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RN crisis: In a time of high nurse turnover, Bon Secours kept staffing models flexible

COVID-19 has driven unprecedented levels of nurse burnout and staff turnover at healthcare organizations across the country. While job satisfaction among healthcare workers generally dwindled, high turnover among nursing staff has led to a nursing shortage crisis. Identifying employees with intentions to leave their jobs has never been more critical to boost nurse retention rates and reduce the cost of high turnover.  

Like many healthcare organizations, Bon Secours Memorial Regional Medical Center, a hospital in the system’s Richmond, VA, market, faced elevated staffing demands during the pandemic. Fortunately, its RN turnover rates didn’t rise in parallel—an accomplishment in part attributable to quickly launching a Flight Risk Analytics assessment to identify where turnover risk was highest and, subsequently, introducing a variety of care models.   

For example, hospital leadership decided to stabilize the night shift on the neurological unit by adding LPNs. These LPNs helped distribute medication and assisted with clinical assessments so RNs could focus on the more complex needs of high-acuity neurological patients.   

Increased first-year nurse turnover at Bon Secours Memorial Regional Medical Center was another issue that leadership was able to address more successfully with insights from the Flight Risk assessment. In response, the healthcare organization adjusted its orientation and onboarding processes to account for the recently graduated class’s limited clinical experience (due to the shift to fully virtual education). They established cohorts of new nurse hires with a clinical leader who could teach skills usually covered late in nursing school, such as safe medication administration.   

The foundation and tenets of the Magnet Recognition Program® undergird the health system’s staffing efforts: Leadership is committed to promoting nurses’ professional development, being a source of new knowledge and innovation for other organizations, and leading the reformation of professional nursing care delivery. Integral to fulfilling these principles is their willingness to give staff a voice—and then to listen.  

"We are committed to taking the pulse of what happens at the bedside. We survey to learn what is getting in the way of our nurses’ ability to do their jobs and, frankly, how they feel about our system’s ability to respond to their needs." —Andrea Mazzoccoli, Chief Nurse and Quality Officer, Bon Secours Mercy Health 

"I think it was more important to pulse survey this year than any other because the work we asked of our nurses was extremely difficult. We can’t ask them to continue to do this work if we don’t do our best to support them, and that means listening and responding to how they are feeling."  — Robin Johnson, Chief Nursing Officer, Bon Secours Mercy Health 

Key takeaway: Assess the effectiveness of your staffing model and make changes where needed to improve nurse retention. 

COVID-19 forced many nurses and nurse managers to step into expanded roles and help with responsibilities that don’t leverage their most valued skills. This, in turn, has tested leaders in new and unexpected ways. To adapt to shifts in resources caused by a widening staffing gap, nurse turnover, and leaves of absence, consider running your own Flight Risk Analytics assessment to identify where burnout is most prominent and whether adjustments in clinical and managerial roles would positively impact employee engagement and outcomes.  

This is the first in our three-part “RN Crisis” series. Check out our second article that examines Cleveland Clinic's strategies for engaging RNs and elevating well-being among nurses, and our third article exploring UCLA Health's approach to assessing its leadership structure and opening communication channels between unit directors and the C-suite.

About the author

As Chief Nursing Officer, Jeff leads Press Ganey’s focus on improving patient and caregiver experience and developing nursing leadership at healthcare organizations nationwide. He also plays an integral role in the company’s workforce initiatives, including Press Ganey’s Workforce Well-Being Collaborative, which focuses on supporting caregivers as they deal with the ongoing challenges of the pandemic. Prior to joining Press Ganey, Jeff served in various chief nursing officer roles at both community-based organizations and major academic medical centers throughout the US. In addition, he was the inaugural Vice President of the Magnet Recognition and Pathway to Excellence programs at the American Nurses Credentialing Center.

Profile Photo of Dr. Jeff Doucette, DNP, RN, NEA-BC, FACHE, FAAN