Reduction of RN Staff Turnover
Angela Jackson, Danielle Carter, Ashleigh Davis, Yawandale Birchett-Thompson, Haley Bauserman
Abstract
Hypothesis: If hospital units incorporate journaling
as a self care and turnover effort among their RN
staff, then hospitals will see a reduction in RN
turnover.
AIM-Proposed solution: With the intervention of
adding journaling as a self care activity for all RN
staff, we are hoping to see a change in nursing
turnover.
Data and Analysis: Frequent staff turnover creates
the costly burden of having to recruit and onboard
new hires and can create stress among existing
teams.
Root Cause: Based on our research, the COVID-19
pandemic has also contributed to decreased job
satisfaction, an increase in psychological distress,
and turnover among nurses..
Conclusion: Research suggests nurses who
participate in regular and intentional self-care are
likely to provide better quality care for their patients
and are less likely to experience nurse burnout.
Introduction and Description of
the Issue
Macro Description: Research suggests that lack of
self-care and mental health awareness is a universal
component of nurse turnover in facilities all over
the world. Especially during the COVID-19
pandemic, nurses have felt overworked, neglected,
and tired thus leading to higher turnover rates.
Micro Description: Supporting data, according to
St Mary’s Hospital leadership, demonstrates
continuous increase in RN staff turnover rates at
90-day and first year timeline points throughout
2021. Over a six month period St. Mary’s lost a
quarter of their overall nursing staff each month
from January to June in 2021.
Bon Secours Memorial College of Nursing
Data and Analysis of the Issue Proposed Solution Conclusion
AIM - Proposed Solution
● SMH averaged a monthly loss of 39% of its newly In an attempt to reduce RN staff turnover related to ● High nursing staff turnover rates can negatively
licensed nurse staff between January and June 2021 stress, we want to implement the strategy of using impact the quality of care for all patients. Statistics
● SMH experienced its greatest nursing staff declines reflective journals to improve self-care for all RN staff show nurse burnout has increased globally, in large
among newly licensed nurses, reflecting a nationwide part because of Covid-19 pandemic and we see this
and would like to see 1% change within one year of
recurring trend within our own facilities including St. Mary’s.
implementation.
● Lack of adequate staff levels can cause hospitals to ● Research suggests nurses who participate in regular
We will conduct quarterly survey check-ins for all and intentional self-care are likely to provide better
have to turn away patients needing care, which in turn
nursing staff to gauge satisfaction of the journaling. quality care for their patients and are less likely to
leads to a decrease in hospital revenues
this meeting would take place with your clinical experience nurse burnout.
St. Mary’s Hospital RN Turnover Rates January – June 2021 leaders of your unit, it is a conversation not an ● Through self expression and positive thinking,
interrogatio or analysis of what was written. guided journaling can benefit nurses and serve as a
1st Year Nurse Overall Nurse Voluntary form of self-care.
T/O Rate Staff T/O Rate Departure T/O ● The improvements recommended are designed to
Date
Rate Logistics increase staff satisfaction, reduce turnover, and
create a supportive work environment for
Jan-21 37.7% 22.9% 22.2% ● Purchasing and distributing journals
healthcare teams.
● Allow staff 15-30 minutes a week for
Feb-21 38.0% 24.6% 23.8%
journaling during work hours
Stakeholders
Mar-21 37.3% 24.8% 24.1% ● The Market of Bon
● Nurses + Chief Nurse
● Managers
Secours References
Apr-21 39.6% 25.1% 24.5% ● Directors
● HR
● Administration ● Chief Executive Officer Green, J. (2022, Feb. 5). Staff retention challenges and
May-21 40.1% 25.3% 24.9% goals. [Class presentation]. Project study site visit, Bon
Secours St. Mary’s Hospital, Richmond, VA, United States.
Jun-21 45.0% 26.3% 25.9%
Potential costs
● Journals and pens – $2,500
● Marketing communication costs- built into SMH existing Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L.
Source: Bon Secours St. Mary’s Hospital
administrative costs (2017). Reducing Annual Hospital and Registered Nurse
● Personnel costs – included in existing break times and
current salaries of stakeholders Staff Turnover—A 10-Element Onboarding Program
Intervention. SAGE Open Nursing, 3, 1-13.
Root Cause Timeline https://doi.org/10.1177/2377960817697712
G
● Stakeholders partner and discuss – May -
The constant stresses of nursing trigger severe Labrague, L. J., & de Los Santos, J. (2021). Fear of
October 2022
anxiety and psychological disorders. The ● Roll-out/educate clinical leaders and RNs – COVID-19, psychological distress, work satisfaction and
COVID-19 pandemic has also contributed to November 2022 turnover intention among frontline nurses. Journal of
decreased job satisfaction, an increase in ● Review turnover rates January - June 2023 nursing management, 29(3), 395–403.
psychological distress, and turnover among https://doi.org/10.1111/jonm.13168
nurses.
Hypothesis: If St. Mary’s Hospital (SMH) Data Collection Tang, J., & Hudson, P. (2019). Evidence-based practice
guideline: Nurse retention for nurse managers. Journal of
units implement strategies to improve self Gerontological Nursing, 45(11), 11-19. doi:
care and mental health among RNs, then ● Review RN staff turnover rates 10.3928/00989134-20191011-03
SMH will see an idecrease in RN turnover. January - June 2023