Two recent nursing workforce studies by the Florida Center for Nursing at the University of Central Florida show that, even during a recession, retaining nurses is still a huge problem.

 

While the growth rate in new hires surpassed expectations, the state still faces steep challenges in retaining nurses and counteracting the trend in an aging workforce, according to the study. And the hardest place to retain nurses was in nursing homes.

 

In the two-year period from 2008 to 2010, for every five Registered Nurses that Florida gained, three nurses left the state or the profession. The state gained more than 27,600 RNs, but at the same time lost nearly 16,200 RNs. There are approximately 160,000 total RNs in Florida.

 

For Licensed Practical Nurses, the figures were worse. Florida lost roughly seven out of every 10 LPNs the state gained. The state licensed more than 10,500 LPNs in the past two years, while it lost 7,615. There are approximately 50,000 LPNs working in Florida.

 

Also, the average age of Florida nurses increased a full year from three years ago. Now, 46.5 percent of nurses are more than 50 years old.

 

Jennifer Nooney, PhD, associate director for research at the Florida Center for Nursing, said she and her colleagues were surprised at the high attrition rates given the economic recession. "We thought state and professional attrition would calm down, but there seems to be about as much churn in the workforce as there has ever been," Nooney said.

 

The study was based on licensing records renewed every two years so there's no way to know exactly why nurses left. Nancy Dinon, director of human resources for Orlando Health, said her own internal surveys show nurses mostly leave to relocate. That's often because nurses have an easier time finding employment, she said.

 

"For the past 8-to-20 months, they've often been the primary bread winner for their family and sometimes their extended family," Dinon said. "If their spouse or partner secures employment somewhere else, they are more mobile and will relocate."

 

Willa Fuller, RN, executive director of the Florida Nurses Union, which predominantly has a presence in South Florida, said nurses leave the profession for a variety of reasons, including stress and bureaucratic requirements.

 

"Maybe the jobs need to be re-engineered so nurses can focus on what they really want to do, why they really became nurses, because they care about patients," Fuller said. "A lot of times at the end of the day what you felt like is that you've shuffled patients around and been on the phone."

 

Fuller and her union have pushed over the years for a state law requiring hospitals provide nurses a voice in safe staffing levels, which is another factor that can increase nurse job satisfaction and retention Fuller said. A version of the bill in the most recent legislative session failed to pass out of committee.

 

"Even before it was a fight it (nurse staffing levels) was one of the factors that impact what nursing is like," Fuller said.

 

Hospital administrators such as Tammy Long, director of nursing resources at University Community Hospital in Tampa, are charged every day with the goal of retaining nurses. Long said offering a wide variety of opportunities among five campuses gives the hospital's roughly 1,000 nurses a lot of flexibility and decreases burnout.

 

"You can do anything you want in nursing," Long said. "We just need to get creative in providing them that opportunity."

 

She said partnerships with local universities and nursing schools have helped along with incentives for those already employed at the hospital to receive advanced degrees. One woman who started in the deli is now a charge nurse on a cardiac unit, Long said.

 

"I can tell you endless stories of people we hired into entry level positions and now they are nurses," Long said.

 

At Orlando Regional Medical Center, Beth Rudloff, RN, chief nursing officer, said her hospital has experienced about a 9 percent turnover rate. For the past eight years, they have focused on retaining graduate nurses through a three-month orientation training to help transition new hires into their jobs.

 

"We have had terrific results with this program," Rudloff said. "Many hospitals struggle with retaining new nurses. We don't struggle with that at all. We really see these nurses stepping up to leadership roles."

 

Rudloff said the hospital also works to keep open communication among bedside nurses and administrators. The hospital has what they call unit practice councils where they meet once a month to discuss certain issues.

 

"It's great because I can get input from almost every unit each month about how things are going," Rudloff said.

 

Workplace satisfaction is still a large factor for nurses leaving the profession, said Nooney. Her group is currently offering small grants to hospitals that put together an innovative project to retain nurses with a strong way to measure its effectiveness.

 

"Part of the problem for hospitals is that they are all doing unique things," Nooney said. "It's like reinventing the wheel. It seems there are a lot of hospitals doing a lot of interesting things but there is not enough evidence-base for the best way to increase nurse satisfaction and retain nurses."