Nurse Retention: Nature and Causes


In any organization, recruiting and retaining the right staff are the major issues facing the organization’s policymakers (Cosack 1). With the currently registered nurse shortages, concerns about nurse turnover and retention have heightened. To solve these challenges, health care organizations aim at improving their nurse retention. In so doing, health organizations have been forced to improve on their nurse’s turnover and improve on their working conditions (Cosack 1).


As illustrated by the article, a hospital’s inability to retain its nurses is likely to have some adverse effects on their delivery of health services. Eventually, nurse shortage will lower the hospital’s quality and productivity. As indicated by research, higher nurse-to-patient ratios result in an improved health care system (Kennedy 51). On the contrary, reduced nurse-to-patient ratios result in increased surgical mortality, increased job dissatisfaction, and increased failure-to-rescue rates. In this regard, several factors have contributed to the hospital’s inability to retain its nurses. Among the cited problems are inadequate staffing, lack of respect and support for the nurses from the top management, favoritism in promotion, delayed salary increments, and increased stress levels in the nurse workforce.


Exit interviews are the most appropriate ways an organization can use to obtain accurate and authentic feedback from their staff. As a result, James should try to improve on the exit interviewing processes. First, James should ensure that the interview questions are short, precise, and unambiguous. To improve on this, James should guarantee that he evaluates the questions for simplicity. Similarly, he should avoid many questions considered emotional by the employees. By being clear to the employees, he should inform them that exit interviews would not have any repercussions, especially in their recommendations, hence encouraging them to give honest feedback (Kennedy 14). Likewise, for an effective interview, James should ensure that employees’ participation in exit interviews is voluntary. Thus, no employee should be compelled to attend the exit interview or be forced to answer a questionnaire.

Assessment alternatives

Another major assessment alternative that can be employed by hospital management to determine the underlying causes of turnover, and enhance retention in the future, is the formative assessment. Formative assessments should be conducted regularly to identify contentious issues among the hospital’s staff members along the way and guide the hospital’s administrators in making appropriate future decisions. Similarly, formative assessments would provide feedback to the hospital’s employees hence assuring that their grievances are taken into consideration (Kennedy 93).

An additional alternative that can be used by the hospital’s management in identifying their future threats is the SWOT analysis. Through this method, the hospital’s management would not only be able to evaluate their strengths and weaknesses, but also identify future threats unfavorable to their operation, among which are nurse retentions. By employing the SWOT analysis, the hospital would be able to eliminate future threats that would otherwise catch them unaware.


From the information collected, James should be able to identify and address several factors affecting his nurses’ motivation and performance leading to their exit. From these reports, James should be able to identify means of motivating his staff. Through this, he should be able to improve on the hospital working conditions, link incentives and performance, and eliminate favoritism within the workforce. Other benefits that may help him increase nurse retention include an increase in their bonuses, pension, insurance, and loans (Cosack 1).

Works Cited

Cosack, Sabine. “Retaining key employees in times of change.” The McKinsey Quarterly. Version 1. no publisher, 2010. Web.

Kennedy, Kate. “2011 Employee Job Satisfaction and Engagement.” A Research Report by the Society for Human Resource Management ( SHRM). Version 1. no publisher, Web.