Causes of Low Rates of Nurse Retention

This essay reviews the various causes of low retention rate among nurses, including psychological experiences, job dissatisfaction, work patterns, lack of promotional opportunities, poor financial incentives, and the work environment.

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Causes of Low Rates of Nurse Retention
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It is an issue of international concern that nurses are consistently leaving their jobs as
well as their profession (Halter, et al., 2017). Consequently, a high labor turnover rate of nurses
results to low retention rate, an issue that is continuously becoming much worse in the developed
countries. There exist a huge pool of literature that seeks to explain the causes of the high
turnover rate. Further on, various scholars and researchers have ventured into seeking answers as
to why nurses eventually resolve to quit their jobs in one workplace and seek employment in
another, or worse still, leave the profession for good. This essay is a detailed review into the
various causes of low retention rate by looking into the causes of a high turnover rate and the
effect or contribution of each cause into the final resignation decision of a nurse.
To begin with, nurses while in the workplace are subjected to various psychological
experiences some of which may be a bit hard to cope with. Some of the common disturbing
psychological experiences and that contribute largely to a high turnover rate are burnout and
stress (McHugh, et al., 2012). Work-related stress results in low stability to the schedules of
work as well as lack of satisfaction in career prospects. Moral stress is another classification of
stress that badly affects nurses in the workplace. The aforementioned is mainly attributed to the
ethical climate of a hospital which nurses may find unfriendly and resolve to leave. On the other
side, burnout results to either physical exhaustion or emotional exhaustion or both (Whitney &
Ochsman, 2013). They both warrant the decision of a nurse to leave the profession and seek
more appealing and less tiresome career or workplace. For example, when a nurse has to work in
an intensive care unit for more than 20 hours, both types of exhaustion are bound to occur.
Intentions of nurses to leave the workplace are also brought about by job dissatisfaction
(Currie & Carr Hill, 2012). There are various causes of job dissatisfaction. Researchers have
reported that some nurses are not satisfied when they are unable to provide a high quality of

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health care to their patients and more so in high acuity units. Other nurses are not satisfied with
the workload placed on their shoulders where some complain of being overworked while other
says that they are underworked and thus not exploiting their full potential. Low staffing is
another factor that leads to dissatisfaction as well as inter-staff conflicts and thus influencing the
decision of a nurse to leave (Debisette & Vessey, 2011). A nurse could, for example, resolve to
leave a particular healthcare facility when there is a poor relationship between the nursing staff
and the nurse leader, which adversely affect the quality of work.
Working patterns have also been linked to the high turnover rate (Benoit &
Hallgrimsdottir, 2011). Shift work, for example, is a common reason that may cause nurses to
make a decision to leave. Evenings and night shifts, to be more specific, are common times that
many nurses are not willing to work. This is due to personal and family-related issues where
many nurses want to spend their evenings with their children and/or their family. A constantly
changing Rota is to blame for the issue because it forces people to shift from the work patterns
that they are already accustomed to. When a Rota is reshuffled, for example, and mother nurse
who is always in the day shift is placed in the night shift, she may be forced to quit the job for
the sake of her children.
Low or no promotional opportunities are directly attributed to the high turnover rate.
Nurses are also human beings who need development as well as professional growth. Where
there are perceived low opportunities of growth and development as well as advancement in the
nursing field, a large number of nurses resolve to leave such workplaces and seek greener
pastures (Maville & Huerta, 2012). For nurses to feel motivated and growing, promotion in terms
of ranks must be available. Lack of wage increment as a motivator is another promotional aspect
that contributes to nurses leaving the workplace or the profession. When a nurse, for example,

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stagnates in the same pay grade for 2-4 years, such nurses could leave and such for other
workplaces or profession where they will feel promoted.
Financial incentives have also been identified as an organizational determinant with a
large contribution to the high turnover rate (Armstrong, 2012). When nurses are not satisfied
with their remuneration, and with their organizations showing no incentives to improve them,
nurses usually resolve to leave that particular organization. When the unsatisfactory pay rate is
symmetrical across all healthcare organizations, nurses who are unsatisfied may resolve to quit
the profession and seeking a livelihood in other professions. Nurses are also unsatisfied when
they are continuously required to do extra work without compensation. When nurses, for
example, are told by their managers to work for extra hours but no compensation is availed for
the same, they will end up quitting working for that healthcare facility as they will feel exploited.
The work environment is another determinant that affects the turnover rate and
subsequently, the retention rate (Huston, 2013). Nurses are human beings and want to work in
safe and conducive environments. Poorly ventilated rooms, lack of protective working materials
and equipment are some of the poor working environment conditions that warrant the intention
to quit by a nurse. Nurses, for example, will want to quit working in a facility where protective
gears such as gloves are not available. They are not ready to expose themselves to any
contaminations that could alt6er their health.
In conclusion, it has been discussed that the low retention rate among nurse is a
consequence of high turnover rate. The various causes of high turnover have therefore been
identified and discussed in details. Psychological experiences such as stress and burnout, job
dissatisfaction, and work patterns are some of the causes that have been discussed. Other causes
i.e. lack of promotional opportunities, poor financial incentives, and the work environment are

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the organizational factors that have been discussed. Alongside each cause, the effects that come
into play have also been discussed with the support of relevant examples.

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References
Armstrong, M. (2012). Armstrong's Handbook of Human Resource Management Practice (12,
illustrated ed.). Kogan Page Publishers.
Benoit, C., & Hallgrimsdottir, H. (2011). Valuing Care Work: Comparative Perspectives.
University of Toronto Press.
Currie, E.J %Carr Hill, R.A. (2012). What are the reasons for high turnover in nursing? A
discussion of presumed causal factors and remedies. International Journal of nursing
studies, 49(9), 1180-1189. https://doi.org/10.1016/j.ijnurstu.2012.01.001
Debisette, A., & Vessey, J. (2011). Annual Review of Nursing Research, Volume 28: Nursing
Workforce Issues, 2010. Springer Publishing Company.
Halter, M., Boiko, O., Pelone, F., Beighton, C., Harris, R., Gale, J., . . . Drennan, V. (2017,
December 15). The determinants and consequences of adult nursing staff turnover: a
systematic review of systematic reviews. BMC Health Services Research, 17(824).
doi:10.1186/s12913-017-2707-0
Huston, C. J. (2013). Professional Issues in Nursing: Challenges and Opportunities (revised ed.).
Lippincott Williams & Wilkins.
Maville, J. A., & Huerta, C. G. (2012). Health Promotion in Nursing (3, revised ed.). Cengage
Learning.
McHugh, M. D., Kutney-Lee, A., Cimiotti, J. P., Sloane, D. M., Aiken, L. H., & Fagin, C. M.
(2012, February 1). Nurses' Widespread Job Dissatisfaction, Burnout, And Frustration

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With Health Benefits Signal Problems For Patient Care. HHS Author Manuscripts, 30(2).
doi:10.1377/hlthaff.2010.0100
Whitney, P., & Ochsman, R. B. (2013). Psychology and Productivity (illustrated ed.). Springer
Science & Business Media.