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High employee turnover is a pressing issue in the world of healthcare hiring. With turnover rates climbing up to 41% in 2021, it’s more important than ever to hold onto the great nurses who come through your doors. The turnover problem is a major expense for healthcare, with the cost of replacing a nurse sometimes hitting $64,000. That’s not to say the cost of a high turnover rate is just monetary—when long-term employees leave your business, they take their invaluable experience with them. Even in the midst of a candidate shortage, there are always ways to increase your nurse retention rate. Start reducing turnover with these twelve tips. 

12 Practical Tips for Reducing Turnover in Healthcare

1. Make the Right Hires

During a staffing shortage like the one the healthcare industry is currently experiencing, it may be tempting to hire anyone with the minimum qualifications. Sometimes this is unavoidable—you need to maintain staffing ratios by hiring a certain number of employees. The more selective you can afford to be, however, the less employee turnover you’ll see in the long run. The right people aren’t just qualified. They’re also committed, passionate, and interested in growing alongside your organization. 

To increase your ability to be selective, you’ll first need to increase the number of applications you receive for any given open position. You can start attracting the right candidates by optimizing your job posts for greater visibility. Take recruitment further by forging connections with CNA and HHA schools (or creating your own CNA training program) and working on your social media visibility. 

2. Onboard Both Online and In-Person

Onboarding is your first chance to introduce nurse retention strategies, but not everyone agrees on how to approach it. Some job seekers prefer online onboarding, while others prefer that the entire process takes place in person. Since the first few days at a new job are exactly when employees begin formulating opinions about their employers, it’s important to craft a strong onboarding experience that puts any jitters to rest. 

A hybrid approach to onboarding is the best way to appeal to the largest group of new employees, and make more time for personalized attention. When you begin the onboarding process online, you can quickly take care of the essentials—verifying credentials, collecting personal information, and getting e-signatures on paperwork. Once your new hires actually join your workforce, you’ll have more time to focus on their specific duties and goals. 

3. Communicate With Staff

Nurses want strong communication from their managers, and the good thing is that providing this costs nothing. The majority of turnover happens within the first few years of a nurse’s tenure, so these early days are critical for establishing your values and management style. 

Employee retention strategies can start before you even send the job offer. Show that you can meet your staff’s needs by keeping the flow of communication strong during the interview process. Email or text candidates with reminders about next stages, keep them updated on where they stand in the hiring process, and encourage them to ask their own questions at any time. As soon as possible, connect new hires with a specific individual who will be available to respond. Be explicit about the chain of command, so they know exactly where to take any concerns. 

4. Offer Competitive Pay

The COVID-19 pandemic has taught us that nurses are quite willing to relocate for a competitive annual salary. Along with benefits and positive company culture, fair compensation is a clear priority for healthcare workers. 

Depending on your workplace and industry, you may consider developing a compensation philosophy. This involves putting together an explicit, written statement about how you compensate, including information about pay based on relocation, education, and experience. Organizations like Skilled Nursing Facilities and Home Health Agencies should maintain a wage grid that takes account of competing companies and industries in the surrounding area. Understand the average pay for similar roles in your area, and when possible, offer competitive wages. 

Improving your pay is a concrete way to attract talent, but this isn’t the only one. Remember the other factors healthcare workers look for: support, a clear mission, strong benefits, and room to grow. Prioritize these things, and you’ll reduce your average cost of employee turnover annually.

5. Help Employees Forge Social Bonds 

One common reason healthcare organizations see high employee turnover rate is compassion fatigue, or burnout. There’s no getting around the fact that nursing is often as stressful as it is rewarding. One of the most important ways nurses manage stress is by forming strong workplace friendships.

Your healthcare staff will create friendships with or without your assistance, but as a manager, you can take important steps toward reducing turnover by supporting these bonds. Make social events a part of your onboarding process, introduce a “buddy system” during onboarding, or initiate meetings between new hires and more seasoned employees in similar roles. While excessive and unprofessional socialization is a concern for some managers, employee friendships will benefit healthcare managers in most circumstances. Busy nurses need the relief that comes from taking moments to laugh, vent, and celebrate together. These bonds are also valuable to your diversity efforts, since affinity between staff members lends itself to a better sense of inclusion and mutual support. 

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6. Create an Inclusive Environment

Your diversity, equity, and inclusion efforts might be designed to address specific issues, but in practice, these core values often improve the employee experience for every single team member. It’s hard to avoid the reality that different workplaces have different cultures, and new hires may be under great pressure to fit in. A strong diversity strategy can’t always change this, but it can give all employees access to support and advocacy. Offer staff members equal access to professional development through extra training and career counseling. Invite your staff to apply for promotions, and make periodic pay raises the standard. 

Examine clear factors affecting diversity, like pay equity, and more subtle issues, like company culture and workplace inclusion. Conduct periodic training to help your employees (including leadership) understand how their actions create a positive, or hostile, work environment. Sometimes hostility is veiled as social bonding. Coworkers might share a laugh over a name they don’t know how to pronounce without any conscious ill will, but actions like these are still alienating.

