The strategies that dropped vacancy rates at 10 systems

In the midst of staff shortages, health systems and healthcare groups have become more creative and focused on retention strategies.

From listening to nurses to providing more well-being and flexibility options to improving patient safety, here are the top retention strategies that leaders said have decreased turnover rates:

Dianne Aroh, MSN, RN. Chief Nursing Officer at Virginia Mason Franciscan Health (Seattle): Listening to our teams is the single most important retention strategy for any organization. Competitive compensation, bonuses, benefits and initiatives will attract people into our organization; however, our culture and how we treat people is ultimately what will keep them. At Virginia Mason Franciscan Health, we constantly seek to understand our nurses' needs and jointly develop solutions to address them. As a result of this collaboration, we're implementing virtual nursing as an innovative staffing model. Virtually Integrated Care allows us to provide an additional layer of care so we can better support our bedside nurses and patients. It also offers nurses a more flexible alternative to the physically demanding role at the bedside while maximizing the application of their experience and wisdom.

Kim Blanton, DNP, RN. Chief Nursing Officer at UK Albert B. Chandler Hospital (Lexington, Ky.): I would reiterate the importance of focusing on nursing well-being and assuring a safe workplace environment. The other important aspect is helping to reduce the job duties that take the nurse away from the bedside. Improving workflows such as documentation allows more time at the bedside and less time at the computer. Our nursing team, in collaboration with IT, has been working to reduce the number of clicks and different screens in our electronic documentation system. This allows the nurse to have a more streamlined documentation workflow and ultimately spend more time at the bedside with the patient. These workflow changes help improve the nurses' satisfaction with the job.

Sarah Brown, MSN, RN. Chief Nursing Officer at UnityPoint Health (Cedars Fall, Iowa): If we can empower our nurses to create and deliver the healthcare experience they'd wish for their own loved ones, recruitment will be less of a challenge. At UnityPoint Health, we continue to prioritize being a place where our nurses and team members can do this. We're engaging our nursing leaders and empowering team members to give back, to lead and to develop a positive professional practice environment that is committed to continuous improvement and exceptional care. We believe doing this allows our nurses to practice with more autonomy, and our patients and communities will reap the benefits.

Lauren Cutter, DNP, RN. Chief Nursing Officer at Jackson Memorial Hospital (Miami): We have established a strategy and process where nurses have regular touch points — from the nurse manager level to the senior leader level — to ensure that we are all aligned with each nurse and employee's specific goals. With these touch points, leadership works to facilitate those goals and visions, whether it be moving to a unit with a higher level of care, joining a committee or being part of a project that provides exposure to the community. We strive to create an environment where our nurses and employees can grow.

Vicki Good, DNP, RN. Chief Clinical Officer at the American Association of Critical-Care Nurses: Nurses continue to use their voices advocating for the work environment to be addressed. The health of the work environment is one of the primary reasons nurses cite when leaving an organization. Now, the AACN is supporting interprofessional teams advocating for HWEs. the AACN is working tirelessly with hospitals and health systems across the United States to bring interprofessional teams together to move the AACN Healthy Work Environment Standards from paper to implementation. Nurses who work in units that are actively working on implementing any of the six AACN Standards for Establishing and Sustaining Healthy Work Environments reported higher satisfaction with their job and the profession, better quality of care, more shifts with appropriate staffing and less intent to leave their current positions.

Kathy Isaacs, PhD, RN. Chief Nursing Officer at Kentucky Children's Hospital (Lexington): Starting a career in nursing requires a solid foundation right from the beginning. One critical strategy to enhance retention is to ensure new nursing graduates successfully transition from being a student to being a full-time nurse. Our Nurse Residency Program is structured as a one-year support and educational program for new graduate nurses who serve in a bedside role. Participants work with expert nurses on improving a number of skills, including critical thinking, leadership and communication. It also offers an opportunity for new nurses to learn more about evidence-based practice and patient safety.

Rosalie Mainous, PhD, APRN. Dean of the University of Kentucky College of Nursing (Lexington): Enculturation of each student in a College of Nursing to the norms and the culture of the profession are critical to the success of those who remain in the profession over time. Building soft skills, resiliency and offering peer mentors facilitates the development of the role and who we are as nurses. Partnerships with our academic-practice partners to aid the transition to practice and diminish the stress of the new nurses as they enter the profession is fundamental to retention.

