Cracking the Code of Nurse Turnover: 3 Essential Triggers and Retention Tactics

When critical care nurse and professor Karen Kesten, DNP, APRN, CCNS, CNE, FAAN, heard about OR nurses working alongside nurses in the ICU during the pandemic, she became aware of the challenges affecting perioperative nurse retention. Topping the list were excessive work demands leading to burnout.

After the pandemic, Dr. Kesten leveraged her role as a nurse researcher and director of Doctor of Nursing Practice Scholarly Projects at The George Washington University School of Nursing in Washington, DC, to investigate factors impacting turnover among perioperative nurses. She surveyed nearly 200 CNOR-certified nurses, asking about their reasons for considering leaving the role and what motivated them to stay.  

One of the most telling findings from her study was that younger nurses – not just their older counterparts – were leaving or anticipating leaving their role or the profession post-pandemic, especially if they didn’t have leadership support.

To her surprise, Dr. Kesten found that gender, race, highest education level, and years of experience as a perioperative nurse were not significantly related to turnover.

Dr. Kesten’s poster, which shared these and other findings on turnover and retention, recently took first place at AORN’s annual conference. She hopes her research will help organizational leaders create innovative strategies to retain perioperative nurses. “Perioperative nursing leaders can develop strategies to retain the experienced, proficient yet aging workforce, as well as strategies to attract and retain nurses new to the perioperative nursing field,” she said.

Here are three turnover triggers and the corresponding nursing needs she uncovered that could support retention strategies:  

Turnover Trigger #1: High Work Demands

Demands beyond normal perioperative nursing care pushed surveyed nurses to consider leaving the role they had loved. These additional challenges during and after the pandemic included:

• Staffing shortages
• Frequent turnover and influx of travel nurses
• Changing practice guidelines specific to COVID-19

Nurses need: Organizational acknowledgment of these challenges, along with resources to handle these demands. Improved communication, flexible scheduling, and sustainable practices are vital to periop nursing succession planning.

Turnover Trigger #2: Unhealthy Work Environment

Despite loving their work, OR nurses reported that workplace issues which negatively impacted their own health were driving them away, including:

• Burnout
• Bullying
• Lack of work-life balance
• Lack of incentives
• Unhealthy workload

Nurses need: Flexible scheduling and a healthier work environment to keep them from seeking work elsewhere.

Turnover Trigger #3: Lack of Support

Perioperative nurses were most likely to leave their roles when they worked in environments lacking resources, high-level organizational support, and direct management support.

Nurses need: Communication, creation of community, and recognition of their value. Feeling valued as employees fosters loyalty to the organization and was a primary reason they wanted to stay, Dr. Kesten said.

“It is imperative that healthcare organization leaders realize they have the power and opportunity to address the work environment to ensure a stable workforce. Our research also found that an overwhelming number of perioperative nurses love what they do—leaders need to tap into this passion and demonstrate value to keep their nurses.”

Register for Virtual Pass and receive access to the poster gallery, including Dr. Kesten’s poster, “Factors Impacting Turnover Among Perioperative Nurses as Triggered by the Pandemic.” Through July 15, you’ll also get on-demand access to 70 sessions, 4 keynote talks, and more.