7. Set Attainable Career Growth Goals

Show your commitment to nurse retention from the very beginning. During onboarding, ask about your new hire’s goals for professional development. Use this information to collaborate on an actionable plan to help them succeed. One part of reducing turnover is showing that your staff can meet their goals within your organization. 

Not every new hire enters the workplace with specific goals in mind. If a nurse’s only goal is to grasp the responsibilities of their current role, that’s perfectly fine as well. Just keep the door open, and show that there is support available if they want to talk through their career path. Great nurses might stay in the same position for years, but that doesn’t mean their work is static. Let them know that additional training and mentorships are available, and encourage them to take advantage of resources that will help them excel where they are. 

8. Let Staff Pick Flexible Shifts

Caregivers list shift flexibility as one of the top reasons they stay at their organization. This shouldn’t be a surprise—a job needs to fit with the rest of an employee’s life in order to be sustainable. Although it can be very hard to implement, flexibility is also an important indicator of a healthy work-life balance. It’s not an option for every organization, but allowing nurses to pick their own shifts has tremendous benefits, including reducing turnover.

Shift flexibility benefits all healthcare workers, but it’s especially important for people who are juggling responsibilities. Studies have shown that women are more likely to be their family’s primary caregiver than men, meaning they often have less wiggle room for changing shifts. On top of that, lower-earning adults are more likely to sacrifice their shifts to handle other responsibilities than their higher-earning peers. Since white men earn higher wages than any other group, including in healthcare, they are generally the last to be asked to miss work. This can mean that women and people of color miss chances to advance, and get stuck with inflexible, low-paying positions. To retain diverse talent, offer scheduling flexibility where you can.

9. Provide Educational Opportunities

Help your staff advance or change their careers by helping them access education opportunities. Education can take place within your organization or beyond. College classes, online training, and internal coaching are all options for staff seeking paths to career advancement.

Be proactive about offering these opportunities. If you leave it up to employees to seek them out, you will inadvertently be favoring individuals who have learned to expect more support from managers. Rather than asking staff what kind of education interests them, ask about their professional interests. Together, figure out what education they need, and then figure out where they can find it. 

10. Check In With Staff Regularly 

Whether your employees are determined to grow or unsure of what they want to do next, keep up with regular check-in meetings. These can double as both career check-ins and “stay” interviews, where you can actively work on reducing turnover by monitoring staff happiness and commending good work. This is also a great chance to engage staff, involving them in decision-making around logos, uniforms, and other organizational changes.

Take the opportunity to solicit feedback from your employees. Ask what they most enjoy about their work, and what they would like to change. According to the Harvard Business Review, most people don’t quit their jobs because they dislike their managers—but they are likely to leave if leadership doesn’t give them a chance to flex their skill set. Take a pulse on employee satisfaction, and ask explicitly if there are any underutilized skills they’d like to improve or show off. Make room for them to do so, and you’ll have happier employers adding more value to your workplace.

11. Recognize Your Employees’ Successes

Celebrate employees’ contributions to your business, both large and small. Recognize employees verbally, both in the moment and in meetings with team members. Give credit to employees who performed well or came up with creative solutions to problems. Simple recognition can go a long way toward reducing turnover.

Show appreciation for all staff with periodic bonuses and perks. Note strong performers, and bring up successes during conversations about performance and advancement. It’s nice to be recognized verbally, but nothing beats seeing your hard work transform into an advancing career. 

12. Promote Your Staff and Help Them Grow

Career planning, inclusivity efforts, and regular check-ins are only meaningful if you back them up with actual promotions. If an employee is giving their all and seeing no growth, they’re likely to pursue career development elsewhere. 

Approach promotions with the firm intention to promote diverse candidates. This intention will likely push you to dig deeper about why some candidates are doing well and others are struggling. If your top performers are mostly white, ask yourself how your business can better support employees of color. When staff members are struggling, speak to them directly about their needs. 


Apploi is on a mission to help healthcare hire, onboard, and retain staff more successfully through smart job distribution, digital credential management, streamlined onboarding, and reducing turnover. With automatically created digital employee records and up-to-date credential analytics, we make it easier to keep your staff work-ready, whether you’re a team of tens or hundreds.

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.

Melanie Boroosan

Over her six years in healthcare administration, Melanie has managed human resources, legal, compliance, payroll, and recruitment efforts at a corporate level. This oversight granted her a deep appreciation for the unique needs of healthcare managers, and for the direct ways that business operations affect the wellbeing of each employee. As Apploi’s Director of Healthcare Innovation, Melanie draws from her experience in healthcare HR and ancillary long-term care to pursue a vision of holistic healthcare staffing. Her work is rooted in the knowledge that great care begins with improving quality of life for all healthcare workers.