Combating Employee Turnover in the Worst of Times


The coronavirus pandemic could shake even the most veteran healthcare professionals, leading some to seek a career change. Experts offer tips on how to offset employee turnover by keeping providers at your facility onboard and engaged. 

Employee turnover is expensive. 

You know this. But have you thought about how much it costs the typical healthcare facility in actual dollars and cents?

The mean cost of turnover for a bedside RN is $44,375, with the range spanning from $33,300 to $56,000, according to the 2020 NSI National Health Care Retention & RN Staffing Report. The end result, according to NSI, is the average hospital losing $4.9 million per year. 

The same report includes some other figures that highlight what NSI calls an “RN staffing crisis.” For example, this research points to the current vacancy rate of 9 percent, a full point increase from last year. NSI’s RN Recruitment Difficulty Index “remains elevated, at 81 days on average,” according to the report.

The picture this study paints gets a bit rosier when considering advance practice and allied health professionals across the board. Over the past five years, these groups have recorded turnover rates below the hospital average, according to NSI. 

Still, turnover is never not a concern for healthcare system administrators, and there are a lot of good reasons to make your staff want to stay with your facility. 

That’s not an easy task in the best of times, when levels of burnout and occupational stress among healthcare professionals are already high. 

The Coronavirus pandemic has done absolutely nothing to drive down those levels, of course. Which makes the next few months critical. 

Healthcare professionals will (maybe) get a chance to step back and collect their thoughts as things slowly return to some semblance of normalcy. And many might well decide they need a change of scenery, professionally speaking. 

Or, shaken by what they’ve seen over these last few months in the midst of the COVID-19 pandemic, others might decide they want to turn down a new career path altogether. But there are several steps you can take to help make sure your invaluable providers remain on board and engaged. 

Engagement begets retention

The stress that healthcare professionals experience during a crisis like the coronavirus pandemic could leave even the most veteran provider a big disengaged. 

That sense of disengagement could be the first sign of an employee who’s ready to try something new in their career.

Indeed, Gallup has studied the correlation between employee engagement and retention in its State of the American Workplace report, determining that those who are engaged in their work are more likely to stay with their current organization, reducing overall turnover and the associated costs. 

“They feel a stronger bond to their organization’s mission and purpose, making them more effective brand ambassadors,” the report reads. “They build stronger relationships with customers, helping their company increase sales and profitability.”

It’s up to your facility’s leadership to ensure employees still feel plugged in to your mission and their role in fulfilling it, says Carlos Castelan, managing director of The Navio Group, a management consulting firm that advises healthcare companies.

“When employees are engaged, they are all in,” says Castelan. “Whether it’s a project or a company goal, engaged employees believe their time, work and effort is rewarding. When employees are engaged and have a sense of meaning in their work, they become more committed to the company they work for, and have a greater drive for producing results.” 

Executive teams and managers must also regularly reinforce the organization’s vision through team-based and one-on-one communication, he adds. 

“Communicating a clear vision and goals to employees allows them to understand how their work fits into a bigger picture and assures them that their work is important and meaningful.”

Sam Cross, founder and administrator of Broad Street Home Care, a Wilmette, Ill.-based provider of personal care, says the organization has stepped up internal communication efforts throughout the pandemic, and overall performance has improved. 

“We’ve increased communication, utilizing technology to maintain connectedness,” says Cross. “We’re focused on our procedures and making sure everyone is prepared with the proper equipment and techniques,” he says. 

In addition to the necessary protective personal equipment, the organization conducts pre-shift symptom checks on employees and offers direct support in accessing healthcare and telehealth services, in the event that an employee experiences coronavirus symptoms, for example. 

“The result is that everyone is empowered, elevated toward this common goal of keeping people safe and healthy, and reducing fear and anxiety.”

Fostering development

Employees thrive with this type of support, says Cross.

Broad Street Home Care also offers employees professional support in the form of in-service training, which it combines with group-building social events, as well as tuition assistance for skills training and certification. 

Fostering this type of professional development is equally important to employee engagement and retention. 

Consider, for example, a recent study of more than 2,000 employees, which found workers at organizations that offer professional development opportunities are 15 percent more engaged in their work, and companies providing professional development enjoy retention rates 34 percent higher than those that don’t. 

Efton Hall, senior vice president of healthcare, life sciences and the public sector at Berkeley Search Consultants, advises promoting employee development plans that include succession planning and growth opportunities. Hall also suggests increasing communication and leadership visibility during difficult times, like right now. 

“This is a common practice during normal times. Keep it going during these ‘new normal’ times. Don’t become a stranger. It’s ok to be that masked person that continues to be in the mix at a safe distance.

“Provide regular updates on important issues that offer encouraging news, i.e., the health status of employees, a victory with a patient recovery, replenishment of the PPE stock, for example,” continues Hall. “Let staff know they are doing a good job and that they are valued.”

Employees will remember all of this down the road. And that’s when it will really count, says Hall. 

“Realize that the war for talent will escalate when the pandemic has passed,” he says. “Build defense mechanisms that defend against your employees being poached. Review your wage equity to confirm it’s competitive, consider stay bonuses and/or hazard pay differentials.” 

Castelan offers one additional tip to stay on top when the talent battle really begins to heat up.  

“Get ahead of poaching from competitors by identifying top talent and sharing that evaluation,” he says. “From there, managers can have regular conversations about the larger company vision and work as well as the unique opportunities that exist for that employee.”

To ensure that your top providers continue to develop within your system, Castelan suggests identifying high-visibility, special assignments or projects, rotation to other areas, mentorship with top executives and faster promotions and raises. 

“If you’re trying to convince an employee to stay, chances are it’s probably too late, so it’s important to make them feel valued, and [to feel] they have a future at the company that helps both the [organization] and the employee achieve their goal,” he says. 

“It’s easier to retain star employees than to try to replace them. So, providing meaningful work is key to engagement, productivity and employee retention.” 


1. NSI Nursing Solutions Inc, 2020. Accessed April 27, 2020


2. Patient Safety & Quality Healthcare, 2019. Accessed April 27, 2020.


3. Gallup, 2017. Accessed May 1, 2020.


4. Better Buys, 2016. Accessed May 2, 2020



Encouraging Employees to Take Time Out

Burnout is always a risk for healthcare professionals, especially at a time like right now. 

To keep providers on board, engaged and happy, Sam Cross, founder and administrator of Broad Street Home Care, tries to create a work environment where they feel comfortable pumping the professional brakes when necessary. And he strongly encourages his staff to speak up when they feel their jobs are taking a toll on their health. 

“People are expected to raise their hand if there are concerns with their physical, mental and emotional well-being, along with their ability to perform their job,” says Cross. “We would much rather pay time off as a precaution, rather than risk anyone getting sick or breaking down.”

But, while “everyone understands that this is a long haul, and it is actually counterproductive to push yourself to the point of exhaustion,” few employees take advantage of this time, says Cross. 

“So we have to be proactive. … Our staffing coordinators are working constantly to ensure we have backup, and our nurse supervisors are providing guidance to remain healthy both on and off shifts.

“We are encouraging [employees to take] family time, and taking the time to acknowledge the importance of everyone’s role,” he continues. “Probably most important are the heartfelt thanks we are expressing to each other on a daily basis.”

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