High labor costs continue to stress health system leaders.
In 2023, for example, the average turnover cost for one staff RN grew to $56,300, up from $52,350 in 2022. The financial stakes are high — with each 1% percent change in RN turnover estimated to cost or save the average hospital $262,500 per year. In response, healthcare leaders are looking at new ways to attract and retain the next generation of nurses.
Becker’s Healthcare and Works recently conducted a brief survey of chief nursing officers to learn more about the qualities, skills and certifications that are top of mind in their searches for future employees; the current challenges and successes that organizations are experiencing with nurse recruiting; and investments that hospitals and health systems are making to advance nurse recruitment and retention efforts.
More than three-quarters of the 115 survey respondents work at hospitals or health systems, and close to two-thirds (63.4%) work at organizations with more than 250 beds.
Please select the most accurate description of your organization.
Flexibility is an important retention tool and strategic differentiator
Interestingly, 42% of the CNOs surveyed indicated that “reducing nurse workload” was one of the top-three most difficult things to offer or change as part of their organization’s nurse retention strategy.
Although it may be difficult for hospitals and health systems to reduce nurse workloads, many recognize the value of flexibility to employees and are leveraging it in their nurse retention strategies.
More than half (60.9%) of CNOs who participated in the survey indicated that flexible work schedules and arrangements are very important to their nurse retention strategies. For 48% of respondents, “flexible work arrangements” ranked as one of the top-three most necessary changes or updates to attract and retain the younger generation of nurses.
Flexible work arrangements take a variety of forms. While the most popular option among survey participants is self-scheduling, only 31.3% of respondents said their organizations offer that to employees. Interest is strong, however; among the 68.7% of organizations that don’t offer self-scheduling, 88.7% of CNOs said they were considering technology that would allow nurses to pick their own shifts.
“Clinicians are no longer tolerating pre-pandemic working conditions, and the next generation of nurses expects flexibility. We’re starting to see hospitals optimize their current workforce by leveraging digital tools to track talent data. At Mercy, we partnered with Trusted’s Works platform to create Mercy Works On Demand.”
Betty Jo Rocchio, DNP, CRNA, CENP, Senior Vice President & Chief Nurse Executive, Mercy
Other popular types of flexible work arrangements cited by the survey participants include the ability to pick up extra shifts according to preferences, part- time work with hour requirements and the ability to work across different care settings.
What types of flexible work arrangements does your organization offer?
Self-scheduling
31.3%
Ability to pickup extra shifts, according to preferences
29.6%
Part-time work with hour requirements
28.7%
Ability to work across different care settings
28.7%
Choosing which weekends to work
26.1%
Schedules to accommodate new mothers
25.2%
Hybrid shift lengths
24.3%
Hybrid roles
23.5%
Gig work without hour requirements
23.5%
Virtual nursing
22.6%
9 a.m. to 5 p.m. schedules
22.6%
Four-day work weeks
21.7%
12-hour shifts starting at anytime
21.7%
Figure 2: Types of flexible work arrangements offered by survey respondents’ organizations
High demand for nurses with compassion, empathy, and strong communication skills
When asked to identify the most important characteristics or skills they look for in potential nursing recruits, CNO survey respondents rated compassion and empathy highest, followed by strong communication skills. CNOs prioritized these qualities above characteristics like attention to detail and clinical competence.
While many nurses may be innately compassionate and empathetic people, it’s important to keep in mind that without sufficient bandwidth on the job, it’s difficult to display these traits to patients and peers.
What are the most important characteristics or skills you look for in potential nursing recruits?
0%
10%
20%
30%
40%
50%
60%
70%
80%
Compassion and Empathy
27%
18%
25%
Strong Communication Skills
23%
26%
17%
Critical Thinking and Problem-Solving Abilities
18%
20%
17%
Attention to Detail and Clinical Competence
12%
24%
18%
Adaptability and Flexibility
19%
11%
23%
1
2
3
Figure 3: Survey respondents’ most important characteristics or skills in potential nursing recruits
Embracing technology is essential to recruit the next generation of nurses
When asked what aspect of their organization’s nurse retention strategy was most difficult to offer or change, CNOs ranked “embracing new technologies meant to alleviate burdens” as the least difficult.
When it comes to leveraging technology as a differentiator, more than one-third of CNOs (39.1%) indicated that digital recruitment platforms are an effective recruitment strategy to attract the next generation of nurses.
Nearly half (48%) of the CNO survey respondents ranked “embracing technology” as one of the top- three most necessary changes or updates to attract and retain the younger generation of nurses.
