As the role of nurses in the US healthcare system continues to expand, healthcare systems need to work harder than ever to reduce turnover and develop their nurses. Nurse turnover is costly to employers and disruptive to patient care, but high-quality information about what drives this turnover is scarce.

How can an HR professional design programs to retain nurses without knowing what actually affects their decisions to leave? Do opportunities for professional development matter more than feeling appreciated? How much does pay matter?

What Convinces a Nurse to Stay?

The data show that feeling appreciated and believing that their employer has a bright future are by far the most important components of retention. Interestingly, pay fairness and transparency are more impactful on retention than pay relative to the market in general. This graph shows each component’s effect on retention. Longer bars indicate components that prevent nurses from leaving more effectively.

We used responses to the PayScale Salary Survey from thousands of nurses to try to answer these questions. We asked survey respondents to rate their workplace engagement across a variety of dimensions from one to five and to indicate whether they plan to seek a new job in the next six months. By comparing people with different engagement ratings, we are able to identify each component’s unique effect on intent to leave.

How Does This Compare to the Rest of the Workforce?

These results line up closely with our previous work studying employee engagement. In 2017, we published our Employee Engagement and Retention Report, which used data from more than half a million survey respondents to estimate the effects of a variety of engagement factors to both reduce turnover and increase and satisfaction. The two key insights were the same:

1. Feeling appreciated and feeling that the employer had a bright future were the most important contributors to worker satisfaction and retention.
2. Feeling that pay was determined in a fair and transparent way was significantly more important than a worker’s market position in determining satisfaction and retention.

Our previous study was widely applicable, but given the physical and emotional demands of nursing and the importance of intrinsic motivation in all healthcare careers, we might guess that nurses respond differently to the components of engagement than the general workforce. The data show that is not the case.

Feeling that pay was determined in a fair and transparent way was significantly more important than a worker’s market position in determining satisfaction and retention.

Click to tweet

Simple Tips to Reduce Turnover

Key takeaways from this research:

1. The most important components of retention are cheap or free. Showing your nurses that their hard work is appreciated and that the organization is headed in the right direction could be as easy as an email that highlights a exemplary employee or team.
2. High pay alone will not prevent turnover. Employees’ perception of their pay process is more important than their market position. Having open and honest conversations about how you pay can go a long way to improving engagement.
3. Professional development can be a differentiator. In a field where advancement is closely tied to continuing education, an employer can differentiate itself from the competition by offering more, higher-quality opportunities for professional development.

In a career as demanding as nursing, ensuring that employees are satisfied and motivated is both imperative and challenging. No single engagement strategy will satisfy everyone, but our data suggest that employee messaging is an easy and effective place to start.

For more detail on the engagement methodology, please refer to the 2017 whitepaper.

Tell Us What You Think

How are you reducing turnover for nurses in your organization?