Why is staff turnover considered bad?

SHGR, MSN, RN, CNS · Sep 22, 2012

my job has the worst of both worlds - high turnover in the new people perhaps caused at least in part by the miserable attitudes of the other half who have been here 20-30+ years, which is perhaps caused in part by the fact that half their coworkers are always trainees... it's hard to get anything done when everyone is unhappy.

More likely that the newer people leave because of the chronically unhappy long-termers?

Aeterna, BSN, RN · Sep 22, 2012

My unit is also in the same boat of high turnover rates. I think it is a huge concern if the unit is a highly specialized unit, such as L&D as monkeybug talked about. Specialized units require good basic nursing skills, as well as specific skills and knowledge that take extra training and experience to acquire.

My unit is a mixed medical/oncology unit. It used to be separate, but I was hired around the time they merged the two together. As a result, medical nurses were forced to take on complex oncology patients and the oncology nurses were forced to take on medical patients when oncology was their passion. It resulted in a lot of dissatisfaction so a lot of the nurses left, specifically a lot of the oncology nurses. Consequently, only a tiny handful of remaining nurses were actually certified to give chemotherapy.

As a result, there was a huge push to get all the nurses chemo-certified. Because there were so few chemo nurses, they were sometimes saddled with two or three patients getting chemo at a time! It is not only unsafe but very stressful. But, because they were in a hurry to get all nurses chemo trained (including me), the training was very rushed. This was also very stressful!

The high turnover rate, though, means that sometimes I am now considered one of the "experienced" chemo nurses, even though I've only been giving chemo on-and-off for a little over a year. Just a couple of weeks ago, I was working over the weekend and had two patients getting chemo, including a high-sensitivity one. I looked at the schedule and realized that, besides the charge nurse, I was the most experienced "oncology nurse" (there was another nurse or two with lots of medical nursing experience, but very little experience with oncology). I was sweating bullets the entire shift but luckily, nothing bad happened.

Dissatisfaction is building up again now, however, for a number of reasons. I suspect that there's going to be another mass exodus of nurses leaving our unit for hopefully greener pastures. Our unit has a terrible reputation for being one of the most chaotic and heavy units in the city, so not many people apply for open positions except for new grads, who haven't heard of our reputation yet. If a lot more of us leave, I'm not sure what the docs are going to do if there's not enough nurses to do chemo, but I'll leave that up to the hospital management to figure out since they've neglected this unit for far too long.

Chiggysmom · Sep 26, 2012

Poor work environment but not necessarily the other staff. We too have had a lot of nurses leave in the last few months (greater than 5) and it wasn't because of the "other staff", it was because of poor working conditions, scheduling, short staffing and more and more and more ridiculous documentation! I love it when people "Just Say No" to the insanity. Eventually, one would think, that management would catch on and want to improve conditions but thus far, nothing. They have, however; hired a bunch of new nurses to replace those that left (BTW-all that left were relatively new nurses and some were just barely off of orientation-so hospital lost big buck$$$). As for me, I'm not holding my breath!

joanna73, BSN, RN · Sep 27, 2012

I'm at my 2 year mark. I don't forsee staying longer than another 6 months. I'm not really learning anything new at this job. More importantly, morale is low and conflict is high among staff. A healthy work environment is my first priority, not length of time spent with an organization.

FMF Corpsman, MSN, RN · Sep 27, 2012

There must be a happy medium, then- a moderate level of turnover.

That would depend on the size of the facility. Granted, I'm an "old fart" and reportedly, things have changed from when I was building my career, but it used to be that once you found your niche, you settled in for your career, and worked it out. There were a few exceptions to the norm, but for the most part, there wasn't a great deal of turnover. Growth was offered within the facility by different Floors, or Specialty Units or even Education, QA, Specialty Clinics or what have you. As I said, I'm old and things have changed, likely for the better, and people probably don't stay around so long as they did. Back then, it wasn't unusual for people to retire from the facility with 30 to 40 years on the job. Yeah, I know a lot of you youngsters will probably say that's way too long for anyone to be on the job, but these were nurses and professionals with patient care as their primary focus and you couldn't find a better group of nurses anywhere. They exemplified nursing to the finest degree and we could do well to find a group of new grads that would put one tenth of the effort and professionalism they had, we would be in good shape.

