A Literature Review on Nursing Turnover and Its Financial Implications

Healthcare organizations require a stable, well-trained, and fully-engaged nursing staff to provide effective levels of patient care. However, maintaining this foundation is challenged by a shortage of 1 million nurses in the United States projected for 2020. The current nurse shortage is driven by a broad set of factors related to recruitment and retention - fewer workers, an aging workforce, and unsatisfying work environments—that have contributed to a different kind of shortage that is more complex and expected to last longer than previous shortages. The determinant factors of nursing turnover frequently reported in the research are job dissatisfaction, job stress and intentions to leave, control over decisions and organizational commitment. Nursing turnover has tremendous impact on the quality of care and patient outcomes as well as posing a financial burden on the organization; however, research shows only a weak association between the two. The costs of per nurse turnover range between $22,000 to $64,000. It has been a challenge to generalize the financial impact of nurse turnover because of the inconsistent definitions and measurements as the variability in costs reported through different studies. The purpose of this essay is to provide a literature review of the past decade to assess current knowledge on the subject and to provide recommendations to improve nursing retention. The public health significance of organizations to retain nurses is twofold: to improve the quality of care provided and effectively control the costs of care. These factors deserve attention considering the steadily increasing costs of health care in the recent decades and nursing shortages in the industry