Staff turnover

dishes, BSN, RN · Jul 13, 2016

On high turnover units the 'seasoned' staff become anyone who has worked on the unit for longer than six months, the rest of the staff are usually new hires with less than six months experience. These high turnover units tend to have higher than average incidences of sentinal events and deaths because the staff failed to rescue patients. Nurses who recognize that events could have and should have been avoided, feel helpless to prevent the events from happpening in the future and tend to leave before they burn out.

mmc51264, BSN, MSN, RN · Jul 13, 2016

Sounds like where I work! I think there are inconsistencies in accountability on my unit and I think the hiring choices have something to do with it. When you hire many young people from far away, they get homesick. I have seen that a lot. I work weekends and we are a really bonded group. Night shift seems fairly bonded. I think it has a lot to do with a feeling of teamwork-you don't all have to be best buds, but it is nice to work as a team.

We have issues like day shift vs night shift; weekday vs weekend; nurses vs aides. Lots of different dynamics. I love my job, but I see things and am not sure who exactly I would approach to try and fix things-and that is part of the problem.

Been there,done that, ASN, RN · Jul 13, 2016

If I do need to vent or ask questions, I won't shoot down those with whom I disagree or have opinions I don't like. I have the maturity and where-with-all to handle what I asked for, to start with. I am aware this is a public forum and all kinds of opinions will follow any questions I have to ask. I will acknowledge, it's a lot tougher to be asked to bring creative solutions, rather than just gripe to my manager. Some are just not up to the task. That is fine. But then they need to understand, they are either choosing to settle, or will simply move on to an environment better suited to them. Those are the only solutions left when one is not willing to actively work for change.

What a most excellent way to describe "butt hurt". :laugh:

Wrench Party · Jul 13, 2016

Not sure what to tell you. If you don't want to help improve the situation, and don't want to leave, there's not much you can do besides go up the chain of command.

As one who has had micromanaging, absentee, and complete lack of managers, I leave a position as soon as I smell that management is incompetent.

Career Columnist / Author · Jul 13, 2016

When you have a unit like yours, it's hard to turn it around without deliberate strategy and resources. The manager is not effective- but his/her hands may be tied as well as not having the skills.

I've seen change happen after a mass exodus, when the unhappy folks leave and the remaining folks gel into a team. Eventually they attract positive, like-minded folks.

I've seen change happen when management and higher leadership changes- holding the manager accountable for retention and other outcomes. You see a trickle-down effect for the good.

Surviving in a unit like this takes a firm mindset- "I can only change myself, not others" "I will do my best for my patients today" "I know I make a difference for my patients"

Best wishes

Mhsrnbsn · Jul 13, 2016

It could just be the more experienced nurses are chasing the money, I hate to sound so crude but a lot of studies have shown that there isn't "as much" money in nursing positions where the nurses stay and stay for a long time, and a lot of times don't get fair raises for good performance, however switching things up every few years or so tends to net them more money because they have experience and can kind of get the ball rolling with numbers they want for pay. Some places have a fairly liquid pool for offer pay others have a strict bracketed set. Honestly, morale comes from above, if you have a manager that doesn't motivate you encourage you and pat you on the back once in a while coupled with lack of raises... But being told when your wrong can be a huge reason for the leave, I have seen it a million times. Effective leaders are nurturing leaders not punitive or unable to stand for their staff when warranted

quazar · Jul 13, 2016

I have no idea what to tell you other than to keep your head down and try to ignore/tune out as much of the negative talk as you can. I don't mean ignore your coworkers or be rude, I mean to try to separate yourself physically from them and anyone participating in negative talk that makes morale worse than it already is, in the name of self preservation.

I just left a unit like this, after hanging on for as long as I could. I held on because I loved what the unit had been when I first came on board many moons ago, and hoped it could be salvaged, despite mounting evidence to the contrary. Finally I called it quits when I realized the unit was done for, and that all the signs were there that there wouldn't be any change for at least 5 years (time enough for corporate to get a clue and then enact change, which is always slooooooooooooooow). I have seen 2 previous units in addition to this last one completely implode, and a mass exodus of staff was always the last sign that the 4 horsemen were indeed upon us, IYKWIM. If you really want to stay, stay, but know that it's going to pretty much be a mind over matter situation, because it will be a long uphill battle, to be honest. If you're ready for a fight, then get ready, dig in, set your mind, and just do it.

Having BTDT 3 times now, however, I have to say, if it were me, I'd get the heck out of there. It's not worth the stress, IMO.

Ruby Vee, BSN · Jul 13, 2016

Your unit's problem is YOUR problem. Whatever is making so many nurses leave... is a major concern.
Certainly the grass is not always greener.. but YOUR grass is on fire. Feel free to stay.. but if 13 other nurses couldn't find the motivation... I can't tell you where to look.
Best of luck with that.

Whatever is making so many nurses leave may just be a case of newbies fleeing Med/Surg for sexier specialties. If the OP is happy in her job, I cannot say she has a major problem. The OP may be the rare nurse who is suited for and LIKES Med/Surg and if that is the case, she ought to be applauded, not condescended to.

Ruby Vee, BSN · Jul 13, 2016

It is a managers problem to fix when all of their staff are leaving. We know what the problems are and have made them aware but they are not fixing it. I'm not unhappy there nor have I said that I was. I am sad and discouraged that so many good nurses are leaving. I'm trying to stay positive among so much negativity. This is a forum to discuss these things among peers but not to get slammed with judgements. Maybe we should all just post about rainbows and unicorns?

Rainbows and unicorns are rare and overrated. If you like your job and want to stay, more power to you. The fact that other people are unhappy and are leaving affects you, to be sure, but you can choose not to let it ruin your working life. I worked the past dozen years in a place with such monumental turnover that at any given time we had just lost or were losing fully a third of our staff and often had 30 people or so in orientation. You can choose to be a part of positive change. I've been a preceptor for years, and have taught various topics for the education department. Not only did I feel as though I was contributing to a positive change in unit culture, I got to know all of the newbies well -- another positive thing. Good luck!

Shelby, BSN, RN · Jul 14, 2016

What are some of the problems that your unit has which is causing the high turnover?

What are you doing or plan to do to help facilitate change?

The nurses on my Med/Surg unit try to help each other out all the time. People ask each other, "Is there anything I can do for you or your patients?" We pass meds, hang fluids, accu checks, and stick IVs for each other all the time.

We also have lots of little parties where we all bring in food for one reason or another. We do it for holidays, birthdays, going away, or just because. About once a week someone will bring in something small and sweet for everyone to have and share (doughnuts, cookies, cupcakes, etc).

We also try to talk to each other about things other than work. We are friends with each other on Facebook and talk about or home life. We try to act more like a family than just coworkers.

Sometimes leading by example is very helpful. When others see you being cheerful and positive, they are more likely to imitate that.