Today, that same facility, has basically brutalized all of their long-term employees. Those close to retirement, were literally forced out the door, they bought out their retirement packages, were told that the offer in front of them was all they were going to get, and see you later. The Hospital knew they could hire new staff at much cheaper wages and they basically cleaned house. Subsequently staff that had stood by the Hospital for as long as 45 years was summarily escorted off the property. So would I recommend anyone stay at any particular place for a long time? No, if you get a better offer, for more money or that would improve your skill-set, or in anyway, makes your life easier, go for it. Those days of employee loyalty are no longer realistic. It is obvious that Employers have no loyalties to their employees, regardless of any claims to the contrary. Sadly, We have come to a time when it is basically every man/woman for themselves and be sure to CYA, because no one else is going to do it for you. As much as I love Nursing, and I truly did. I was one of those people who can say I never worked a day in my life, because what I did, I loved it so much, I couldn't call it work. And as much as it breaks my heart now, I'm glad I'm retired, because it isn't the same anymore.

sweetiepie2 · Dec 8, 2012

I hired in on an Oncology Unit that we did clinicals on while in nursing school. The nurse manager was loved by everyone. After 2mnths she left and our new manager is horrible. We have turned over nearly half of our nursing staff in the last year. We have LPN's which is very inconveniet due to the fact that we hang lots of blood and chemo that they cannot do at our hospital. A large portions of our pts have MP or PICC that they cannot access or administer meds through either. We are assigned the same number of pt, but as an RN we are responsible for whatever they can not do as well as care plans and can be held responsible if they miss something on a pt that we were assigned to oversee as an RN. I understand RN:LPN relationship, but we are not allowed to delegate any duties to the LPN's. Half the time we are in the room initiating and monitoring blood administration they take smoke breaks and won't even make themselves available to answer call lights. One LPN is pretty close with the NM:we had a situation where a nurse needed to have a few hours for a dr appt but was turned down, the LPN left mid shift for a non emergent home situation with no questions asked. Pt loads are horrible and divided equally: I had a VIP pt that was dying from cancer with hourly pain/nausea meds,chemo with hourly checks, pt with dressings that took an hour and half for three nurses to do as well as a confused pt(hepatic encephalopathy) that was not by the nurses station who had horrible vomiting and diarrhea(bed alarm would go off:nurses would turn bed alarm off and not back on so pt fell). We have a nurse aid that will go out of her way to avoid helping with bedbaths or changing briefs:another of the NM picks:she is not allowed to do vs or glucs per NM. She constantly goes behind our backs and questions nursing decisions so we have to go behind her and reassure and reeducate pt r/t care. We are only supposed to flex to nights every eight months, but after remaining on nights longer than the ordinary two months I was flipped back for three weeks "to accomadate another employees request" per NM. The holiday schedule sucks I had to work July 4 as well asThanksgiving, CHristmas Day and New Years Day:there are nurses who were hired after me that did not work Christmas Eve or Christmas last year who do not have to work Thanksgiving, Christmas Eve or Christmas Day this year:I questioned my boss about it and she lied repeatedley and made up fake policy and was upset when I called her out on it: I was so frustrated that I hung up on her. The crazy part is 3/4 of the girls I work with are great, I love working with Oncology pts, but I feel like I do not have a choice but to leave. Rarely does a day go by at work that a nurse it not crying from frustration d/t such a horrible workload. Any advice is appreciated. Oh I was the only nurse on the unit to work Thanksgiving and CHristmas Day other than two who requested to work the holidays. Also 2LPN are allowed to split a shift on Christmas Day so they only work 6hrs instead of the 12 required of the rest of us over Christmas Eve and Christmas Day. Do not know what to do!

iNurs5, CNA · Jul 23, 2021

When you're squeaky, which was my learning moment, some people target you for it no matter how relevant your concerns to the problem. They just don't want to deal with the actual issues you're addressing. We'll learn how to cope with things. For example, a CNA disappeared and didn't answer call for a few hours. I ended up taking care of 36 people. The residents complained about me. I was the one got in trouble for not answering the call light in timely manner. How could I? I had 4 hoyers who needed to be in bed after lunch and put them back in their chairs before dinner. I had three showers, combative resident, isolation, and passed breakfast, lunch, and dinner trays.

