Nurse Turnover and Its Adverse Effects on Patients


The turnover rate for new nurses often reaches as high as one in five individuals. It is a costly and impactful factor in the healthcare workforce. A nurse’s ability to fulfill responsibilities and meet patient needs is strongly dependent on emotional and psychological health. Adverse working conditions and high-pressure healthcare environments will result in deteriorating well-being which will lead to poor delivery of care and high turnover rates.

Context

Nursing turnover is a highly concerning issue in the healthcare system. There are significant supply-demand gaps for nurses in developed countries as the utilization of healthcare continues to increase. Turnover creates both costs and operational issues such as hiring and training, productivity decrease, lack of experience and poor organizational knowledge, and a dysfunctional work environment with errors in care provision.

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Nursing turnovers can exceed 33% within the first two years and result in a cost of up to $64,000 per individual (Halter et al., 2017). Labor conditions and high-pressure environments are often cited as contextual factors for this phenomenon. Nurses experience rapid and extensive burnout due to intensive scheduling, emotional trauma, and psychological pressures. As a result of secondary outcomes, care quality begins to diminish as patient safety, staff participation, and optimal outcomes are negatively affected.

1st Con-Point

The nursing profession includes components that call for intellectual and emotional labor and pressures. The high rate of turnovers can be associated with increasing demands from nurses in modern healthcare. Nantsupawat et al. (2014) stated that the work environment consists of factors all of which influence the level of stress, satisfaction, and well-being of nurses. A nurse will most likely leave if the work becomes distressful or unbearable for several reasons. According to Rushton, Batcheller, Schroeder, and Donohue (2015), the extreme levels of stress experienced by nurses are directly associated with moral distress and burnout.

This is directly correlated with turnover rates and successful attempts of retention by hospitals. A nurse’s willingness to participate in the job depends on their level of emotional stability in a challenging profession.

2nd Con-Point

One of the primary variables affecting turnover rates is the level of nursing professional satisfaction. Nurses who can develop resilience are more likely to experience professional satisfaction and longer careers with greater capacity for duty and stress resistance. Therefore, by managing stress levels and providing adequate support to develop resilience in nurses, turnover rates can be decreased in the long term. Cho et al. (2015) note that lack of strong supporting resources and leadership strongly decreases satisfaction. A prolonged decline in dissatisfaction and emotional fatigue will lead to turnover. Therefore, competent management and the offering of supporting resources are vital for the retention of nurses by improving professional satisfaction.

3rd Con-Point

Increasing turnover rates are beginning to have negative impacts on healthcare delivery and patient wellbeing. Cho et al. (2015) present evidence that policies that negatively affect nursing work environments and cause dissatisfaction with eventual turnovers are directly correlated to increased mortality levels. The needs of patients and their families are no longer fulfilled as the remaining staff is stretched thin and lacks the human capital to fully engage in the health delivery process. Patients may experience uncertainty and a lack of patient-centered care. As a result, optimal outcomes are less common, and overall satisfaction is decreased.

Conclusion

Nursing turnover rates are impacted by high-pressure working environments which impact their emotional stress levels. Professional satisfaction is the key variable to maintaining retention and resilience in nurses, often dependent on the workplace support systems in place. Nevertheless, high turnover rates continue to have negative impacts on the quality of healthcare delivery as well as patient outcomes and satisfaction. The intertwining nature of these aspects suggests that solutions focusing on mitigating nurse turnover rates can potentially improve the overall quality of the healthcare industry.

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References

Cho, E., Sloane, D., Kim, E., Kim, S., Choi, M., Yoo, I…. Aiken, L. (2015). Effects of nurse staffing, work environments, and education on patient mortality: An observational study. International Journal of Nursing Studies, 52(2), 535-542. Web.

Halter, M., Pelone, F., Boiko, O., Beighton, C., Harris, R., Gale, J., Gourlay, S., … Drennan, V. (2017). Interventions to reduce adult nursing turnover: A systematic review of systematic reviews. The Open Nursing Journal, 11, 108-123. Web.

Nantsupawat, A., Kunaviktikul, W., Nantsupawat, R., Wichaikhum, O., Thienthong, H., & Poghosyan, L. (2016). Effects of nurse work environment on job dissatisfaction, burnout, intention to leave. International Nursing Review, 64, 91–98. Web.

Rushton, C. H., Batcheller, J., Schroeder, K., & Donohue, P. (2015). Burnout and resilience among nurses practicing in high-intensity settings. American Journal of Critical Care, 24(5), 412–420. Web.

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