Introduction
Issue Identification and Definition
Despite numerous discussions that the sphere of American healthcare has been considerably improved during the last decades, the healthcare system undergoes the changes and challenges that promote a nurse shortage and general crisis. Not many hospitals are ready to solve the problems caused by poor financing or too high patient expectations. The current paper aims at identifying an issue and searching for some solutions. Nurse turnover is a recurring issue in a number of hospitals and special health care organizations (Jones & Gates, 2007). Many medical workers face the problems of job dissatisfaction, frustration, and stresses and decide to quit nursing and find something more appropriate (Hayes, O’Brien-Pallas, Duffield, Shamian, Buchan, Hughes, Laschinger, & North, 2012). Nurse turnover is the process that nurses are eager to leave their working places or even change the sphere of work because of different reasons. This solution predetermines the quality of patient care, the ability to meet the needs of patients, and the expenses in the healthcare sphere considerably.
Reasons for Nurse Turnover to Be Chosen as an Issue for Discussion
As it has been stated above, nurse turnover may have a number of reasons that differ by their nature. The issue of nurse turnover touches upon several aspects of nursing: financial (poor salaries and high prices), personal (the necessity to combine working and family responsibilities), physical (sleeping disorders and stresses), and psychological (job dissatisfaction and the necessity to consider new rules and meet new expectations) (Kovner, Brewer, Fatehi, & Jun, 2014). Besides, turnover also influences health care and patient care considerably from financial and psychological points of view (Staggs & Dunton, 2012). The necessity to investigate so many issues to understand one problem is the main reason of why nurse turnover is chosen for discussion in the paper.
Nurse Turnover Discussion Plan
A discussion plan has to be properly developed in the paper to introduce the solutions and understand why so many nurses cannot stay in the same hospitals for a long period of time. First, the identification of turnover as a crucial problem for nurses has to be done. Then, the literature review provides a chance to learn better the chosen issue and understand what has been already discovered about nurse turnover and what aspects have to be additionally investigated. Finally, different aspects of nursing practices have to be combined with the problem of turnover to choose the most appropriate solutions.
Nurse Turnover in Health Care Policy
Medical organizations want to choose a good plan according to which the staff retention is possible. However, employers do not want to meet all nurses’ demands at the expense of their own need. Therefore, some misunderstandings, frustrations, and even conflicts may take place in (Staggs & Dunton, 2012). The point is that nurse turnover is a result of several factors in a nursing career being changed and worsening the situation considerably. For example, a nurse with seniority for about ten years can hardly be willing to change a hospital and a team she belongs to. However, the necessity to follow a new order, inability to raise her salary, and evident disrespect of her duties by the employers lead to job dissatisfaction, multiple stresses, and, what is apparent, a desire to change a working place or even change the sphere of work at all.
At the same time, nurse turnover influences considerably the quality of care offered (Hayes et al., 2012). Many patients get used to the services of the same nurses and are ready to trust in their secrets and wishes. However, a sudden change of personnel may influence inpatient behavior and attitude other medical workers.
Nurse Turnover as a Problem that Should Be Solved
Turnover and Its Impact on Nursing
Though nursing is the sphere of life that aims at helping people and providing them with the most important health care services, it is also characterized by a number of problems, challenges, and misunderstandings based on wrong behavior, poor knowledge, or inappropriate solutions. Turnover, as a process, may influence nursing in several ways depending on the region and country it takes place (Jones & Gates, 2007). The most evident outcomes of turnover in nursing are:
- Impaired quality of patient care;
- High staffing costs;
- Possibility of losing patients;
- Increase of other workers, who want to change working conditions;
- Discontents among all people involved in the sphere of nursing and in the activities of a particular hospital.
The sphere of nursing has to be properly organized to provide people with the required portion of understanding, financial rewards (salary), and good working conditions. Nurses have to help patients to overcome the challenges connected with their poor health conditions, psychological problems, personal discontents, and the inabilities to accept the truth as it is. The idea that a hospital loses such an important worker, who takes care of the details and promotes the relation between a doctor and a patient, makes people think about the most effective ways of how to improve the conditions and change the situation. Nurse turnover can take place, but its rate should not be too high not to create a significant problem (James, 2014). Though it is costly for hospitals to lose nurses, managers and employers do not want to change and improve the conditions for that the rates become lower.
Health Care Needs and Nurse Turnover
The health care system undergoes considerable changes all the time: employers want to find out more benefits, patients expect to get better services, and nurses are eager other people respect hard work they have to perform day by day because they know how crucial their role in hospitals is (Kovner et al., 2014). Nursing managers have to demonstrate their best leadership skills to provide nurses with the required portion of empowerment and self-esteem. It has been proved that such issues like job satisfaction and nurse empowerment define turnover intent (Hayes et al., 2012). Nurses cannot be replaced in hospitals because neither doctors nor other medical workers can perform all nursing duties and combine all of them on an appropriate level.
Nowadays, health care needs touch upon different aspects: technological, psychological, developmental, governmental, etc. Nurses take special courses to know how to provide people from different hospital departments with communication and exchange information in time. The current technological progress helps to save people’s time. Still, not all doctors are able to use the innovations to find the necessary material or share the information got within a short period of time. In their turn, nurses help to promote the exchange of information about patients properly, and when one nurse is absent in this system, a patient or a doctor cannot got the required treatment or data for diagnosis in time.
