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Volume 15, Number 3 Summer 2008
Retaining Experienced Staff: Using the Evidence
to Support Nurse Retention Activities
Suzy Evans, BSN RN CPN, TCH Clinical Nurse Council, Roxie Foster, PhD RN FAAN
Background: The Clinical Nurse Council (CNC) at The Children’s Hospital (TCH) is committed to
representing and supporting nursing staff. The Council is comprised of approximately 30 nurses from
inpatient units, outpatient clinics, the emergency department, and all Network of Care sites. In an
ongoing effort to make TCH one of the best places to work, the CNC designated nursing retention as a
2008 goal. To guide retention activities, the Committee surveyed staff nurses about those aspects of
their work environment that most affect their intent to stay at TCH.
Methodology: A 15 question Zoomerang survey was sent to all Level I-IV staff nurses and Clinical
Coordinators in April 2008 (N = ~800). The survey included descriptive questions, rating scales, and
open-ended questions. Analysis involved descriptive statistics for numbered results and a
comprehensive qualitative analysis of text data.
Findings: Almost 75% (N = 596) of nurses responded from across the organization. A majority of
respondents worked fulltime (70%) and 60% worked the day shift. Forty-one percent had worked at TCH
less than 5 years, 26% had been employed from 5 to 10 years, and 14% had 20 or more years
experience at TCH.
Staff rated their department morale and their own morale on a 0-10 scale. For the department morale,
50% of responses fell between 6 and 10. They rated their own morale somewhat higher with 65% of
scores falling between 6 and 10.
Staff was also asked to indicate the importance of 15 factors in “keeping you at TCH.” Over 90% of staff
indicated that 7 of the factors were either quite important or very important (Table 1). Fewer staff
assigned a score of very important to educational opportunities (49%), patient population (46%),
friends/peers (46%), and relationship with direct supervisor (42%).
Table 1. Selected retention factors in order of importance
Not at all A little Quite Very
Factor important important important important
n % n % n % n %
Competitive salary and benefits 8 (1) 29 (5) 97 (16) 460 (77)
Satisfaction with schedule 2 (0.3) 18 (3) 122 (20) 454 (76)
Teamwork 2 (0.3) 17 (3) 134 (23) 441 (74)
Recognition for expertise 6 (1) 35 (6) 192 (32) 363 (61)
Autonomy in nursing role 5 (1) 25 (4) 211 (35) 355 (60)
Opportunities for development 7 (1) 42 (7) 202 (34) 344 (58)
Voice in how unit operates 7 (1) 48 (8) 206 (35) 335 (56)
For information related to nursing research at The Children’s Hospital,
please contact Anne Marie Kotzer, PhD RN CPN FAAN at (720) 777-6984 or kotzer.annemarie@tchden.org
Conversely, staff was asked how often each of 11 issues/stressors had made them think of leaving
TCH. Not feeling appreciated was the reason staff were most likely to consider leaving (n = 314 or
52.6% for responses of “quite often” or “very often”).
In an open-ended question, nurses were asked what empowerment meant to them. They responded
that it meant being empowered to: (a) practice with autonomy, (b) participate in decisions, and (c) make
a difference. Further, nurses were empowered by: (a) having a voice, (b) being heard, (c) being trusted,
(d) having adequate resources, and (e) having opportunities for growth. Staff indicated the importance of
recognition factors in this order: monetary bonus (83%), SEEDS (67%), verbal thank you (45%), written
thank you (43%), gift certificates (39%), food (9%), and recognition in TCH News (5%).
Two themes emerged from the open-ended question about the most important reason to stay at TCH:
Personal Satisfaction (pediatric population, job satisfaction, salary/benefits, schedule, co-workers, and
seniority) and Organizational Satisfaction (TCH mission, recognition, hospital’s reputation, quality of
care, and hospital culture). Another open ended question addressed changes necessary to keep staff at
TCH. Four themes emerged including Valuing the Professional Nurse (competitive salary/benefits,
tenure, appreciation/recognition, and career development opportunities), Improving the Work
Environment (staffing, scheduling, leadership, business philosophy, interdisciplinary relationships, and
physical structure), Reducing Hassles, (improved commute and improved parking), and No Changes
Necessary.
Implications: The Clinical Nurse Council is committed to further evaluating survey responses and
developing action plans for the top issues. The CNC plans to share this information with the Human
Resources Department and Service Excellence Teams with the expectation that collaborative problem
solving can best address retention needs.
UPCOMING EVENTS
Dissemination Team
NURSING GRAND ROUNDS
Meets every other month (3rd Thursday, 8:00 –
11:30 a.m. – 12:30 p.m.
9:00 a.m.) Sunlight Peak Conference Room
TCH Conference and Education Center
Next Meeting: October 16
2nd Floor
November 20
December 18
October 22
Evidence-Based Education: Innovative Evidence-Based Practice Teams
Teaching Tools Created by Students Research & QI
Nursing Student Panel Meets every month (1st Thursday, 7:30 –
8:30 a.m.) Cottonwood Conference Room
November 19 Next Meeting: November 6
A Model to Measure the Complexity of Nursing December 4
Workload: A Comprehensive Test
Janet Houser, PhD RN Clinical Expertise
Department of Health Services Meets every month (2nd Thursday, 7:30 –
Administration 8:30 a.m.) Sunlight Peak Conference Room
Regis University Next Meeting: November 13
December 11
December—Canceled
Happy Holidays! Patient/Family Values and Preferences
Meets every month (4th Thursday, 7:30 –
NURSING RESEARCH COUNCIL 8:30 a.m.) Cottonwood Conference Room
Meets quarterly (4th Thursday) Next Meeting: November TBD
9:30 – 11:00 a.m. December TBD
Mt. Wilson Conference Room
Next Meeting: October 23
