Nurse retention: Intergenerational conflict linked to whether nurses will stay on the job

A positive work environment is essential to whether experienced nurses will stay at a hospital, according to a new study published in Nurse Ethics.

The research, conducted by four nursing educators from the University of Arkansas and the University of Texas at Tyler, examined factors that may explain why a major academic medical center was having difficulty retaining mid-career nurses.

Hospitals experience a 16.5 percent turnover rate of registered nurses, at a cost of $44,380 to $63,400 per nurse, according to the study. Due to the high cost of attrition, executives at the medical center wanted to determine what nurse leaders could do to improve retention of seasoned nurses, said Charleen McNeill, an assistant professor of nursing at the University of Arkansas, in a study announcement.

The research team surveyed 67 recently hired mid-career and early-career nurses at a mid-sized hospital in a metropolitan area in the Southwestern United States. They found that newly hired mid-career nurses scored higher on job satisfaction and intended to remain in their jobs.

"The work culture that leaders create--the environment that nurses are working in--is the most important thing related to retention," McNeill said in the statement. "It's very expensive to hire new nurses. When we have good nurses, we want to keep them so we need to understand what's important to keep them."

The hospital environment is often tense because there are four distinct generations that now work together, a situation that often creates conflict, according to McLean.  Nurse leaders can diffuse the tension by leveraging the strengths of each generation and developing strategies that empower all nurses.

"Younger generation nurses feel like they don't have power over their practice, they're not in charge, and that is logical because they are novice practitioners," she said. But these younger nurses have an understanding of technology that seasoned nurses often lack. More experienced nurses can then help these new nurses learn in the clinical environment.

"Successful nurse-leaders find ways to garner the strengths of each generation of nurses to achieve the best patient outcomes," McNeill said.

In addition to the importance of positive working relationships with colleagues, nurses will stick with a job if nurse leaders also are supportive. A recent study in the Journal of Advanced Nursing found that transformational leadership, a management style that encourages employees to work toward a collective goal, improved retention of nurses early in their career.

"Our results specifically suggest not only that we promote supportive leadership practices (transformational leadership) but, most of all, that we spread the word that abusive leadership creates working conditions that could be detrimental to the practice of nursing at career start," researchers said.

To learn more:
- here's the study abstract
- read the announcement