“Leveraging technology for staffing and scheduling decisions in healthcare settings offers numerous advantages, primarily enhancing efficiency and introducing flexibility to scheduling systems. Automated algorithms can swiftly analyze vast amounts of data to generate optimized schedules that meet staffing requirements and individual preferences.”
Brian Weirich, DHA, MHA, RN, CENP, Chief Nurse Innovation Officer, Bon Secours Mercy Health
In your organization’s nurse retention strategy, which of the following have been the most difficult to offer or change?
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Reducing nurse workload
17%
11%
14%
Reducing nurse stress and burnout
17%
5%
17%
Recognizing nurse contributions
5%
20%
13%
Offering work-life balance/flexible options
11%
11%
15%
Fostering a healthy workplace culture
14%
8%
14%
Offering career advancement opportunities
12%
13%
10%
Offering competitive compensation and benefits
9%
17%
3%
Addressing staffing shortages
6%
11%
9%
Embracing new technologies meant to alleviate burdens
10%
3%
6%
1
2
3
Figure 4: Most difficult aspects to offer/change in nurse retention strategies, per survey respondents
What changes or updates do you believe are necessary within the nursing profession to attract and retain younger generations?
0%
10%
20%
30%
40%
50%
60%
Embracing Technology
23%
10%
15%
Flexible Work Arrangements
14%
23%
11%
Focus on Diversity and Inclusion
11%
17%
19%
Enhanced Benefits Packages
16%
11%
18%
Professional Development and Career Advancement
16%
12%
14%
Emphasis on Work Environment and Culture
12%
16%
10%
Holistic Well-Being Initiatives
9%
11%
13%
1
2
3
Figure 5: Changes or updates survey respondents believe are necessary to attract and retain younger nurses
Ready to get introduced to works?
As hospitals and health systems compete to attract nursing talent, technology and flexible work arrangements are key pathways to success. Works offers an industry-pioneering workforce management platform that helps healthcare organizations bolster nurse retention through a centralized staffing model, while driving clinical cost savings.
Works drives clinical cost savings and bolsters nurse retention through flexibility and workforce optimization. With Works, clinicians move across units and hospitals and you fill more shifts with your own labor resources.
Frontline Nurse Mental Health & Well-being Survey
Frontline Nurse Mental Health & Well-being Survey
Frontline Nurse Mental Health & Well-being Survey
Trusted Health set out to understand the impacts of the COVID-19 crisis on nurses & their mental health in the U.S. Read our insights now.
Trusted Health
Frontline Nurse Mental Health & Well-being Survey
Frontline Nurse Mental Health & Well-being Survey
By Trusted Health
Overview
In recent years, the issue of burnout and mental health amongst clinicians has become a hot topic within the healthcare industry. Prior to the COVID-19 crisis, burnout among nurses was at an all-time high, with some studies estimating that up to 63 percent of nurses exhibit symptoms such as job-induced stress, anxiety, and depression.
The pandemic has only exacerbated this issue, as frontline nurses find themselves delivering care for a high volume of acutely ill patients, often in situations with limited crisis response training or supplies of personal protective equipment (PPE). Many have been asked to ration care or have watched their colleagues fall sick. A recent peer-reviewed study of frontline healthcare workers in China found that a large proportion reported feelings of depression, anxiety, insomnia, and psychological distress.
As part of its overall mission to better support nurses -- the backbone of our healthcare system -- Trusted Health set out to understand the impacts of the COVID-19 crisis on nurses in the U.S. Through survey responses from 1,425 nurses, a picture emerges of a population who remain committed to their profession despite feeling under-supported by their facilities and by the larger industry in which they work, and whose mental health and well-being has declined as a result of the pandemic.
About the Survey
One thousand four-hundred and twenty five nurses from all 50 states and the District of Columbia responded to the survey, which was sent by email in mid-April 2020. Sixty-five percent reported that they were providing direct care to patients with COVID-19 in their current role.
Key Findings
The majority of nurses are concerned about contracting COVID-19 in the course of doing their jobs. Eighty-one percent of respondents reported being at least “slightly concerned,” and two-thirds were either “concerned” or “very concerned.”
How concerned are you that you are going to contract COVID-19 in the course of doing your job?
Nurses’ mental health and well-being has declined significantly since COVID-19 began. On a scale of 1-10, nurses rated their current mental health and well-being an average of 5.4, compared to an average of 7.6 prior to the COVID-19 crisis, representing a decline of nearly 30 percent.
