Nursing Staff Turnover

  1. Our class guest speaker today was the VP over Human Resources of a large health system. He told us that according to research the 4 factors which contribute to the turnover of nursing staff in hospitals are:

    1. Interpersonal relationship problems (usually involves poor manager-staff relationship)

    2. Work environment, including staffing ratio

    3. Work processes - lack of adequate support staff, too many hassles involves in getting the work done

    4. Compensation

    He also said that "nurses don't leave hospitals, nurses leave mangers".

    I though these observations are right on with what is happening in nursing today--what do you guys think?
  2. Visit spineCNOR profile page

    About spineCNOR, DNP, RN

    Joined: Jun '02; Posts: 577; Likes: 11
    Staff Development Coordinator - OR


  3. by   l.rae
    l would take issue with "nurses don't leave hospitals"....l am sure it is true to a point...almost sound another passing the buck....blame the nurse...nurse manager in this case....the nurse manager has little controle over #2,3,4 due to budget issues which higher management controles......nurse managers largely are rated on their ability to control the budget.....those who can't and stand up for the staff typically don't make it.
  4. by   llg
    It sounds to me like the speaker was just trying to "blame the nurses" -- in this case, nurses who have performed well enough to be promoted to managerial positions -- for poor hospital administrative practices. Nurse managers are usually caught in the middle. They don't WANT mandatory overtime, or poor benefits, etc. but they have to live with the direction set by upper-level administration. Then, guys like the speaker in the original post blame the middle manager when the staff isn't happy with the lousy working conditions! He should at least be willing to share the responsibility for nurse satisfaction with the nursing managers. After all, he is a head of Human Resources.

  5. by   Stargazer
    Well, I wasn't there, so I don't know exactly how this guy was spinning it, but I doubt he was trying to blame nurses for anything except #1. Anyone with half a brain cell knows that managers have only partial control over staffing levels in their own unit, and none at all over ancillary personnel, and certainly not over compensation. So I don't get a "blame-the-nurse" scenario from what spineCNOR posted. It sounds to me like he was describing a systemic failure.

    As to those 4 points? #'s 1, 2, and 3 were precisely why I left my bedside nursing position, and the crappy new hands-off invisible manager of our unit was my primary reason for saying sayonara.
  6. by   spineCNOR
    Sorry, I clearly wasn't communicating well in the above post--

    this executive does believe that the hospital administrators are responsible for staffing ratios, and for support staff- he says that he is working on other execitives in his organization- CFO, etc- to budget for more nursing positions, especially on med-surg units to get the ratios of patients to nurses down.

    Work processes also includes departments other than nursing--housekeeping, lab, etc - because, as we all know, nurses always have to pick up the slack of other departments. For example, at one hospital where I worked, the lab management decided not to staff for phlebotomists on the weekends, so in addition to everything else we had to do we had to draw routine labs on the weekend. Somehow, other departments can always say they don't have the staff, or whatever, and nurses get stuck with picking up non-nursing tasks.

    #4- he also did not imply that this is a nursing responsibility.
    Mid-level nurse managers certainly have no control over compensation.

    As for the comment "nurses leave managers" - this included ALL hospital management, including non-clinical managers, such as hospital CEO, etc..

    Sorry that my comments weren't clear the first time--please forgive me!
  7. by   llg
    Oh ... don't worry ... there is nothing really to forgive. I just mis-interpreted the post. I am happy to learn he wasn't blaming the poor nurse managers for everything. I hate to see them getting dumped on from "both sides" so often.

    I agree with his idea in one sense -- and that is that most of the problems we have are the results of decisions that were made by someone at some point. In the end, people made the decisions and it is people that will have to live with the consequences and deal with whatever problems arise.

    The provision of health care is a human activity ... and behind every flawed condition or system, there are humans who contributed to it.

  8. by   P_RN
    Moved to General Nursing Discussion at SpineCNOR request. Good discussion topic.
  9. by   EmeraldNYL
    Wow, it's nice to see that Human Resources at least has some insight on the situation. Did he just list problems, or did he also suggest some ways to solve these problems?
  10. by   spineCNOR
    Emerald, he does have some ideas. One thing he is working on is trying to conserve on technology and funnel that money into more nursing positions. One thing he tries to do is to negotiate with doctors to use technology that is cost-efficient, yet still meets the patients needs, for example, working with surgeons to select the more cost-effective of 2 comparable brands of surgical staples.
  11. by   liberalrn
    Wow, he sounds like an able administrator! wish I could work w/ him. I agree in principle w/ all that he is saying, but I would pass the buck a little further up the hierarchy.....DON or VP nsg is where the major policy decisions are all starts at the top!
  12. by   Tweety
    I would have to agree with what he says.

    Also, being in med-surg on nights, I see a lot of turnover simply because people get their expereince and move on. Many can't handle the hours of night shift either.

    I recently left an unit because of #1. Poor staffing and patient ratios can be a super stressor as well.
  13. by   fiestynurse
    I sure would not want to be a nurse manager in his organization. I do believe that nurse managers play an important role in job satisfaction, however, I believe that most nurse managers are not supported by upper management and not given the tools to be effective leaders.
  14. by   NicuGal
    I have seen 2 turnovers due to who the nurse manager was and I foresee it happening in our unit again soon. Sure a lot of it comes from upper and they are just the puppet, but the NM needs to be at least courteous to her staff and tell them what is going on and why, not just doing it and saying live with it. Also, always harping on the staff, never saying when they do a good job is really irritating too. And a holier-than-thou attitude is really really irrititating!