Health systems can significantly improve nurse retention rates by ensuring their nurse managers have a level of support and job structure that enables them to have consistent and meaningful interactions with their team members, according to a new report from the American Organization for Nursing Leadership and Laudio.
The "Quantifying Nurse Manager Impact" report is based on Laudio's data set, which spans more than 50 acute care hospitals and hundreds of ambulatory and clinical facilities across the U.S. It includes more than 8,000 managers and 100,000 health system employees, including more than 34,000 registered nurses.
Five key findings:
Leader engagement has a significant effect on nurse retention.
- On teams where nurse managers regularly have purposeful interactions with their nursing staff, turnover is significantly lower. In teams with an average annual nurse turnover rate of 20%, the report found that one purposeful interaction per nurse per month led to a seven-percentage-point decrease in the overall annual turnover rate (to 13%), enabling health systems to avoid excess attrition costs. Meaningful interactions included those that are specific to the work or behavior of an individual employee and range from check-ins to celebration and recognition.
Nurse managers' number of direct reports affects nurse turnover.
- The median number of direct reports for nurse managers, which is also known as span of control, is 46. The analysis showed about 25% of all inpatient nurse managers have spans of control of at least 78.
- Across six major specialties, nurse managers in the top quartile (overseeing a team of more than 78 people) have higher turnover rates. Larger span of control is also tied to higher incremental and overall overtime use.
Appropriate use of assistant nurse managers is tied to lower RN turnover.
- Among departments where managers are in the top quartile for direct reports, those with up to four assistant nurse managers had lower turnover rates on average.
- Meanwhile, the report found the presence of too many assistant nurse managers in larger departments is tied to higher turnover, which may be due to structural challenges or a lack of clarity in role definition.
"Nurse managers have one of the hardest jobs in healthcare," Robyn Begley, DNP, CEO of AONL and chief nursing officer of workforce for the American Hospital Association, said in a news release. "Nurse leaders can use this data to make operational adjustments in real time to support these front-line leaders."
The new report mirrors the efforts of health systems that have been focused on better supporting their nursing leaders over the past year. On this front, systems have taken a close look at what their nurse managers are responsible for on a given day to identify what tasks could be delegated through technology or other roles, such as assistant managers. Read more on what drives nurse leaders satisfaction and how systems are responding here.