In the 2023 study, “Connection is Retention: Lessons from Leaders with Unusually High Nurse Retention,” Crucial Learning and The American Organization for Nursing Leadership (AONL) partnered up to better understand what is driving the nursing turnover crisis in our country and what can be done to help.
An analysis of 1,090 first-hand stories from nurse managers and clinical staff found that overwhelming burnout and feelings of despair have become the default for many nurses. And while particularly detrimental in health care, additional research efforts confirm that burnout and stress is not unique to health care. Employees everywhere are struggling.
But what can be done? The resultant study found one potent factor that could substantially improve the workplace for nurses. The findings from the study also offer valuable takeaways for any leader, in any industry, battling burnout and turnover. In this article, we’ll review the three keys nurse managers can use to reduce burnout on their teams: care, growth and help.
The Impact of Managers
The study analyzed nurse managers with the lowest nurse turnover in their departments despite facing similar stressors to their counterparts in high-turnover departments. These outliers were equally busy, managing similar departments and subject to equivalent labor market conditions. And yet they retained nurses at a far higher rate. The key difference between these managers and their higher-turnover peers was a focus on connection.
These managers focused on three keys to building connection — care, growth and help. When they did, their nurses were 81% more likely to intend to stay in their positions indefinitely, according to the study. Ultimately, nurse managers who create a culture of connection characterized by offering care, growth and help can be remarkably better at retaining their workforce.
Care: “I feel a sense of belonging and believe my manager cares about me as a person.”
Consider this example:
“My manager holds regular zoom drop in opportunities for staff to connect with her. These may be general opportunities to raise any topic of concern or focused on specific topics, such as security on the unit.”
- Growth: “My manager takes an active interest in my personal and professional growth.”
Consider this example:
“I had a new graduate nurse with several medication errors. We put her on a performance improvement plan but also spent a lot of time with her to talk through some job-related anxieties and the importance of the work we do and why we have to have so much focus on safety. This was a few years ago and this nurse truly blossomed after this experience. She became a leader on the unit and one of our most passionate workers. She has remained connected to us even though she has since moved out of state. She is doing very well on her new unit.”
- Help: “My manager steps in to help when I need it.”
Consider this example:
“When several team members left on unexpected FMLA, our manager personally helped the team with the additional workload and put some projects on hold as they realized there weren’t any resources to work on them.”
What Works
In a review of hundreds of examples of nurse experiences that led to both connection and disconnection, a handful of manager best practices emerged.
- Connection is about feeling, not frequency. Effective connection shouldn’t just be a checkmark on a to-do list, it should include thoughtfulness, attentiveness and personalization.
- Always be collecting dots. Hospitality guru Danny Meyer creates unique moments of connection with his hundreds of thousands of daily guests by admonishing team members to always be collecting dots. This means that in every interaction you have, listen and look for hobbies, interests or other bits of personal information people share. Then use them to help the team member know you care. For example, if you find that someone’s son is ill, take the parent a treat to give to the child or let the parent go home early.
- Connection = sacrifice. What you care about is what you spend time and effort on. You may have many responsibilities, but when you sacrifice your time to care for others, they’ll know you value them. The authors of the New York Times bestseller “Crucial Influence” say, “People aren’t likely to trust your words until you demonstrate your willingness to sacrifice old values for new ones. You’ll need to create visible and believable evidence by sacrificing time, money, ego and other priorities before people will take similar risks themselves.” It doesn’t have to be a grand gesture — just make an effort to reach out and connect.
- Keep the promises you make. Even the smallest broken promises damage perceptions of care, growth and help far faster than equivalent promises kept. Make your promises clear, then be exact in keeping those commitments. In an article by Harvard Business Review, Donald Sull and Charles Spinosa suggest that promise-based management or crafting and keeping commitments clearly can create greater trust and enhance performance. When something does fall through the cracks, take initiative, own up to the mistake and apologize.
These best practices are not meant to pile on more work and responsibility for already overloaded managers. Rather, they are actionable items — real skills — for helping your people feel valued. When practiced intentionally and repeatedly, these recommendations will streamline your efforts in helping employees feel less stress and burnout. You’ll create a happier, more resilient, and more committed team by showing care, growth and help.
