Nurse turnover in the Emergency Department often runs high due to burnout, compassion fatigue and injury. According to a report issued by the Emergency Nurses Association (ENA), an estimated one in five emergency room nurses leaves the profession within his or her first year of hire. And up to one-third leave within two years.
This high rate of turnover can exert a massive financial impact on a hospital. The ENA pegs the expense to replace an individual RN at $82,000, and the cost may be considerably higher to recruit, hire and train a specialized ER nurse. Using the national nurse turnover rate of 14 percent, the ENA says the average hospital can expect to spend upwards of $4 million per year on nurse turnover.
Fortunately, nurse executives can proactively address nurse turnover in the ER to significantly reduce clinical staff churn and expenses. In fact, one British emergency department reduced its ER nurse vacancy rate from 65 percent to 14 percent in about a year using several creative strategies you can implement, too.
Provide New ER Nurses with an Extended Preceptorship
The emergency department can be a very challenging work environment for new graduate nurses, yet you should not shy away from hiring new grads into the department because they often bring fresh energy and an eagerness to learn that can benefit the unit in many ways. It’s true, however, that graduate nurses require more training when they join the department than seasoned ER nurses do, and one way to develop these new grads is by offering them an extended preceptorship.
The Medway Foundation Trust (MFT) – a healthcare provider in England – created an ER nurse preceptorship that extends to 18 months, which gives its graduate nurses a very solid foundation in critical care. To make this type of extended preceptorship feasible from a staffing standpoint, you can use the features of your scheduling software to make shift coverage painless. With a few clicks, you can easily integrate multiple preceptor shifts into your schedule without leaving any schedule gaps.
Develop a Structured Educational Program
The MFT found success in retaining ER nurses by partnering with local universities to create emergency nursing-specific courses at the bachelor’s and master’s level. These courses enabled new and experienced ER nurses alike to learn advanced care techniques and prepared them to handle the demands of the ER nurse role.
You can adapt this same concept by developing a structured educational program that provides your ER nurses with a clear pathway for career development. Offering these types of classes helps your nurses feel better equipped to handle the ER’s high-acuity patients while also demonstrating your commitment to the nurses’ success – and evidence shows that staff who feel valued by the organization tend to job-hop less often.
Incorporate Regular Off-Site Training and Governance Days
To foster a collaborative atmosphere in the ER, consider the approach used by the MFT to create small staff teams to learn together and provide shared governance. Each team should participate in regular off-site days devoted to training and governance sessions. MFT found this strategy helped ER nurses feel empowered in the workplace, which subsequently led to higher retention rates.
Providing off-site days to your nurses need not disrupt your staffing, either. You can add the dates to your scheduling software, and each team’s nurses can sign up for their designated off-site day. Then you can incentivize any open clinical shifts to encourage other nurses to cover them. Incentivizing shifts with small rewards like a premium parking space is easy with ShiftWizard, and nurses enjoy receiving a perk in exchange for taking on an extra shift.
Reducing nurse turnover in the ER can be challenging for any nurse executive. But with innovative thinking and creative strategies like those employed by the Medway Foundation Trust, you can set your department – and your nurses – up for success for years to come.