Please rate the state of your mental health and well-being (10 is the most positive; 1 is the most negative
Nurses don’t feel that their health and well-being are being prioritized or supported. On a scale of 1-10, nurses rated their current facility an average of 4.8 in terms of the support it has provided related to their mental health and well-being. The rating with the highest percentage of responses was 1.
How satisfied are you with the level of support your facility has provided related to your mental health and well-being? (10 is extremely satisfied; 1 is not at all satisfied)
Nurses also report feeling unsupported at a systemic level. When asked how they think that the healthcare industry prioritizes and supports nurses’ mental health and well-being, nearly 95% said they felt that it was either not a priority or that it was a priority, but that there were inadequate measures in place to support it.
How well do you think the healthcare industry prioritizes and supports nurses’ mental health and well-being?
Despite these findings, most nurses remain committed to the profession. The vast majority of respondents (79%) said that the COVID-19 crisis has not impacted their career plans, and they remain as, or even more, committed to nursing than they were previously.
How has the COVID-19 crisis affected your career plans?
Fifty-two percent of nurses say their feelings about being a nurse haven’t changed, while 33 percent said they were more proud to be a nurse than they were before the crisis.
How has the COVID-19 crisis affected your feelings about being a nurse?
Recommendations
Wellness programs must be accompanied by structural changes in order to be effective. According to the American Hospital Association, nearly 90 percent of hospitals have some kind of employee wellness program, but overall participation remains low. While these programs are an important element of promoting a culture of mental health and well-being, they are insufficient without larger structural changes that get at the heart of the issue. One such change -- and perhaps the most important -- is an effective staffing system. No amount of gym discounts or healthy snacks can compensate if nurses are working excessively long hours, have unsustainable patient assignments, or aren’t able to take a break during the day. In general, the industry needs to focus more on larger systemic changes, rather than passing the burden on to nurses to manage their mental health and well-being at an individual level.
Nurses need specialized support programs tailored to their needs. Providing patient care comes with a unique set of stressors that requires more than a one-size-fits-all approach. While Employee Assistance Programs provide basic counseling that is sufficient for some needs, nurses who are working in high-stress units like the ICU or ED -- certainly those on the frontlines of a pandemic -- often require more comprehensive support. We should be offering nurses an ecosystem of options that includes access to crisis support, cognitive-behavioral skills building, and mindfulness techniques. Trusted and The Ohio State University’s College of Nursing recently launched a program in this vein. It offers nurses working on the frontlines of the COVID-19 crisis access to wellness support and evidence-based strategies from nursing faculty and advanced practice nursing (APN) students who have an innate understanding of the challenges that come from being a clinician. Our hope is that this “nurses-for-nurses” approach to providing mental and emotional support will be a model for other similar programs in the future.
We need to change the way that we educate nurses. The nursing profession suffers from a massive academic-practice gap. Newly licensed RNs often find that their schooling hasn’t prepared them for the structural realities of being a nurse, and one-third ultimately leave their first post within two years. One of the ways that undergraduate and graduate programs can address this issue is by integrating skills building around wellness and stress management into the curriculum. Nurses would then enter the profession with a solid foundation that could then be expanded and refined through access to tailored content around mental health and well-being offered via their mandatory Continuing Education Units (CEUs).
Conclusion
The COVID-19 crisis has highlighted not only how indispensable nurses are, but also the ways in which the health care system is failing them. At this moment, when the eyes of the world are on our healthcare workers, we have a choice to make about the legacy of this pandemic. We can add what will no doubt be the long-lasting effects of the crisis to the issues of burnout and mental health that were already afflicting our nursing workforce, or we can use this as a catalyst to come together to find sustainable solutions to support them. At Trusted, we certainly hope it’s the latter. Through our partnership with The Ohio State University -- our recently launched Mental Health and Well-being Resource Center -- and by partnering with organizations who share our nurses-first mission, we are committed to doing everything we can to support the individuals who consistently risk their own well-being to protect ours.
About Trusted
Trusted is where modern nurses go to build their careers. Nurses are the backbone of our healthcare system and yet their options for finding new roles are cumbersome and outdated. Trusted is on a mission to change this by matching the nurses on our platform with a range of flexible jobs that meet their preferences and career goals. With support from a dedicated Nurse Advocate and unmatched insight into compensation and contract details, Trusted makes it easy for nurses to navigate the job search process and manage their careers with confidence.
Trusted supports hiring in all 50 states and has connected the nurses on its platform with thousands of opportunities. Based in San Francisco, CA, Trusted has raised $25 million in funding from Craft Ventures, Felicis Ventures, and Founder Collective, as well as healthcare innovators like Texas Medical Center and Healthbox. For more information, visit www.trustedhealth.com.
