7 Free Things Hospital Administrators Can Do to Increase Morale and Improve Nurse Retention

According to a fact sheet on the nursing shortage presented by the American Associate of Colleges of Nursing, healthcare is one sector of the job market that continues to grow, despite tough economic times. The U.S. Bureau of Labor Statistics states that 283,000 jobs have been added in just the last year alone. In fact, even with the staggering levels of unemployment, nursing jobs sit open:

According to a report released by the American Health Care Association in July 2008, more than 19,400 RN vacancies exist in long-term care settings. These vacancies, coupled with an additional 116,000 open positions in hospitals reported by the American Hospital Association in July 2007, bring the total RN vacancies in the U.S. to more than 135,000. This translates into a national RN vacancy rate of 8.1%.

The nursing shortage is nothing new, but we must not sit idly by and assume it’s going to fix itself. It won’t.

An issue affecting the nursing shortage that often isn’t addressed is registered nurses who leave the profession, before retirement age, due to stress and burnout. According to Dr. Christine T. Kovner and associates, “13% of newly licensed RNs had changed principal jobs after one year, and 37% reported that they felt ready to change jobs.”

In March 2005, the Bernard Hodes Group released the results of a national poll of 138 health care recruiters and found that the average RN turnover rate was 13.9%, the vacancy rate was 16.1% and the average RN cost-per-hire was $2,821.

So if you are looking to put a dollar amount of the cost of low moral, there it is for you. $2,821. Nearly $3000 in healthcare costs if your healthcare organization has to hire a new employee because one finally became bitter, disgruntled, or devalued enough to make a move, either to another facility, or perhaps even another profession altogether.

But there are some very easy and free (that’s right, for profits, you heard me. FREE) ways that hospitals and other healthcare organizations can improve morale and retention among nursing staff.

1. Say Thank you.

This may seem self-explanatory, but often it is entirely forgotten. There are going to be times of high stress, acuity, and census in healthcare. It is often unavoidable and sometimes nurses may need to work extra shifts and longer hours. There may also be changes within the organization that are unavoidable and may affect nurses. We know this.

Do us a favor, and simply say: Thank you. And say it often.

Thank us for enduring the challenges of a stressful job, for getting up and coming into work, for saving lives, for being compassionate and caring to your family members, for improvising, thinking on our toes, and because we choose you as an employer.

By telling us Thank you, you will show us that we are valued, that what we do is noticed and that you couldn’t do it without us.

As much as our profession wants to scream about its autonomy, everyone needs to be shown that they are appreciated for what they do.


2. Keep your promises.

If you make one, keep it. If you can’t keep one, don’t make it. It’s that simple.


3. Treat everyone with consistency and fairness.

As a hospital administrator you can and should be friendly with the staff, you manage. You can enjoy great relationships with them. However, it is nearly impossible to be friends with your employees without showing favoritism. Truthfully, if you use good ethics and have integrity, it may not be intentionally, but subconsciously, you may be cutting favors for your employee friends that you aren’t for others.

We Hate this!

Rules should apply to everyone equally. Policies should apply to everyone equally. One person should not be allowed to fall continually below standards or break rules because “that’s just the way the are” and you are friends with then. This is unacceptable and an insult to those of us meetings standards and following the rules.

Be firm and military if you have to be, but please be consistent with all of your employees. Equal praise and equal punishment.


4. Follow-up on nurses concerns, even if there is nothing that can be done.

Don’t just write it on your notebook and assume we know you handled it. Investigate the issue, and let us know what can or cannot be done about it. Even if that is nothing, we appreciate that you did take the time to investigate our concern before writing us off.


5. Have Transparency Within the Organization.

Keep us informed of pending changes that may affect us. Make information available and easily accessible to us. Make pay standardized and information available upon inquiry. Invite us to interdepartmental and executive meetings. Explain to us how much the budget is, where is goes, and how our work and efficiency effects it.

Notify us of changes as soon as you are aware of them and do so with honesty and professionalism. Don’t treat us like children and don’t belittle us for breaking a rule that we didn’t even know existed. Let us know when rules change, how to access the rules, and what are the consequences if they are broken.


6. Let nurses pick their schedule.

Simple enough. The software exists. Most nurses love it. It’s flexible for staff and easier for managers. Make guidelines clear and ensure everyone is aware of requirements for weekend coverage and holidays, and just let us pick our days/nights to work. You’ll spend less time (and therefore money) to schedule the shifts; your staff will miss less work and be happier and more productive,


7. Offer incentives if you inconvenience nurses.

If you call me at home and want me to work, may it worth my while. Sure you are going to pay me, but if I am at home, you are taking time away from my family and me. Time that wasn’t meant for work. Time that I can never get back. So before you pick up the phone and ask me if I want to work today, determine if you need me, and what it is worth the organization. Can you pay me extra? Can you give me a weekend off? Can you buy my lunch? And if there isn’t, and you still need me to work, at the very least, can you please say thank you?

Nurses need to feel valued. And as much as we could all use a few more dollars in our pocket, our value isn’t just in the amount we are paid. We need to feel needed, wanted, and appreciated. And luckily for the one’s, fulfilling these requirements often won’t cost a thing.


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8 thoughts on “7 Free Things Hospital Administrators Can Do to Increase Morale and Improve Nurse Retention”

  1. The hospital I work for is making many changes and morale is pretty darn low right now. I think they need to read this.

  2. No 5 is inspired!!…..
    Would be  great if it happened!

    Might just try to see if I can bring it about!!

    Don’t really fancy my chances though!! 🙂

  3. Stellen Krankenhaus

    Yes Livingdead nurse, not only yours but all nurse manager should know this. Really worthy information. Thanks for sharing.

  4. Wow! I had no idea!!! No wonder the medical industry is always looking for nurses! That is one of the most difficult jobs there is… I can’t believe that. I completely support you!!

  5. I love number four! I get so frustrated when I voice a concern to administration and they don’t even acknowledge it. Just show that you care enough to listen 🙂

    1. exactly.
      I cant tell you how many times when I ask a question it’s met with defensiveness and disregard.
      At least take the time to ask me questions and inqure more, before immediately trumping any concern I have. If I cared enough enough to speak up about it, you should care enough to at least listen.

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