Nurse manager retention: 5 things to know

Nurse manager turnover rates are highest within the first four years of leadership, suggesting a crucial opportunity for health systems to boost retention by investing and supporting nurses who are new to managerial roles, according to a new report from the American Organization for Nursing Leadership and Laudio.

The "Trends and Innovations in Nurse Manager Retention" report is based on insights from Laudio's platform, which includes data on more than 200,000 frontline employers and AONL-led interviews with nine nurse managers. The AONL is an affiliate of the American Hospital Association. 

Five key findings: 

1. Nurse managers are most likely to exit management and return to a frontline team member role within their organization within their first four years as a manager. The annual management exit rate for those in their first few years in the job is between 10% and 12%, on average.
   
   
2. The average annual nurse manager organizational exit rate is 7.5%, though can be as high as 12% for managers with around three years of experience.
   
   
3. Nurse manager turnover is associated with a 2 to 4 percentage-point increase in average RN turnover in the year following the transition.
   
   
4. When asked what would improve nurse manager retention, 89% of the leaders interviewed rated a healthy work environment with a focus on physical and psychological safety as their top priority. This was followed by promoting leadership development, identifying and developing future leaders early, and addressing manager role complexity.
   
   
5. Managers indicated a desire for more flexibility when it comes to their schedule and the structure of their roles. In conversations with nurse managers, several key strategies emerged in how their systems approach flexibility. One included establishing a "manager bill of rights" that normalizes days off and establishes a cadence in working from home every week or two. Another strategy was a four-day work week, which health systems are increasingly embracing for managers. Health systems are also allowing managers to share leadership positions, known as "top sharing," which typically was reserved for frontline employees. 

View the full report here.