Nurse turnover in older adult social care: how to enhance nurse retention

Nurse turnover is one of the most pressing challenges facing social care organisations today. With the number of nurses entering the workforce declining and demand for older adult care expected to rise over the coming decades, retaining experienced nurses in this sector is crucial for maintaining sustainable, high-quality social care. 

But why are nurses in older adult care switching employers? I conducted a study with Dr Manhal Ali and Professor Jonathan Winterton (Leeds University Business School) to shed light on this phenomenon. I conducted 56 interviews with Dutch older care nurses to understand their turnover motives. 

The insights of this study provide social care organisations with a roadmap for developing retention strategies tailored to the unique needs of nurses in this field. 

The most common reasons nurses switch employers in older adult care 

1. Tense work environment 
   Nurses in the study frequently cited a tense work environment as a key reason for switching employers. The shortage of nursing staff, combined with high demands in healthcare, created a strained atmosphere. Nurses described a lack of collegial stability, which led to constant complaints, frustration, and an overall negative atmosphere. 

2. Desire for personal development 
   Nurses also expressed a strong desire for personal growth and development, especially for nurses with significant tenure. For many, switching jobs provided an opportunity to work in new settings, observe how other organisations operate, and learn new skills. 

3. Lack of work challenge 
   The repetitive nature of some roles in older adult care made many nurses feel under-challenged. Caring for the same patients over long periods, coupled with performing tasks below their education level, left many feeling that their skills were not being fully utilized or appreciated. 

4. Demanding workload 
   Due to nurse shortages, many were asked to take on additional shifts. Nurses felt they had little choice but to accept these extra shifts for care continuity, which exhausted them mentally and physically. 

5. Unacknowledged voice 
   Another key reason for turnover was the feeling that their voices were not being heard. Nurses reported that leaders either ignored or failed to involve them in decision-making processes, leading to frustration and disengagement. 

What can social care organisations do to improve nurse retention? 

Social care organisations have the opportunity to address these pain points and create a more supportive environment that retains nurses. Here’s a look at actionable strategies: 

1. Foster a supportive work culture 
   Leaders should prioritise creating a positive, open work culture where nurses feel supported and valued, for example, by hosting regular team-building activities to strengthen collegial relationships. 

2. Offer professional development opportunities 
   To retain nurses eager for professional growth, social care organisations should provide career development pathways that allow nurses to upskill and take on new responsibilities. Also, social care organisations can organise in-house training programmes or partner with educational institutions to offer advanced certifications. 

3. Address workload management 
   Nurse retention also depends on effectively balancing workloads. Strategies to manage this include implementing staffing models that reduce the reliance on overtime shifts, and encouraging technology to streamline administrative tasks and free up nurses’ time for patient care. 

4. Promote collaborative leadership 
   Finally, leadership needs to be more collaborative and responsive. Social care organisations can establish regular forums for nurse feedback where leaders actively listen and respond to concerns. They can also encourage shared decision-making, involving nurses in policy creation, workflow adjustments, and other key organisational changes.  Healthcare organisations should provide leadership training for nursing leaders to ensure management is equipped with the tools to effectively support and inspire their teams. 

By addressing work culture, development opportunities, workload management and leadership practices, social care organisations can create a more engaging, satisfying workplace that encourages nurses to stay for the long term.