Veronica Martin, DNP, RN. Chief Nursing Officer of South Region of CommonSpirit Health (Chicago): If I have to narrow it down to a single most important strategy, it would be shared decision-making. Allowing nurses to collaborate with each other and their supervisors about scheduling decisions empowers team members. It gives nurses a voice and an opportunity to be heard and taken seriously about their work-life balance needs.

Gwen Moreland, DNP, RN. Chief Nurse Executive at UK HealthCare (Lexington, Ky.): I think the most important strategy we are doing to retain nurses is investing in our people. We invest in our people by supporting professional governance, nurse well-being and workplace safety. We offer benefits to support their professional development through certification, advancement and advanced education. Additionally, our culture is one of learning and providing care in a collaborative, compassionate model which encourages all team members to ask questions, escalate concerns and utilize the expertise of your team. 

Tiffany Murdock, PhD, MSN, RN. Senior Vice President and System Chief Nursing Officer at Ochsner Health (New Orleans): We are focused on embedding a culture of empowerment and implementing clear structures to listen to our nurses, hear their feedback and take action on their concerns, and their ideas and opportunities for improvement. We want our nurses to have a seat at the table, to help define our practice model and create the nursing voice. By really listening to our nurses, we are committed to identifying opportunities to uplift and invest in our bedside nurses, which we believe is a large component of nursing recruitment and retention.

Carol Porter, DNP, RN. Senior Vice President and Chief Nursing Officer at University of Texas MD Anderson Cancer Center (Houston): One of the most important strategies to retain nurses is to recognize and respect that every nurse is an individual with personal needs and professional goals. At MD Anderson, we lead with an innovative and inspiring environment that supports growth and empowers nurses. In November, we announced the establishment of the Meyers Institute for Oncology Nursing. Providing wellness, educational and professional resources tailored to oncology nurses and nurse scientists, the institute will elevate nursing practice as they achieve their individual goals. We are also launching the Nurse Leadership Academy, an internal effort to advance our nurses' leadership capabilities and create programs to support nurses throughout their careers. These forward-looking efforts will help nurses realize their fullest potential in every aspect of the excellent care they provide and will inspire the next generation of top talent to pursue careers in oncology nursing. 

Carolyn Santora, MSN, RN. Chief Nursing Officer and Chief of Regulatory Affairs at Stony Brook (N.Y.) University Hospital: The most important strategy for the retention of nurses is to acknowledge and recognize nurses for the critical role they play in healthcare within hospitals, as well as identify the impact that they make on society as a whole. The organization must understand and appreciate nurses for their leadership skills, clinical knowledge and compassion and connection to patients. Proactively, Stony Brook University Hospital has worked on all these elements: recognition, appreciation, creating professional work environments, listening to the voice of their staff nurse, creating environments to support respite and prevent burnout, compensation, and appropriate nursing workload. This has led to decreased turnover (below the national average) and a greatly reduced vacancy rate.

Bryan Sisk, DNP, RN. Chief Nursing Executive at Memorial Hermann Health System (Houston): I believe that our most effective strategy at Memorial Hermann for retaining nurses is a robust focus on their well-being. This encompasses a comprehensive suite of wellness resources aimed at promoting physical and mental health, recognizing that a nurse's well-being is foundational to job satisfaction and retention. The organization supports this by integrating work-life balance through flexible scheduling options, ensuring nurses can manage personal and professional commitments effectively. While innovative care models and opportunities for professional development are part of Memorial Hermann's approach, the emphasis on well-being through health resources, schedule flexibility and a supportive culture is central. This focus on the nurses' health and happiness is identified as the single most important factor in retaining nursing staff, underpinning all other retention strategies.

Jennifer Shull, DNP, RN. Chief Nursing Officer at Kettering (Ohio) Health: We have involved our nurses in creating a work environment that ensures they can find joy in their work, including removing barriers, working on processes that are redundant, offering shared governance, allow nurses to work at the top of their license and ensuring nurses have a voice in the processes we create. We as nursing leaders need to ensure we're creating work environments where nurses feel they are able to do a good job and find joy in what they do. How we structured nursing care models today will not sustain us in the future, so we've got to get creative in how we support nurses so we can retain them. 

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