Future Nursing Practice
Nurse turnover is a current problem that creates many problems in future. There is a direct dependence between nurse turnover and other health care issues. For example, the current technological progress makes nurses develop their IT skills and share information about patients, their histories, and treatments quickly. The managerial department defines the duties that have to be performed by nurses properly and consider the needs of patients at the same time. In other words, they are responsible for the ways of how nurses perform their functions, understand the essence of their functions, and are satisfied with the duties and working conditions (all important factors that define the rate of turnover) (Kovner et al., 2014). Therefore, such spheres like nurse management, IT department in hospitals, and personal aspects in regards to the work of a nurse are the three main practices that have to be thoroughly investigated in a future to understand the peculiarities of nurse turnover better.
Relevant Healthcare Policy
To create appropriate working conditions and make sure that patients’ expectations are similar to the services offered by nurses and other medical workers, it is necessary to promote appropriate healthcare policy. In fact, healthcare policy helps people be confident in the level of care offered when they are ill, injured, or eager to get a consultation. As a rule, the healthcare system is managed according to the issues defined by healthcare policy. Therefore, nurses get to know about their functions, working conditions, and other benefits and challenges of their work from healthcare policy identified by a particular hospital. The impact of healthcare policy on patients is evident, and nurses have to understand what they can do to promote safety and satisfaction of patient, deliver the necessary services, and achieve the satisfied outcomes (Abood, 2007).
One of the possible ideas to develop a powerful healthcare policy is to rely on the patients’ feedbacks. Nurse turnover is the result of personal dissatisfaction and the inabilities to combine the needs of patients with the abilities of nurses. If patients inform that nurses perform their functions on a high level, such nurses and their work have to be appreciated. As soon as nurses understand that their work is noticed and evaluated properly, they get their rewards (oral, written, or even financial) and try to do their best not to worsen their reputations.
Statistics
Unfortunately, the current turnover rates and facts prove that nurses are not always satisfied with the conditions under which they have to work. About 17.5% of American nurses change hospitals during the first year of their work, and more than 43% of nurses choose other working places within the first three years (Kovner et al., 2014). The results of such rate are significant from a financial point of view: from $22,000 to $65,000 are spent because of nurse turnover in different regions of the USA. As a rule, these costs depend on the necessity to create successful advertisements, cooperate with agencies, promote training programs, and correct the errors that have been made by managers and other workers, who have to take care of the working environment (Jones & Gates, 2007). Hayes et al. (2012) prove that nurses with high seniority usually do not want to leave their working places in case they are empowered. Still, many case studies prove that job dissatisfaction, long working days, and nights, and stresses caused by patients and the necessity to solve their problems make even the mature nurses think about changing work (Staggs & Dunton, 2012).
Summary and Conclusion
Main Points
In general, the evaluation of nurse turnover and its impact on the quality of care and patient satisfaction shows that usually poor working conditions, lack of nurse empowerment, and inabilities of different departments of the same hospital to cooperate turn out to be the reasons for why so many nurses remain to be dissatisfied with their jobs and want to leave hospitals or even the chosen spheres of education. The following conclusions have been made in the paper:
- Nurse turnover is the current problem that bothers many nurses and employers nowadays and has to be solved soon not to create more complications in the future.
- Nurse turnover is the process that defines the level of care given to patients.
- Nurse turnover is characterized by various types of costs that are both expected and unexpected (like the necessity to search for new staff, explain patients the recent changes, make sure of the quality of work of new nurses, etc.).
- Nurses may not want to leave their jobs in case they are satisfied with the conditions under which they have to work and see that their work and intentions to help patients are respected by their employers and patients at first.
- Any nurse is a human being with his/her emotions, needs, and wishes. It may happen that personal stresses or dissatisfaction can influence the way of work. Still, these factors should not make nurses leave their jobs and start doubting about the worth of the work they perform.
New Areas for Learning
Regarding all achievements and conclusions made in the paper, it is possible to identify several areas of new learning that can be used for further study. They are the work of a managerial department that defines the duties of nurses and the abilities to perform the required work properly and the innovations within an IT department that help nurses save time and exchange information fast. As soon as these two areas are analyzed deeply and improved accordingly, it is possible to clear up how the changes influence the nurse turnover rate.
References
Abood, S. (2007). Influencing health care in the legislative arena.OJIN: The Online Journal of Issues in Nursing, 12(1). Web.
Hayes, L.J., O’Brien-Pallas, L., Duffield, C., Shamian, J., Buchan, J., Hughes, F., Laschinger, H.K.S., & North, N. (2012). Nurse turnover: A literature review – an update. International Journal of Nursing Studies, 49, 887-905.
James, C. (2014). Nurse turnover is high, but is that a problem?Health and Medicine. Web.
Jones, C. & Gates M. (2007). The costs and benefits of nurse turnover: A business case for nurse retention. OJIN: The Online Journal of Issues in Nursing, 12(3). Web.
Kovner, C.T., Brewer, C.S., Fatehi, F., & Jun, J. (2014). What does nurse turnover rate mean and what is the rate? Policy Politics Nursing Practice, 15(3-4), 64-71.
Staggs, V.S. & Dunton, N. (2012). Hospital and unit characteristics associated with nursing turnover include skill mix but not staffing level: An observational cross-sectional study. International Journal of Nursing Studies, 49(9), 1138-1145.