Improving Hospital Turnover

Actual Comments on Why Employees Leave:

“Being a more positive ‘nurse-oriented’ organization would have made a big difference for me. The organization I am moving to has a significant focus on nursing. I was actually interviewed by the VP of Nursing, which would be virtually unheard of at this company. I understand that this company is a premier hospital with amazing physicians, but I often felt that the let-the-doctors-do-whatever-they-want–and-punish-the-nurses attitude is a huge hindrance to success.

“I actually sat in meetings whereas nurses we were yelled at for contact gowns being strewn on the ground after physicians and residents rounded and failed to properly use gown receptacles! How can the organization expect nurses and techs and staff to take their roles seriously when we are treated like second-class citizens compared to the physicians?

“This is a common theme at the hospital and as I step into a role as a mid-level practitioner, I thought long and hard about the type of organization I want to be a part of, and having shadowed nurse practitioners throughout the past two years at this company, I knew it would not be a supportive, positive environment.”

The Solution

In this example of hospital turnover, we have an experienced, upwardly mobile nurse leaving to take a job across the street. Why? Because he or she felt their ego was getting stepped on by a cultural/managerial preference toward physicians.

It could be inferred from the quote that the nurse worked at an elite hospital known for its elite staff of physicians. Could that emphasis on top physician talent have created systemic managerial deference to the reputation-providing physicians at the expense of the nurses in the trenches? The ones who are, to oversimplify, performing the brunt of the actual round-the-clock patient care?

The inference drawn from this revealing exit interview quote suggests, “Yes.”

A couple of things:

That executive-level nurses are not involved in the process of hiring floor nurses at the hospital could possibly speak to the size of the institution, could indicate the existence of a culture where nurses are considered to be a casual institutional investment.

The issue used to specifically illustrate the discrepancy in treatment is one where the nursing staff was “yelled at” by management for not picking up the gowns of physicians and touring residents who had not disposed of them properly in receptacles. While, we presume, physicians were not reproached for their apparent disregard of procedures.

Events such as those are clearly symbolic to employees. And certainly serve to increase hospital turnover by building the impression that the workplace is biased toward a group or class of employee.

Having talented, happy nurses is vital to any hospital. Highly trained and hardly expendable, RNs are in short supply relative to need and have been for decades.

And it’s not going away. By 2025, it’s estimated by industry observers that there will be a shortage of 260,000 nurses in the United States.

If an organization takes a hard look at itself and evidence points to a culture of inequality, changes can be made to reverse this negative impression. Applied to hospital turnover, those efforts could include fostering collaboration between RNs and physicians.

Doctors could be reminded that they cannot be the only ones responsible for patient outcomes. Change could be made by reiterating that positive outcomes are the result of a team effort in which both parties—doctors and nurses—are equally responsible and necessary.

The role of nurses is not to serve/support doctors, but to serve/support the patient. And when patients have positive outcomes, it helps the reputation of the individual physicians.

Once the goal of patient well-being and positive outcomes are emphasized, teamwork and cooperation rise. And the sense of subordination nurses can experience in the hierarchical structure of the modern hospital can steadily defuse.

When RNs feel they’ve become (or are actively reminded that they are) equal partners toward an end goal, hospital turnover rates go down.

(This blog post is brought to you by HSD Metrics, an exit interview company that helps companies reduce employee turnover by providing automated reference checking, exit interviews, and by measuring employee retention. The comments from exiting employees that are featured in this blog are collected from actual exit interviews conducted using ExitRight®, HSD Metrics’ exit interviewing service. If you are interested in learning more, contact us today. Because we place the privacy of our clients at the top of our priority list; the names of all involved parties are kept completely confidential.)