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The ongoing nursing shortage has forced healthcare employers to think carefully about nurse retention strategies and hiring. Nurse turnover happens when nurses retire, leave the workforce, or take a job at a different company. It’s a widespread issue, and a costly one. 

Onboarding is one of your best opportunities to introduce nurse retention strategies. Strong onboarding can help you set the tone with new staff, make them feel good about their workplace, and introduce opportunities for them to grow alongside your organization. Home Care Pulse has even found that employers who offer at least 3 hours of onboarding can reduce their turnover by 42%. 

The State of Nurse Retention and Turnover

Nurse turnover rose by 5% between 2020 and 2021, up to a shocking 41% for the average hospital. Although this is a definite spike, nurse retention has been an issue for a long time—and it costs employers every year. Between temporary positions, job ads, and training for new employees, the high average cost of turnover can be painful. A single RN can cost anywhere from $22,000 to $64,000 to replace. Losing a nurse affects your bottom line, but it also hurts hard-to-measure factors like morale. Plus, if you’re losing veteran healthcare professionals, you’re saying goodbye to their priceless experience.

Despite the shortage of nursing applicants, the Bureau of Labor Statistics predicts that RN roles alone will grow by 7% between 2019 and 2029. Even as managers struggle to find nurse candidates, demand is increasing. To add to that, America’s population is aging quickly. By 2030, 1 in 5 Americans will be age 65 or over. That’s an unprecedented population of older citizens. Healthcare will need both new graduate nurses and well-seasoned staff to provide a high quality of care for this large group of older patients.

How to Use Onboarding to Boost Nurse Retention

Gallup Analytics‘ RN staffing report states that most nurse turnover happens in the first two years, making onboarding an important time for nurse retention. New nurses start assessing their workplace administration from the time they fill out an application. By helping the application and onboarding processes go smoothly, you can immediately show off your commitment to creating a positive work environment. 

Good onboarding includes preparation, clear communication, a sense of purpose, and a structure to help new staff grow. Taken together, these are all tools to help staff feel supported in healthcare organizations, ultimately reducing turnover levels. Here are six ways to use onboarding to increase job satisfaction and strengthen your nurse retention strategies.

1. Provide a Support System

Boost morale from the beginning by giving new nurses a sense of leadership and community. Introduce them to their peers during onboarding, and give them opportunities to meet healthcare leaders from different teams. Schedule week 1 social events to encourage positive relationships with nurse managers and other healthcare workers. If possible, schedule a one-on-one meet and greet with a seasoned staff member in the same role. Consider pairing up new employees to go through the orientation process together. 

2. Show Your Nurses How They Can Grow

Take a moment during onboarding to discuss your new hire’s career goals. Together, name the skills or experience they need to meet these goals, and discuss opportunities to move into leadership roles. Show recognition for good work and make room for professional development, possibly through structured leadership development programs. If appropriate, set up mentorships to help them gain these skills within your organization. Finally, schedule a career growth check-in 6 months in the future to see how they’re progressing through their first year. 

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3. Remember That Your Nurses Are People

Compassion fatigue, or burnout, is one of the most common reasons for nurse turnover. You can support your staff’s mental health by making sure new nurses understand their benefits from the beginning. It’s tough to do your best work after a series of 12-hour shifts, so try to avoid straining hardworking staff. Encourage nurses to take advantage of vacation time, shift flexibility, and volunteer days to strike a better work-life balance. Even if it’s counterintuitive, giving more time off is likely to reduce turnover, so the number of days the employee works is higher overall.

4. Communicate Your Mission

From their first day of employment, help nurses feel like a part of something bigger. Explain your mission and show new hires exactly how they’re a part of it. Chances are, every role in your organization is vital to patient safety and team performance. Give new hires a sense of importance, belonging, and pride in their work. After all, if your new nurse is a good fit for your organization, they’ll already care deeply about your mission. 

5. Make Time for Personalized Onboarding

In practice, onboarding is often spent filling out standard, tedious paperwork. As much as possible, get license verification, legal documentation, and personal information out of the way before your new employee steps through the door. Try starting the onboarding process online. Collect important documentation during the application process so you can dedicate in-person time to reviewing company culture and encouraging employee engagement. 


Apploi is on a mission to help the healthcare industry recruit more successfully. We post jobs across 80+ sites and verify licenses during the application process to make onboarding a breeze. Our Onboard & Manage Teams product takes onboarding a step further, automatically creating digital staff records that will stay with your employee through their lifecycle at your organization. 

Interested in learning more about how you can recruit, hire, and onboard healthcare staff quickly? Contact us today for a free demo of our end-to-end solution.

Pritma Chattha, DNP MHA RN

Pritma is a Yale-educated nurse executive with 18 years of experience advocating for patients at the bedside and in the boardroom. She currently serves as the Head of Healthcare Innovation at Apploi—healthcare's leading recruitment and credentialing platform. Over the last decade, Pritma has honed her expertise as a health informaticist, building and improving electronic health records and credentialing platforms. She is the immediate former Executive Director of Electronic Quality and Safety for Alberta Health Services, the largest health system in Canada. Pritma enjoys rethinking healthcare processes to provide safer, better, and more accessible healthcare.