At a time when nurse turnover is reaching astro­nom­i­cally high levels in hospi­tals across the country, it’s more sensible than ever to invest in every facility’s most valuable resource: the people working there.

Cutting corners — in pay, benefits, nurse staffing and other working condi­tions — almost always proves much more costly in the long run, especially when it comes to a facility’s bottom line and its patient care.

A prime example: St. Joseph Medical Center-Tacoma (SJMC), where turnover has reached levels higher even than the already unaccept­able national average.

Nurse turnover is costly

Nurse turnover, or the rate at which nurses leave their positions (volun­tarily or other­wise) on any given hospital unit, costs the average hospital $4.4 million to $6.9 million dollars a year. That’s because it is expen­sive to find, recruit, orient and train nurses, who comprise the largest propor­tion of the health care workforce (the average cost of turnover per nurse is $52,100). This has resulted in a national RN turnover rate of 17.2%, which is unaccept­ably high. What other profes­sion sees nearly one-fifth of its workforce leave for greener pastures every year?

How much more costly nurse turnover must be, then, in facil­i­ties with turnover rates even greater than the sky-high national average. This is being proven by SJMC.

Nurse turnover at SJMC is costing a fortune

Nurse turnover at SJMC is, for lack of a better word, obscene, and incred­ibly costly. 

According to WSNA member­ship data, SJMC turned over 276 nurses in 2017, and 248 in 2018.This comes out to a turnover rate of 24.2% and 20.9% each year, respec­tively – rates much higher than national averages.

Put another way, turnover at SJMC in 2017 was a whopping 44% higher than the national average, while 2018 turnover came in a close second at only” 21.5% greater than the national average. 

These numbers are unaccept­able. Using the average turnover cost per RN (which, it should be added, was self-reported on an industry survey of hospi­tals), we can calcu­late that nurse turnover cost SJMC $14.4 million dollars in 2017 and $12.9 million in 2018.

Is this really the best way for our non-profit insti­tu­tions to be spending our money?

Nurses are telling SJMC how to stop the bleeding

Nurses at SJMC have spoken loud and clear when it comes to how manage­ment can work to reduce nurse turnover. In short, they’re telling their hospital that they need safe staffing, first and foremost. As SJMC nurse Richie Tiamzon put it, we’re asking for the bare minimum needed to properly support ourselves and keep nurses at this hospital so that we can stop the bleeding and properly support our patients and save their lives without destroying our own.”

This is borne out by the research, which has found over and over that RN job dissat­is­fac­tion is inextri­cably linked to unsafe staffing, health benefits and sub-optimal compen­sa­tion. Impor­tantly, decreased RN job satis­fac­tion and increased RN turnover is also linked to decreased patient satis­fac­tion and quality of care.

This passes the common sense test. If I’m admitted to a hospital unit and the average time a nurse has worked on that unit is 1.5 years, I simply will not have the same outcomes as a unit with an average time of 10 years.

In the coming weeks we will continue to explore nurse turnover at SJMC, how the facility is spending its non-profit money, and how its posture towards its nurses is impacting patient care. Stay tuned.