Inside Hackensack Meridian's strategy to reduce nurse turnover

The nation has an average nurse vacancy rate of almost 16%, according to the 2023 NSI National Health Care Retention & RN Staffing Report. At Edison, N.J.-based Hackensack Meridian Health, however, that figure is 6.5%. The secret, according to one of its leaders: creating a strong culture, investing in nurse leadership development and implementing a strong employee referral program.

The system has a strong brand and reputation for being a safe place to work, a place where nurses can work autonomously and spend their entire career, Regina Foley, PhD, RN, executive vice president, chief nurse executive and chief clinical transformation and integration officer at Hackensack Meridian, told Becker's. "We spend a lot of time and money on making that happen, to be candid. It goes back to being magnet designated and having a strong, rich foundation for national certification." 

For many, a strong culture relies on competitive wages, but "if you can't differentiate yourself with wages, how can you differentiate yourself?" Dr. Foley said.

One of Hackensack Meridian's primary ways of differentiating itself is offering educational reimbursements. Nurses are reimbursed to get nationally certified or participate in professional development, including clinical ladder programs. They also have tuition reimbursement for nurses who want to pursue an advanced degree or become a nurse practitioner. 

"We want to incentivize them to do that," Dr. Foley said. "We have a lot of master-prepared nurses and even doctorally-prepared nurses working at the bedside now. The nurse wants to take care of his or her patients. We work hard at making sure they are successful in the practice of nursing and they feel respected and appreciated."

Hackensack Meridian also invests in leadership development, giving nurses the opportunities to expand their skills.

"If the leaders are doing a good job on their units in their departments, then we have a fulfilled staff," Dr. Foley said. "Therefore, they're not looking to go elsewhere. We recognize and are humbled to know that we have to spend time and attention in developing our leaders."

Development programs are also created for nursing students at Hackensack Meridian. Dr. Foley said the system "by design" has a strong relationship with higher education. "Those nursing faculty are part of the fabric of our system," she said. "… We want every [nursing student] seat to be filled. We want those students to have an exceptional experience there in our clinical sites. Seeing what it's like to work as a practicing nurse. I think that is what feeds and bleeds into the low vacancy rates. Our nurses at the bedside accommodate those students, they tell them about programs to pursue, about upcoming vacancies and new roles becoming available." 

Turning staff into recruiters

Another strategy the system uses is incentivizing team members to recruit.

Hackensack Meridian offers a $5,000 referral bonus for nurses with two or more years of experience that joins part-time or full-time from an employee referral, and a $10,000 bonus for operating room positions. In the last year, 1085 people were referred to the system and 255 joined from those referrals.

Employee referrals have become the third-largest source of hires for the system.

"We give an incentive bonus to our nurses or any of our team members to recruit somebody to a key job in the organization," Dr. Foley said. "Money and a competitive age is part of the equation and we take advantage of all those other benefits. But we also know that people going into healthcare have choices and options. We don't want to use an agency nurse or contracted nurses, we want our team members to tell us about that potential person, and we say thank you for doing that."

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