Workplace culture at center of nursing turnover conversation in Oregon

A report from the Oregon Center for Nursing (OCN), finds that workplace culture is a significant factor in dictating whether registered nurses or other medical professionals stick with their jobs. The report details how COVID-19 acted as a “shock” factor and contributed to increasing nurse turnover rates. 

 

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OCN Research Director Dr. Richard Allgeyer said: 

“This pandemic is acting as a shock, and it’s causing a lot of people to rethink their alignment [with company values] and their linkages [to other workers], and it’s causing people to leave.” 

According to a report from the Oregon Nurses Association on turnovers at the Willamette Valley Medical Center, the turnover rate for registered nurses has been on a constant upward trend since 2018 with 19% that year, 27% in 2019, and 38% in 2020.

In the OCN report, Allgeyer described a three-dimensional system for job satisfaction. Those dimensions include a nurse’s link to the people they work with and the company they work for, how well they fit in with the workers around them and how the job fits in with their daily life, and how much the particular nurse would have to sacrifice should they have to switch jobs. 

A shock such as COVID-19 can impact any one of these dimensions in the work environment and be a contributing factor to worker turnover. 

Nursing leaders are concerned for the well-being of their staff, according to the OCN report, and have tried offering resources to deal with stressed out staff — something that many nurses feel hasn’t been met. 

The report states this lack of satisfaction in employer interventions has contributed to nurses beginning to rethink their fit within the company, and whether or not it’s worth staying. 

According to Allgeyer, medical facilities have tried offering employee assistance programs (EAPs), which are work-based intervention programs designed to assist employees in resolving personal problems that are impacting their quality of work. However, he says these resources often go unused. 

“We found out early on that they’re not using [the EAPs]. When we started talking to nurses, they were saying ‘yeah, that’s not what I want. What I really want is some time off. I want to be able to take my lunch breaks. I won’t be able to take my breaks during the workday because I’m exhausted and there’s no relief in sight.’”

Allgeyer explained an alternate approach to address nurse turnover. Leadership within OCN has been sitting down and listening to the concerns of their staff and developed a workplace model that feeds off of the skills each nurse has. The organization is finding ways to allow nursing professionals to work at the top of their abilities.

Allgeyer said:

“There’s been some talk about moving to some more team level or team-based care, which incorporates the use of certified nursing assistants and some licensed practical nurses as ways of allowing nurses to practice more at the top of their level.”

With this model, CNAs and LPNs who have a more advanced skill set will be assigned tasks that take advantage of their abilities. Other tasks will be left to lower-level staff. According to Allgeyer, this model should free up nurses to perform to the top of their expertise and avoid overburdening them with more menial tasks. 

Other health officials are looking through a community and equity-based lens to address nursing turnover. 

During an Oregon Healthcare Workforce Committee meeting hosted by the Oregon Health Authority (OHA), members of the committee discussed House Bill 2949, a bill passed in June 2021. The aim of the measure is to help support a more equitable work environment with the establishment of the Behavioral Health Workforce Initiative (BHWi). 

Leticia Sainz, the Adult Mental Health and Addictions director of the Health Systems Division at OHA, explained how the initiative will help build a sense of community among nursing staff.

“[BHWi] really engages communities in shared decision-making to build structures, processes, resources, and support for increasing recruitment and retention of a culturally specific behavioral health workforce.”