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In May, Becker’s Hospital Review summarized a study (see…/hospitals-face-unpr…) that revealed some alarming trends in healthcare employment. For example:

– The rapid pace at which all hospital employees are switching jobs is widening the knowledge gap. Nearly half of employees have been with the hospital less than two years, and over one-third plan to leave within two years.
– Nearly 60% left because of burnout, long hours or frustration.
– Nearly half plan to retire within the decade.
– Speed of the hiring process and transparency were cited as two contributing factors when considering a job change.

Other studies provide findings equally as troubling:
– The annual turnover rate (which varies by state) is about 16% and is 5% higher at for-profit hospitals (from…/NationalHealthcareRNRe…)
– According to the American Association of Colleges of Nursing (AACN), by 2022 the need for nurses will increase by 20% and the shortage is projected to be 1.13 million RNs. Our population is aging, and nearly 550,000 RNs will retire. More projections can be found here:…/…/Nursing-Shortage)
– According to People Element, a national strategic hiring service, workload, hours and supervisor relations account for 38% of reasons why nurses leave their jobs. Only 10% cited money as the primary reason. (See…/)

Why is this important?
The cost of nursing turnover is not trivial to a hospital. In its “2017 National Health Care Retention & RN Staffing Report” (…/retention-inst…/Nationa
lHealthcareRNRetentionReport2017.pdf), Nursing Solutions, Inc., computes the cost of turning over one nurse at $38,900 to $59,700. And depending on nursing specialty, it can take more than 100 days to fill a nursing position.

More importantly, as People Element, reports “Evidence suggests that some in-hospital or discharge deaths could be prevented with improved nurse-to-patient ratios. In a study (Annals of Internal Medicine) of 232,342 surgical discharges from several hospitals in Pennsylvania, 4,535 patients (2 percent) died within 30 days of hospitalization. Based on a group of that size, investigators estimate that the difference between patient-nurse ratios (4:1 to 8:1) may account for 1,000 deaths. Researchers believe that increased care—which comes with better nurse-to-patient ratios—is a critical factor in decreasing these illness or mortality rates.”

Locally, LHN uses a significant number of contract nurses, who are usually hired by a contracting service instead of directly by a healthcare provider. They play a major role in filling the void left by the the nursing shortage, and are both easier to acquire and easier to fire. Team building can become a difficult problem since job training, accommodation to fellow workers, and learning hospital policies and culture is interrupted by turnover and internal reassignments. A local surgeon told NICHE that
“we really don’t have a surgical team like we had a few years ago.”

Accordingly, NICHE sees a problem–one that is likely to worsen for both of our local
hospital systems but that would seem to affect LHN the most. Certainly, cost-cutting in the
area of nurse-hiring is bad for quality but also brings increased clinical risk. Money
earned at LHN should not be taken out of the LHN system until hiring problems are
better under control.