Successful strategies by employers to retain nurses are only found in “pockets” across the country and more work must be done to tackle sometimes “shocking” turnover rates, senior nurses have warned.
Redeploying staff between wards, unfixed rotas that are published last-minute and a perception of an increasing focus on targets over quality of care are among the problems of greatest concern.
“They are the staff that get moved from place to place, because they are not in charge”
Senior nurses and advisors pointed to poor roster management as one of the main issues when they spoke at Nursing Times’ Deputies Congress event last week.
Nicola Ranger, director of nursing at Frimley Health NHS Foundation Trust, said it was often the newly qualified nurses who suffered the most from highly variable rotas and being moved between wards. At her own trust, she said around 400 nurses were lost each year, which she described as “shocking”.
Around a third were nurses in their first year of employment with the trust, she noted. “They are the staff that get moved from place to place, because they are not in charge,” she said. “They also have the worst off duty….it’s our newly qualifieds that feel the impact.”
She said feedback from band 5 nurses had revealed shift patterns that made her “despair”, which had prompted the trust to now begin a programme of work looking at its e-rostering.
“Looking at a sample of those rotas – some staff have worked a Saturday night, finished at 8am on a Sunday morning and then are back on an early on a Monday. Because someone has counted the Sunday as a day off,” said Ms Ranger.
In addition, the chief nurse said, older nurses were often “a bit disillusioned” because “they feel there is more focus on getting the patient into the bed and out of the bed, and that what actually happens to the patient when they are in the bed is becoming secondary”.
She urged the audience of deputy nursing directors to listen to feedback from not only staff but students, who could be an indicator of future retention problems.
Upon the trust merging to help run struggling Heatherwood and Wexham Park Hospitals NHS Foundation Trust in 2014, she noted Wexham Park Hospital took on around 150 students annually, but only retained three a year.
Critical need to tackle ‘shocking’ nurse retention rates
Meanwhile, Lyn McIntyre, senior nursing advisor at the Department of Health who worked on the recent Carter review of NHS hospital efficiency, said there was “great variation” in how e-rostering systems were being used.
Of the 136 acute hospitals in England, six did not have these systems in place at all, she said.
Those that did were sometimes only publishing their staff rotas two weeks before the shifts were worked, when the Carter review called for rotas to be released at least six weeks in advance.
“If you’re a member of staff and you don’t know what you’re working in two weeks’ time, or you’ve got vacancies and you need to get bank or agency staff and you need to put that out to the bank, you’re giving them a very short turnaround,” said Ms McIntyre.
Ruth May, executive director of nursing at the new regulator NHS Improvement, said there were some “really great” examples of improving retention across the country but that these were only found “in pockets”.
She reiterated her plan to launch a programme of work looking at how to improve nurse retention across England, as revealed earlier this month by Nursing Times.
“I’d like to do a collaborative approach where we bring together a whole group of trusts up and down the country that says these are the challenges, and ask our staff to help us solve that problem,” said Ms May.