease the workload of nurses will decrease turnover.

Improving the environment and implementing solutions that use technology or other mechanisms to ease the workload of nurses will decrease turnover.

Health systems have many retention strategies that they use such as tuition reimbursement, career ladders and shift bonuses. These strategies should continue, and at the same time other ideas should be generated and implemented. It is time for healthcare organizations to embrace nursing turnover.

That may sound silly, but if turnover is expected, leaders can proactively plan for the vacancies and fill positions more quickly. Hospitals may consider shadow programs, sabbaticals, or other methods so nurses can explore other specialties without leaving their organization. Nurses should be able to move between specialties and change their career paths without feeling shame or guilt from their leaders or their peers.

Other retention strategies may include flexible scheduling and allowing nurses to work part-time or PRN in a variety of shift times like 4-, 8-, or 12-hour shifts. The bottom line is that career transitions should be celebrated and encouraged while methods to back-fill important positions are put in place.

Health systems must build the cost of turnover into the annual budget so that the trends can be identified and managed. Understanding this data and building in flexibility for nurses to explore different career paths may be the key to embracing turnover and, in turn, improving retention.

Why do you stay at your job?  What fulfills you and makes you stay (See below)? AMSN would love to hear about your reasons for staying at your organization or tell us about your journey as you have explored other career paths.

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