Early-Tenure Nurse Turnover Puts Added Stress on Managers

• Early-tenure nurse turnover has remained “stubbornly high,” according to a new report from the American Organization for Nursing Leadership. 
• The report argues for “visibility, coaching, and support” for newly minted nurses, but with additional support for managers to do so. 
• New-hire check-ins with direct managers were found to be one of the keys to improving retention. 

Despite some improvements in retention, early-tenure nurse turnover “remains stubbornly high,” according to a new report from the American Organization for Nursing Leadership. 

Of the survey respondents, managers who led a team of 30 nurses had a 27% early-tenure turnover rate compared to 40% for those with 90 nurses under their supervision.  

“High early-tenure turnover puts significant pressure on nurse managers, who must continually hire, train, and support new team members, only to see many leave before reaching clinical independence,” the report’s executive summary states. “This cycle is frustrating and has clinical, operational, and financial consequences.” 

How to Improve Early-Tenure Nurse Turnover 

The report contends that these younger nurses need “visibility, coaching, and support.” One way to do that is through new-hire check-ins, which have a “powerful effect” on retention during the first year of employment. 

“The first year of a nurse’s career is a critical time — it’s when they determine if the fit is right, if they’re getting the support they need to succeed, and ultimately whether the job is sustainable for them,” Claire Zangerle, CEO of AONL, stated in a news release. “Leveraging that first year is essential. As nurse leaders and hospital executives, we can’t miss the moment to engage these valuable members of the care team.” 

AONL found a 6-percentage point increase in retention for 30- or 45-day check-ins with a manager and 6- or 9-month check-ins with a 10-percentage point increase. But when an assistant manager held the check-ins, retention dropped “by 6 percentage points.” 

“New hire check-ins should be a priority, yet managers face increasing administrative and operational workloads, limiting their capacity to conduct them,” the report stated. “Executives must adjust workloads to ensure managers can consistently provide this critical support.” 

Breaking Down the AONL Report

In collaboration with Laudio, AONL spoke to 5,000 nurse managers who supervise 75,000 nurses across more than 100 hospitals. 

Step down/progressive care units and central monitoring/telesitters had the highest rate of turnover at 40% for early-career nurses, followed by emergency department, oncology, and medical surgical, respectively. 

Conversations with nurse managers unveiled a four-phase approach to working with new nurses: 

1. Setting the foundation 
2. Building the foundation 
3. Retaining the talent 
4. Building for the future 

Ultimately, enhancing support for frontline managers is key to bolstering retention, the report concluded. 

“Prioritized investments in these nurses and their managers benefit all involved and yield significant returns for organizations by improving early-tenure nurse retention and generating substantial associated cost savings,” the report stated. 

The Bottom Line

Retention of early-career nurses is a major concern, according to the latest report from the American Organization for Nursing Leadership. It found that turnover rates range from 27% to 40% depending on the number of nurses under a nurse manager’s supervision. Support for these managers is the key to helping both nurse managers with their workloads and improving retention, the report found. 

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