Healthcare executives are never happy when they learn that someone is leaving their job and a replacement needs to be found. After all, the cost of turnover can have a profound impact on the already diminishing margins and hiring someone new takes time and resources away from other important functions of the job.
According to the 2022 National Healthcare & RN Retention Report, published by NSI Nursing Solutions, Inc., hospital turnover increased by 6.4% over the past year, and sits currently at 25.9%. With the average cost of turnover for RNs of $46,100, this equates to a difference of $262,300/year for each percentage change in RN turnover.
Why so much change? Strategic Programs, Inc., has worked on discovering just that and we have devised organizational surveys that alert us to the main reasons.
Why They Leave
Consultant Mike Monahan, RN, MEd, has been conducting exit interviews for 20 years, and notes there are a significant number of people who quit their jobs for a good reason. This could be anything from the family is moving out of the area to having to take care of a sick relative to wanting to go back to further their education.
“We see that for about 43 percent of all cases,” he says. “What becomes more interesting are the 57 percent of people who quit over something related to their job. We have pretty good evidence that some major reasons people leave are primarily because they don’t feel they are being listened to and aren’t getting the rewards and recognition from their supervisors they feel they deserve.”
Another big reason we have found that people quit their jobs is because they feel the workplace is understaffed and they are forced to do too much work themselves, believing co-workers don’t pull their own weight and no one is doing anything about it.
Surprisingly, despite what many might believe, pay is rarely the culprit in people leaving their jobs. “Compensation in health care seems to be pretty good,” Monahan says. “Sometimes it’s about the ratio of work you need to do for the pay, but the pay itself is rarely a primary reason.”
An initial workplace mismatch can also lead to people leaving their jobs. That’s why many healthcare organizations are now investing additional time and financial resources in coordinating an onboarding program in an effort to retain its top talent and decrease new hire time to productivity. This has become incredibly important in recent years, with a Gen-Y dominated workforce exhibiting a decreasing sense of employment loyalty.
At Strategic Programs we offer personality assessments with Professional DynaMetric Programs (PDP) to help a healthcare organization accurately and fully assess candidates, helping match the right candidate to the right job. Assessments can work to proactively resolve issues and impact retention with new hires.
Issues With Management
Sometimes, people will leave their jobs because of conflicts with a boss or other executive about the company’s direction, vision or overall work environment, but the real issue with management usually comes down to receiving proper acknowledgement.
Monahan sees plenty of exit surveys where questions about being treated fairly by a supervisor score very positively, but not being recognized or being treated fairly by these same supervisors comes into play much more often.
Strategic Program’s data suggests that when somebody in the healthcare industry resigns, they are 50 percent more likely to reconsider leaving if someone of importance has a conversation with them. For example, if a pharmacy worker decides to leave and the director of pharmacy talks to them and tell them they’re a good physician tech, and asks why they are leaving, there’s a 50 percent chance they will think it over and a high percentage of people will stay.
Issues With Peers
Conflicts with coworkers and not feeling like a part of the community is definitely something that causes people to quit their jobs, but if people show a little backbone, they should be able to get past these hurdles.
“New hires often find themselves going to work in departments where they have to prove themselves and they don’t feel as welcome as they would like and that contributes to first-year turnover,” Monahan says. “Additionally, those making the transition from a general medical area to more of a specialty like the emergency department or a cardiac lab, find they need to prove themselves before they fit in. Getting along isn’t particularly an issue, but it is in specific units.”
Other issues with peers concern those that aren’t working hard, forcing one employee to do much more work than the others. Some employees don’t pull their weight and do things such as abuse sick leave, take long breaks and do the bare minimum, and this forces other employees to make up for the slack. Again, if leadership doesn’t notice or doesn’t offer them something as simple as a pat on the back, it could turn the hard workers into becoming disengaged.
One issue that has become more prominent in the last decade as a fuse for people quitting is accountability. Monahan says more people are leaving their jobs because they are faced with situations out of their control and being scrutinized for those actions. For example, a patient in the hospital might be there for five days and the nurse responsible for his or her care only works 2-3 shifts. When the scores come in from the patient’s satisfaction survey as they leave, the primary nurse is responsible and will get blamed for anything that went wrong, whether they were responsible for it or not.
Determining why employees quit is an important part of any retention strategy. Often by identifying these items in exit interviews, opportunities for change can be identified and quickly improved.