Am I supposed to function with 36 people in my hands? How about the CNA who worked next to me?

I resigned. I don't have to put up with that kind of treatment. No amount of money can pay me if I'm scrambling with my patient care because someone else was having a short vacation. I got accused that I only picked up my checks. People can put me in any lie detector machine. I gave everything I could. Missing breaks. Yes.

I'm so upset that I had resigned over it. Why some people fabricate lie? What's their intention and motivation?

They must be proud of their integrity.

SmilingBluEyes · Jul 24, 2021

This thread is 9 years old, but the answers still apply.

TriciaJ, RN · Jul 24, 2021

On 9/19/2012 at 8:10 PM, SHGR said:

There must be a happy medium, then- a moderate level of turnover.

Exactly. You don't want a revolving door workplace where everyone is always new and there are no mentors. It also signifies a crappy place to work where no one sticks around.

A place with poor staff and no turnover means bad behaviour is tolerated and no one wants to change jobs and risk having something expected of them.

Both scenarios are a function of poor management and best avoided.

Hoosier_RN, MSN · Jul 24, 2021

On 9/19/2012 at 9:27 PM, SHGR said:

I've read a lot of threads on this board. The collective wisdom of nurses here is amazing. However, there seems to be a common theme that I have been trying to figure out. Every time there is a job/career/management/interview related thread, people mention asking about staff turnover, implying that it is across-the-board bad.

See, I work in what I consider to be a stagnant environment. There is glacially low turnover. There are some staff who have been here a loooooong time, and interactions with them leave me with the impression that a lot of them dislike working here, but that it is just kind of comfortable and mediocrity is tolerated and oh, well. You know, lots of sick calls, management making excuses for chronic poor performance (when management is there at all), things like that.

One day an email came out that we should congratulate so-and-so for having worked there for 20 years. I thought, so shouldn't that mean she would be really super good at what she does by now? Know it inside and out, really own it.

I mean, people move on in normal workplaces, right? Fresh opportunities? Promotions, transfers, growth? What's wrong with working in a place two years and moving on?

Your bio shows you as an MSN CNS, so I hope you have a few years experience. As someone who has a few years under their belt, along with many others on here, when I interview for a position one of the first things I ask about is turnover. You can generally find this out independently before hand as well. I do ask to see if a) they're honest if there is an issue b) corrective action plan if there is a problem. When I've job shadowed, I've made sure to ask multiple employees, not just the one that I'm shadowing, about their feelings related to job and and future plans to stay with this job. I've turned down more than 1 job in my career when the general mood of staff is not good, and turnover is horrific. It's a direct reflection on management, sometimes at multiple levels

ThePrincessBride, MSN, RN, NP · Jul 24, 2021

High turnover is bad because it usually indicates a poor working environment, high burnout and staff dissatisfaction. Also, floor nursing used to be a place from which one could retire...however, it is has gotten so bad that in many units, the most senior nurse *maybe* has five years or so of experience, if that.

Additionally, floor nursing has become so unbearable that even the so called highly coveted specialties (adult ICU, Neonatal ICU, Emergency Room, etc) can't keep staff to save themselves.

LibraNurse27, BSN, RN · Jul 25, 2021

The mindset of organizations has changed too. Amazon hires warehouse workers with the intention they will work for about 3 years max. They pretty much inform people it's not like the old days where you start in the warehouse and work your way up with raises and promotions. Managers are hired from outside and already have management experience. Training is minimal and the pace is intense.

By encouraging people to quit after a few years they save money because they don't have to pay anyone a higher salary since no one stays long enough to earn significant raises. Maybe this model works for this type of job, but in nursing I think hospitals lose money because it takes longer to train nurses. But, if they offer dangerously short orientations and make the work environment miserable so people leave before they move up the pay scale, maybe they do save money (while screwing over the nurses and the patients). Who knows what goes on in the finance/admin department.