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The Cause and Effect of Nurse Turnover in their Organizations


The notion of nurse turnover is an undesirable tendency that has plagued the healthcare sector. This type of trend has proven to be expensive, disruptive and has jeopardized the quality of health care and the safety of the patients. However, there are exceptions to this rule, especially considering the movement of nurses who are considered as non-performing, dismissed from their organizations or decided to leave at their own will. Even though it is still an expensive affair to replace such nurses, in the long run, the affected organizations might be better off. Many scholars and policy makers endeavor to understand the turnover rate of nurses so that they could apply it as a barometer for measuring job satisfaction. Such knowledge could assist in staffing projections. Furthermore, understanding why nurses leave their organizations would assist healthcare facilities and their administrators to formulate policies that could help reduce the turnover rate and retain more nurses.

Background of the Study

Almost all of the nurses leave their jobs for a variety of reasons which could be either voluntarily or involuntarily. Voluntary reasons include job dissatisfaction, employee promotion, enrolling for further studies, change in career objectives or geographical relocation. Involuntary turnover could arise from job dismissal, closure of the health care facility or employee malpractice among others. Other reasons could be classified as both involuntary and voluntary like health issues affecting the nurse or retirement. Due to the various factors causing nurse turnovers, it is extremely difficult to compare the turnover rates for registered nurses. Therefore, a precise definition of the turnover rate needs to be identified (Stokowski, 2014).

In some cases, the turnover rates register higher when the economy is booming, and the jobs are in plenty. Unhappy nursing employers would then have the opportunity to exchange jobs for ones with better pay and improved working conditions. The reverse is true with a weak economy subduing the turnover rates. Brewer, Kovner, Greene, Tukov-Shuser, & Djukic, (2012) observed that the nurse’s turnover rates increased during the earlier years of a nurse’s career. They concluded that 43% of the newly licensed nurses left their jobs within a three-year employment period. This is particularly the case for nurses that did not secure a hospital job as their first appointment.

The movement of nurses from one organization to another could negatively impact on the overall performance of the organization. The report by Tummers, Groeneveld, & Lankhaar, (2013) found that most nurses leave certain health care facilities due to lack of career growth opportunities or insufficient personal development. Also, a negative working environment in the organization pushes many nurses to leave. Overall, such movement impedes the performance of the healthcare organizations and morale is dampened.

Over recent times, many health care facilities have attempted to reduce the costs associated with staffing. The cost of wages and benefits accrued by the registered nurses is usually high, and some health organizations have resorted to cutting costs related to nurse staffing. However, some studies have indicated that adequate staffing of nurses improves overall financial performance and better care for the patients (Everhart, Neff, Al-Amin, Nogle, & Weech-Maldonado, 2013). Another scholar Shaw (2011) posited that there is a relationship between organizational performance and turnover rates. The higher the turnover rates, the greater is its negative impact on the overall financial performance and profitability of organizations.

The American Association of Colleges of Nursing (2016) noted the evolving healthcare environment significantly affects the number of registered nurses. Different nurses have different levels of competency, and as such, each of them must be rewarded by clearly defining their roles and ensuring appropriate compensation relative to their skill level. Low pay rates and workplace issues related to a lack of clear guidelines in nursing practice leads to the increased rate of nursing turnover. Furthermore, the ambiguity of a nurse’s role in a health organization reduces their commitment level to that organization. With a lack of commitment to the health care facility, the nurse is susceptible to role burnout and their intention to leave increases (Han, Han, An, & Lim, 2014).

Research Paradigm

This study would draw from quantitative data derived from relevant literature. The focus would be to evaluate the different concepts outlined below through a positivist approach and by identifying the objective truth from the stated hypothesis. The underlying assumptions of this study are that the financial costs are calculable and are limited to the recruiting, hiring and training of new nursing personnel. Also, the turnover rates associated with either voluntarily or involuntarily leaving the organizations are relatable.

Statement of the Problem

The decision of a nurse to move would eventually affect the performance of health care organizations. The turnover of nurses might lead to a nursing shortage and such a shortage would affect the overall health care given to patients. Understanding why nurses decide to make such decisions is prudent so that better policies could be developed to retain nurses in the healthcare facilities.


The turnover of nurses negatively impacts on the performance of the healthcare institutions. Healthcare organizations require a steady and professionally trained nursing personnel to ensure that they operate profitably and that patients have adequate care.

Significance of the Study

The study will purpose to understand why nurses leave and therefore offer controlling and preventive measures to curb the turnover of nurses. Such findings would provide guiding principles to hospital administrators on what factors contribute to the high turnover of nurses in health care organizations. As a consequence, the hospital management would then take remedial steps to ensure that the rate of nurse turnover is reduced. The paper would also enable various stakeholders understand, which policies would improve nurse satisfaction and the stature of the hospital. Thus, in the long run, the patients would also be satisfied.

Scope and Delimitation

The study will aim to understand the causes and effects of nurse’s turnover by assessing key factors, namely;

  1. Evaluating the value proposition that motivates nurses to work with certain organizations and how the health care organizations maintain such value proposition

  2. Evaluating factors that cause nurses to leave certain organizations even though at first they had appreciated the value proposition

  3. Evaluating how such turnover affects the performance of the healthcare organizations.

The study would limit itself on evaluating the financial costs associated with turnover of the nurses, the major reasons why nurses change organizations or decide to leave the nursing environment and the main retention strategies that could be applied to reduce turnover.

Operational Definition of Terms

Turnover Rate – the number of nurses who leave a health organization either voluntarily or involuntarily to either other health organizations or to a different profession entirely.

Financial costs – these are the costs associated with recruiting, training and hiring of new nurses to replace the ones who have left.


American Association of Colleges of Nursing,. (2016). Strategies to Reverse the New Nursing Retrieved 15 November 2016, from

Brewer, C., Kovner, C., Greene, W., Tukov-Shuser, M., & Djukic, M. (2012). Predictors of Actual Turnover in a National Sample of Newly Licensed Registered Nurses Employed in Hospitals. Journal Of Advanced Nursing68(3), 521-538.

Everhart, D., Neff, D., Al-Amin, M., Nogle, J., & Weech-Maldonado, R. (2013). The Effects of Nurse Staffing on Hospital Financial Performance. Health Care Management Review38(2), 146-155.

Han, S., Han, J., An, Y., & Lim, S. (2014). Effects of Role Stress on Nurses’ Turnover Intentions: The Mediating Effects of Organizational Commitment and Burnout. Japan Journal Of Nursing Science12(4), 287-296.

Shaw, J. (2011). Turnover rates and organizational performance: Review, critique, and research agenda. Organizational Psychology Review1(3), 187-213.

Stokowski, L. (2014). Nurse Turnover: The Revolving Door in NursingMedscape. Retrieved 15 November 2016, from

Tummers, L., Groeneveld, S., & Lankhaar, M. (2013). Why do nurses intend to leave their organization? A large-scale analysis in long-term care. Journal Of Advanced Nursing69(12), 2826-2838.