Nurses enrolled in school or who held graduate degrees were more likely to leave their roles, according to a recent study — a paradox that some systems are reversing with their career programs.
The national nurse turnover rate is 28.7%, however, nurses with an MSN, DNP or PhD had 55% higher odds of turnover than nurses whose highest degree is a BSN, according to the study published in Health Affairs Scholar. Among nurses who left, 8.7% held graduate degrees, and nurses enrolled in a degree program were 84% more likely to turn over.
“CNOs need to recognize that nurses who invest in their education have different expectations and that our organizations need to advance and evolve with them,” Cathy Stankiewicz, DNP, RN, chief nursing officer of AdventHealth Central Florida in Altamonte Springs, told Becker’s. “Higher education often changes what nurses want from their work. That may include more autonomy, more flexibility, more opportunity to lead or more room to use advanced skills without necessarily moving away from direct patient care.”
Hospitals and health systems are cutting nurse turnover rates by creating programs that focus on professional governance, flexible scheduling, paying for certifications and tuition assistance, leaders told Becker’s.
Although these programs aid in keeping nurses working as they work toward their higher degree, it does not always keep them at their current hospital after they graduate. That is why some systems have implemented retention programs specifically for advanced degree nurses.
Pittsburgh-based UPMC has a 0.3% turnover rate for doctorate-level nurses and a 4.3% rate for master’s-level nurses, Maribeth McLaughlin, MPM, BSN, RN, FAAN, chief nurse executive at the system, told Becker’s. The organization attributes its low turnover rate to a career ladder structure that allows nurses to move around the system and into advanced roles. One of UPMC’s most successful programs, called Chart the Course, launched 18 months ago and allows a cohort of high-performing individuals to attend workshops, educational sessions and panels of different types of nurse leaders, such as those who specialize in informatics, advanced practice roles and on the health plan side.
“You have to have a purposeful plan to retain them, and you need to know your talent,” Ms. McLaughlin said. “We really try to help them identify a path forward. Identify your talent, stay close to them and help them grow. Become a sponsor for them — push them forward, recommend them for projects. You may not keep them on your particular unit, but you’re helping them grow.”
Intermountain Health in Salt Lake City has a similar program: iAspire is designed to help nurses with advanced degrees grow at the bedside. Nurses in iAspire had a 7.7 percentage-point improvement in turnover compared to nonparticipants. The system also has a Nurse Leader Academy to help nurses step into their first manager roles.
“Advanced degrees are recognized as part of Intermountain’s career ladder,” Mandy Richards, DNP, RN, chief nursing executive and president of Intermountain Children’s Health, told Becker’s. “Whether you’re building breadth of knowledge needed to practice in a rural hospital or the depth of clinical skill required in a busy ICU, you have the opportunity for professional development and to build competency and depth of understanding.”
These programs have not only improved retention but quality of care, Dr. Richards said.
AdventHealth Central Florida works with its advanced degree nurses to transition them into more demanding environments such as the ICU and ED, which historically have higher turnover rates, Dr. Stankiewicz said. It also implemented a Transition to Acute Care program designed for nurses coming from lower acuity care settings that include dialysis centers, skilled nursing facilities, primary care or even coming out of retirement.
“We know nurses want to build a career for the future, not just a job today,” Dr. Stankiewicz said. “That is why we are being very intentional about building clear, visible career pathways that show nurses how they can grow, specialize and lead within AdventHealth.”
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