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Driving nurse retention through diversity, equity, and inclusion

COVID-19 has exacerbated the already stressful day-to-day environment of caregivers everywhere, with the nursing workforce especially hit hard. Well-being, engagement, resilience, and morale plummeted—particularly among younger generations of nurses—coinciding with a surge in burnout and a staffing shortage that’s reached crisis levels. Over 50% of clinical nurses report high levels of burnout, nearly a third of RNs are at risk of leaving their organization, and one in five is currently at risk of leaving the profession entirely.

The nurse practice environment (NPE) is closely tied to burnout, job satisfaction, intent to stay, and retention. To proactively address these issues, organizations can employ several strategies, from supporting top-of-licensure practice to advancing nurse well-being.

But data from Press Ganey’s employee surveys, including five diversity questions, points to a relatively new strategy worth serious consideration for retaining nurses: More positive perceptions of diversity, equity, and inclusion (DEI) can significantly reduce turnover.

The challenges for nursing leaders go beyond staffing shortages

Healthcare leaders have invested a lot of time, energy, and resources to fix the current state of nursing. Adding personnel seems like an obvious place to start—but it’s by no means a silver bullet. In Press Ganey’s employee experience survey, responses to the statement “My work unit is adequately staffed” saw the greatest decline between 2019 and 2021. But there are no “greener pastures” in healthcare: Out of 56 indicators measured, “staffing” has one of the lowest correlations to turnover, since staffing is an ongoing challenge at hospitals everywhere.

Meanwhile, across all age groups, employee resilience and decompression are down, but activation remains stable (aside from slight declines among younger RNs). This data suggests that, while RNs still feel a deep and powerful calling to their chosen profession, they’re also drained and demoralized after the events of the past two years.    

DEI has emerged as a key driver of nurse engagement and retention

With healthcare workers in general feeling frustrated and drawn to new opportunities outside of the industry, nursing leaders are exploring how they can positively impact retention in a tight labor market. 

Workforce benchmarks from 2021 show that DEI has risen significantly as a key driver of retention and why employees choose to remain at their organization. Press Ganey analyzed the survey responses from more than 410,000 healthcare employees across 118 different health systems and learned that intent to stay in a job is strongly correlated with the value healthcare workers perceive their employer, managers, and peers place on the inclusion and treatment of people from diverse backgrounds. 

Among nursing personnel, this dynamic is particularly stark: The #1 driver of engagement is “The organization values employees from different backgrounds.” Many other top engagement indicators hit on critical DEI-related items, including: 

  • “This organization demonstrates a commitment to workforce diversity” (#5) 
  • “This organization treats employees with respect” (#6) 
  • “My coworkers value individuals with different backgrounds” (#8)

Institutions that invest in diversity, equity, and inclusion efforts are likely to benefit from improved RN retention. Leaders should examine the organization’s work around DEI as a lever for keeping nurses.

Specifically, focusing on the following to improve DEI will also drive nurse engagement and retention

  • View diversity, equity, and inclusion as three distinct concepts that require three different and intentional approaches. 
  • Ensure that hiring practices support diversification across tenure and role types. 
  • Include demographic questions in employee surveys and listening tools to better segment data across all protected classes.  
  • Pulse survey and round routinely on employees to stay on top of evolving engagement levels.   
  • Update your approach to data collection. Use your findings to understand and address unconscious bias, drawing from a variety of perspectives. 
  • Transparently share engagement results with employees at all levels and ranks. Initiate a dialogue beyond human resources and executive leadership to include more voices from across the organization.   
  • Remember that diversity alone is not enough. Diversity must be coupled with equitable operations and purposeful inclusion to drive meaningful cultural transformation.

Today, nursing and hospital leaders are scrambling to put a stop to the nursing crisis and get ahead of issues like burnout to hold onto high-performing members of their teams. Without a concerted effort to improve nurse well-being, the healthcare industry faces a potentially long-term shortage of front-line caregivers.

Press Ganey can help your organization identify areas of focus and accelerate nurse retention efforts. Our employee experience consultants will work side by side with your team to improve nurse well-being, engagement, and retention rates. Reach out to our experts for more information and to hear about our newly launched Nursing Leadership Academy.

To learn more about Press Ganey’s industry initiatives, check out our Workforce Well-Being Collaborative and Equity Partnership.

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