How to Improve Nursing Retention in Spine Practices

Peer Reviewed

Nursing turnover rates are elevated in the United States, with estimates as high as 60% in some healthcare systems, according to a recent whitepaper by Select International. The reasons for poor nursing retention are varied and range from the physical and emotional toll of the job to lateral violence. The whitepaper outlines potential solutions to the nursing turnover problem, including an approach to developing effective nurse managers who can help nurses better navigate their early years in the profession.
Unhappy nurse sitting on the floor in a hospital corridor.Nationwide, nursing turnover rates are growing.Improved nursing retention is important in all medical fields, but particularly in complex areas such as spine care, explained Nicola V. Hawkinson, DNP, RN, RNFA, Adjunct Clinical Professor, New York University College of Nursing New York, NY. “Retention and longevity have a direct correlation to nurses’ education and understanding of the specialty as well as their ability to provide a high level of care. The longer a nurse is in practice, the more he/she sees in terms of complications or situations that would require immediate attention. Retention relates directly to being able to provide the high level of care necessary for spine conditions.”

Nursing retention rates are particularly high among new graduates, with nearly 20% leaving the profession entirely in their first year and one-third leaving within two years, according to the whitepaper. Potential reasons for nursing turnover are listed in Table 1.

Table 1. Why Nurses Leave Their JobsWhy Nurses Leave Their Jobs

“Nationwide, the job turnover rate is much higher than it was a decade ago,” Dr. Hawkinson explained. “People just are not staying in jobs as long as they did in the past, and often leave jobs for a better position.”

“New nursing graduates may leave their first job because they initially get the worst shifts,” Dr. Hawkinson continued. “Thus, it would be interesting to know how many of these new graduates who left positions in the first year were initially put on the night shift and then left for a job with a day shift. Night shift causes tremendous stress and wear and tear on the body.”

Organizations can improve nursing retention by offering a competitive salary, opportunities for overtime, variability in terms of shifts, continuing education and mentoring, and ongoing psychiatric support, Dr. Hawkinson told SpineUniverse. Other solutions to reduce nursing turnover cited in the whitepaper are shown in Table 2.
Table 2. Solutions to Improve Nursing RetentionSolutions to Improve Nursing RetentionEffective nurse managers play a key role in achieving these solutions. New nurse managers need training, support, and mentoring by dedicated leaders throughout their career, according to the whitepaper. “Just as frontline nurses need to feel the support of their managers, managers need to believe that leadership wants them to succeed and is willing to provide the tools,” wrote Bryan Warren, author of the whitepaper.

Nurses Need Ongoing Psychological Support
In addition, Dr. Hawkinson emphasized the importance of providing ongoing psychological support for nurses. Recent nursing graduates may be especially prone to the stress of nursing. Nurse managers can help their team by improving communication through morning meetings, weekly lunches, or support group services, she said.

“Emphasis on mental health is important in all nursing fields, but especially in fields such as oncology or spine care, where traumatic injuries can result in life or death situations and surgery for spine conditions can lead to serious life-threatening complications, such as infection and paralysis,” Dr. Hawkinson said. “A new nursing graduate may want to talk, for example, about the young patient who is paralyzed from a car accident or a patient who died from surgical complications.”

“Nurses and other non-physician health care providers are entering the workforce in numbers that far exceed physician numbers; thus, our attentiveness to retaining these non-physician professionals is going to become important because they are going to become a vast part of the workforce,” Dr. Hawkinson concluded.

Updated on: 09/05/18
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Nicola V. Hawkinson, DNP, RN, RNFA
Adjunct Clinical Professor
New York University College of Nursing
New York, NY
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