How to Create an Effective Nurse Retention Plan: Strategies for Keeping Your Nursing Staff

Alison Shely
September 8, 2023

How to Create an Effective Nurse Retention Plan: Strategies for Keeping Your Nursing Staff

By Alison Shely, DNP, FNP-C

Nurse retention is essential to maintaining an effective healthcare system. With an aging population and a shortage of skilled healthcare professionals, it is critical for hospitals and other healthcare organizations to develop strategies to retain their nurses. Creating an effective nurse retention plan can help organizations ensure their nurses are engaged and committed to providing quality care to their patients. This blog post will provide tips on how to create an effective nurse retention plan, from recognizing and rewarding good performance to developing an onboarding program that is tailored to nurses' needs.

Understanding Nurse Retention

Retention refers to the ability to keep skilled staff rather than losing them to competing organizations. For nurses specifically, this means staying on staff and not leaving to work at other hospitals, units, organizations, or, more recently, travel organizations. Turnover refers to the rate of people leaving staff for other positions.

The Importance of Nursing Staff Retention

Nursing, in general, suffers from high turnover rates, with up to 22% of the workforce planning to leave at any given time. The cost of this can be astronomical at up to $5 million for a single organization per year in the United States. This high price is a result of the money used to recruit and train new nurses increasing with higher turnover rates.

Nursing turnover rates affect patient care and satisfaction as well. Organizations with good retention can count on a highly-skilled group of nurses to build better and stronger relationships with patients, which improves satisfaction and long-term health outcomes.

So, how can we keep our nurses to help our organizations flourish? We’ll discuss different things to keep in mind, including individual strategies, leadership qualities, and things hospitals can do as a whole.

Effective Nurse Retention Strategies That Actually Work

When examining retention and turnover, it’s essential to look at reasons why nurses may be leaving. The most common reasons include the following:

  • Toxic culture or bullying
  • Long hours or forced overtime
  • Limited opportunities for career growth
  • Poor communication

Using these reasons, you can develop a retention plan that actually works for nurses because it addresses their major pain points. Here are some strategies that help address these points:

  • Offer more flexible schedules, including on-call shifts, floating, different hours, shorter or longer shifts, and more.
  • Limit overtime, especially mandatory overtime, as much as possible.
  • Prioritize career development by providing opportunities but not making them mandatory. Not all nurses want to move up the clinical ladder, and they shouldn't be forced. But for those who do, there should be opportunities to do so.
  • Give opportunities for nurses to share their own feedback and opinions. Town halls, suggestion boxes, and check-ins can be helpful ways to make sure the staff is happy.
  • Keep the dialog open between the managers and staff. Maintaining an open-door policy is essential when building trust with your staff. Knowing that they can come to you with anything helps build that relationship and a sense of loyalty.
  • Create a more positive work environment and culture. Not tolerating things like bullying and encouraging outside life activities can be helpful for improving job satisfaction.
  • Reward longevity. Staff members that stay should be rewarded to maintain that solid relationship, trust, and loyalty.

Individuals and managers of nursing units can employ these strategies, but what about leadership and the hospital as a whole?

Best Leadership Qualities for Increasing Nurse Retention

A positive culture and loyalty at any organization start at the top. With leadership, such as a chief nursing officer (CNO) or chief medical officer (CMO), it's always important to keep the ideas of recruitment and retention in mind. Communication is vital when it comes to leadership. Primary qualities that help in regard to retention include transparency, accountability, and compassion, especially within the workplace.

A leader who is compassionate, trusted, and respected is one that people want to work for and feel loyal to. Leaders should maintain an open-door policy, meet with their staff frequently, and be present throughout the organization.  

Strategies Hospitals Can Implement to Reduce Nurse Turnover

Hospitals as a whole can also implement programs to foster nurse retention. One especially effective and successful strategy is an organized and unified onboarding format for new nurses, whether they are new grads or not. This process includes orientation, assigning a mentor, and check-ins throughout the first few months of employment. Studies have shown a drastic increase in retention rates when an onboarding system is used throughout the hospital, as it helps the staff feel valued and part of the organization.

Going back to those original nursing pain points is crucial from an organizational standpoint as well. Having flexible shift options throughout the different units and limiting or eliminating mandatory overtime hospital wide will help nurses feel more in control of their schedules and help prevent burnout. In addition, having this policy be hospital-wide can combat feelings of resentment toward other units.

Holding town halls with the head leadership, such as CNO or CMO, that all staff can attend is important when keeping communication open. To support improvement, these should occur regularly, up to once a month.

A hospital-wide clinical ladder program is a great way to promote career growth and development. A clinical ladder is a stepwise developmental program that many hospitals now use to help implement career development and growth for nurses. It supports professional and personal development, quality patient care, job satisfaction, and nurse retention. Hospital-wide clinical ladder programs foster a community of growth-minded nurses.

The Importance of Starting Now

Nurses are more important to our healthcare system than ever following the COVID-19 pandemic; however, many of them are burned out and ready to leave the profession. While nursing has some of the highest job satisfaction scores, it also has some of the highest turnover rates in the country. Moreover, the nursing shortage continues to worsen. Nurses are leaving the profession almost twice as fast as new ones are coming in, so keeping your nurses is essential!

Try these retention methods, whether on an individual level, a unit manager level, or a hospital-wide level, to hold onto your nurses and create a better environment for patients and nurses alike.


Alison Shely, DNP, FNP-C

Alison Shely, DNP, FNP-C is a nurse practitioner, nurse coach, yoga teacher, and nurse writer who specializes in articles, blogging, and copy. She has been in nursing since 2014, working in intensive care, women’s health, and primary care as a registered nurse and family nurse practitioner. She has written for a variety of publications including, Moxie Scrubs, Aspen University, and more. She is also the winner of the 2020 Shift Report writing contest for Next Level Nursing. Her specialty topics include mental health, health and wellness, yoga philosophy and practice, and community health. She also serves as a mental health coach primarily to other nurses and healthcare workers concerning healthy lifestyles and mental health.

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