To identify top opportunities for improving retention of early-tenure millennial nurses, Advisory Board researchers analyzed millennials' engagement survey responses (including open-ended feedback) and conducted interviews with nursing and human resource (HR) leaders across the country. Further detail on the research background and methodology was reported in Perspectives on Engagement in the July/August 2017 issue of The Journal of Nursing Administration.1 Authors distilled their findings to 2 steps that leaders should pursue. To improve retention, organizations should: 1) give millennials an early sense of accomplishment in their role; and 2) identify and redirect millennial nurses who are considering leaving.

Give Millennials an Early Sense of Accomplishment

Leaders can improve retention of younger nurses by helping them feel growth early in their tenure. There are 2 key points in time that early-tenure nurses may feel they lack sufficient professional growth. The 1st is when the new nurse completes his or her formal on-boarding or residency program. Most organizations offer supports for new hires that include training sessions and preceptors. However, new nurses typically continue to encounter challenging situations in the following few weeks or months on the job. If staff members feel overwhelmed by these situations, they are more likely to leave. Nursing leaders should ensure that staff members have a safe environment to learn and grow throughout their 1st few years. Several organizations across the country have done this successfully by ensuring that nurses have go-to resources for emotional support, for example, through unit-based mentor programs that last beyond a nurse's 1st year or pairing nurses with physicians or staff members in disciplines outside of nursing to increase their comfort working with an interdisciplinary team (and to build a sense of community). Other organizations have focused on building a welcoming culture, such as by motivating staff members to support new colleagues through turnover performance goals.

The 2nd point in time nurses may feel they lack growth is when they feel mastery in their current role. This can happen as early as 4 to 5 months into their tenure. A review of open-ended survey responses from employees younger than 35 years collected in Advisory Board Survey Solutions' Employee Engagement database revealed that within 3 years of tenure, some nurses are already reporting that they feel "stuck" or cannot find growth opportunities. Most hospitals and health systems can provide young nurses with a range of experiences, such as by facilitating transfers to different units or care settings. However, traditional HR practices and tenure policies often make it difficult for staff members to change positions, even when a nurse's preference aligns with a current job opening.

Interviews with nursing leaders yielded several innovations to help direct young nurses into roles that appeal to them. For example, 1 acute care hospital in the Southeast surveys staff members annually about what unit they would like to work on. Managers facilitate nurse transfers between units using quarterly "Draft Day" meetings to review staff members' preferences, evaluate readiness for the new role, and establish next steps. The goal is to improve retention by following through on all transfer requests while giving managers input regarding who can transfer and when the transfer will take place. Other organizations have designed roles that provide greater breadth of experience, such as roles where nurses split time between 2 different units or care settings.

Identify-and Redirect-Staff Members Headed Toward the Exit Ramp

In today's competitive labor market, staff members naturally wonder if better opportunities exist elsewhere. To get ahead of departures, leaders must identify and redirect millennials who are thinking about leaving. The good news is that staff members who are considering resignation often display subtle changes in behavior or other signs that suggest impending turnover. Managers are in the best position to spot these retention risk factors, but often do not know how to uncover less obvious signs or do not prioritize detection amid their other work.

Leaders can improve manager effectiveness by providing managers with specific criteria to assess risk. For example, HR leaders at a midsized health system in the Southeast give managers specific questions to guide check-ins with early-tenure staff members, along with guidance on what answers suggest flight risk. For managers with large spans of control, an alternative to 1-on-1 conversations with all staff members is to provide an assessment tool that managers can use to score flight risk for their most critical direct reports.

Once an organization has equipped its managers to detect retention risk, it should focus on making strong attempts to reverse impending or actual resignations. When an employee shares the decision to resign, managers often miss or avoid the opportunity to discuss the true cause, which may be something that the organization can address. This is understandable given the employee's potential motivation to avoid offending the manager and the manager's reluctance to pry. One way to improve detection of the true cause is relieving managers of the responsibility and giving it to a neutral 3rd party. For example, managers can introduce HR to have these discussions with resigning staff members before they leave. Human resources can offer alternatives and potentially convince the nurse to stay.

A 2nd way that leaders can increase the number of reversed resignations is to target employees who have left the organization but would be an asset if they returned. Numerous organizations have successfully re-recruited former employees by reaching out to nurses who left in the last year to share updates from the organization and gauge interest in returning.

Conclusion

Organizations that have successfully reduced turnover among early-tenure millennials implement 2 key strategies: they help them to feel an early sense of accomplishment and identify-and where possible, redirect-nurses considering leaving. By accounting for the common reasons nurses leave early in their tenure and installing mechanisms to dive deep into individuals' reasons for leaving, leaders can minimize turnover costs while building a committed, loyal workforce.

Reference