A Strategy to reduce turnover on an inpatient oncology unit

Purpose:
Nursing turnover is an issue facing many hospitals. Oncology nursing is a unique field in that suffering and the act of dying are frequent patient characteristics. A strategy to reduce turnover on an Oncology unit was implemented.

Significance:
Literature demonstrates higher burn out and compassion fatigue in oncology nursing. It also reports a necessary balance between work and a nurse's life to combat compassion fatigue leading to turnover. Financial loss, poor morale, and damaged facility reputation were issues facing 7 West.

Strategy and Implementation:
Considering current literature, nursing feedback from exit interviews and current staff surveys, the unit developed a scheduling subcommittee. This staff based group developed and implemented our unit based guidelines. These guidelines incorporate a provision for weekend staffing exemption for all nurses with 2+ years experience. Our goal was to increase nurse satisfaction, provide clinical leadership at the unit level, and to increase retention and decrease turnover. Several other strategies were also implemented including an active shared leadership unit based council which increased staff empowerment. Good grief sessions were set up by the Director of Professional Development to enable staff to ventilate their grief from loss. An Oncology mentoring program was developed and funded through a Beckwith Grant for Innovation. This mentoring program provided a venue for education and conversation about death/dying, optimism, hope, and useful coping mechanisms.

Evaluation:
Our goal was to increase nurse satisfaction, provide clinical leadership, increase retention and decrease turnover. Since implementation new hire turnover decreased from 47.6% to 12%. Press Ganey Scores and NDNQI nursing satisfactions scores have also improved as well as overall morale on the unit.

Implications for Practice:
This program has the ability to address sensitive topics in real time and is helpful in developing cohesion within the nurses on the unit and can be uniquely individualized.