JobsHow a Houston hospital reversed the trend of nurses leaving the profession

How a Houston hospital reversed the trend of nurses leaving the profession

The nursing profession has faced mounting challenges in recent years, with nearly a third of nurses considering leaving the field.

However, some hospitals have managed to reverse this trend through innovative retention strategies. A shining example is Houston Methodist Hospital, which has increased nurse retention rates from 75% to 88% in just two years.

The Nursing Shortage Crisis

High turnover and vacancy rates among nurses lead to negative outcomes like staff shortages, increased workloads for remaining nurses, and lower quality of care.

Texas has higher vacancy and turnover rates than other large states and projects needing 57,000 additional registered nurses within the next decade to meet demand.

With over 500,000 nurse vacancies nationwide expected by 2024, this shortage threatens patient care.

Why Nurses Leave

During the COVID-19 pandemic, nurses faced immense burdens and emotional tolls.

Other top reasons nurses resign are relocation, seeking career advancement, and retirement.

Dissatisfaction with heavy workloads, burnout, poor working conditions, insufficient pay and communication also contribute significantly.

Improving Nurse Retention

Strategies to increase retention include:

  • Flexible scheduling/remote work: Allows better work-life balance. Over 95% of hospitals now offer shift differentials and over 66% provide schedule flexibility/job sharing.
  • Higher compensation: Helps nurses feel valued for their efforts.
  • No temporary staff: Reduces workload for current nurses. Houston Methodist stopped hiring travel nurses, cutting over 200 temporary positions.
  • Career development/specialization: Nurses seek advancement opportunities and specialties like informatics, research or leadership.
  • Improve work culture: Foster positive relationships between nurses and leadership through listening tours, town halls and engagement surveys.
  • Education and training: Invest in residency programs for new nurses and continuing education.
  •  Houston Methodist nurses train for 6 months before working independently.
  • Self-care and wellness: Offer programs to support nurses’ mental, physical and emotional health.
  • Delegate more tasks: Allow nurses to focus on high-level care by delegating other duties to assistants. Educate all staff on scope of practice.
  • Primary nursing model: Assign nurses individual patients to improve accountability and outcomes. But innovative team approaches are also emerging to split workload.

Case Study: Houston Methodist’s Success

Houston Methodist Hospital demonstrated a highly effective nurse retention strategy.

They focused on improving work culture, communication, flexibility, training and compensation. Their nurse residency program, manager accountability, corporate retention strategy and emphasis on self-care were key to success.Nursing Abroad images 14

Nurse Residency Program

New graduate nurses enter a paid 6-month specialized training program before transitioning to independent practice. This produced nurses better prepared to handle workload and stress.

Leadership Buy-In

Hospital leadership made retention a top priority. They implemented corporate-wide retention strategies and trained managers on supporting nurse development and satisfaction.

Manager Accountability

Managers had to report why any first-year nurse left and recommend improvements. This made the nurse experience a shared responsibility.

Work Culture and Self-Care

Surveys, listening tours and town halls identified nurses’ concerns like burnout and emotional tolls. Wellness programs were created to improve coping skills.

Increased Flexibility

Nurses were offered more schedule flexibility, role choices and specialty opportunities. This helped better align work demands with personal needs.

Nursing Abroad ready to launch


Within just two years of implementing these retention strategies, Houston Methodist’s overall nurse turnover dropped from 25% to just 12%. Their first-year nurse retention rate rose from 75% to 88%, retaining over 1,000 nurses who otherwise may have left.

Looking Ahead

The strategies Houston  Methodist used to successfully improve nurse retention and satisfaction can serve as models for healthcare systems nationwide. Investment in nurse residency programs, education, work culture, flexibility and communication are key to both retaining talented nurses and delivering higher quality care. The nursing shortage crisis requires the healthcare industry’s continued focus on supporting and engaging this critical segment of our nation’s essential workforce.

Read More:

“How a Houston Hospital Reversed the Trend of Nurses Leaving the Profession” by William Brangham and Caleb Hellerman, published on Pulitzer Center

“How a Houston hospital reversed the trend of nurses leaving the profession” by PBS NewsHour, published on PBS

“Half of nurses consider leaving the profession, survey finds” by Healthcare Dive, published on Healthcare Dive

Nurses Leaving Workforce: How Will It Impact Patient Care …” by Nurse Journal, published on Nurse Journal

“How a hospital reversed trend of nurses leaving profession” by PBS NewsHour, published on KQED

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