Practices are better at retaining nurses than hospitals, study says

Set hours, stability and opportunities to build relationships with physicians and patients create an attractive workplace.

By — Posted April 19, 2011

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Physician offices may have characteristics that make them attractive employers for registered nurses despite usually paying less than a hospital or a large health system.

"There are some aspects of working in a hospital that can burn nurses out more quickly," said Sanja Licina, PhD, senior director of talent intelligence and consulting with CareerBuilder, an online job search and recruitment company.

RNs work an average of 3.3 years at a physician office before changing employers, according to a CareerBuilder analysis of resumes in the company's database (link). Licina co-wrote the study, which was released March 29.

RNs spent an average of 3.1 years at general hospitals and specialty hospitals before moving on. At 1.8 years, nursing care facilities had the worst retention rate. RNs worked an average of two years at kidney dialysis centers and home health care services.

The report did not analyze why physician offices are better able to keep RNs longer. But people who work in the health care industry said set hours and a greater degree of workplace stability may be the reasons.

RNs at general hospitals earned an average of $67,740 a year compared with $67,290 for physician offices, according to the U.S. Bureau of Labor Statistics. However, experts said the gap may be larger for experienced nurses. Hospitals tend to employ younger nurses, while physician offices employ older nurses.

"Hospitals hire a lot of nurses right out of school, and they can really get a lot of experience very quickly," Licina said. "But in physician offices, the hours are a lot more consistent."

The report's authors concluded that work environment -- more than salary -- was a factor in turnover. A survey of 315 nurses working in a variety of health care facilities, which also was included in the report, found that 35% said salary would be a factor in whether they remain with their employers. But 49% cited too few staffers, 49% cited a lack of advancement, 40% complained of work overload. An organization's poor work culture was listed by 41%

People who run small to midsize practices said nurses are better able to build relationships with physicians and patients than in hospitals. Thirty-two percent of nurses complained about a lack of time with patients.

"Our nurses develop great relationships with patients, and, really, it comes down to your work environment," said Fran Cullotta, administrator of the Midwest Center for Women's Healthcare in Evanston, Ill. "It's important to be able to come to work every day and get along with people that you work with. We try to create an environment where people look forward to going to work and don't dread it. That goes above and beyond the salary and benefits that we can offer."

Administrators at practices said some support is usually possible, even if it is not financial. For example, Cullotta's practice employs an RN who is working to become a nurse practitioner. The practice does not provide tuition reimbursement, but the nurse's work hours are set around her class schedule as much as possible.

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How long will an RN stay?

Turnover, particularly among nurses, has long been challenging for the health care system. CareerBuilder, an online job search and recruitment company, analyzed the resumes of registered nurses in its database to determine how long nurses stay at certain types of organizations.

OrganizationMean RN tenure at last organization in years
Physician offices (except mental health specialists)3.26
General medical and surgical hospitals3.14
Specialty hospitals(except psychiatric and substance abuse)3.09
Home health care services2.09
Continuing care retirement communities2.02
Kidney dialysis centers1.99
Nursing care facilities1.80
All other ambulatory health care services1.92

Source: "TurnoveRX: How to Cure the Retention Problems Ailing Your Health Care Organization," CareerBuilder, March 29 (link)

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