Cost Containment Corner – Avoid an excessive level of nursing staff turnover

December 23, 2015
by Sean Ruck, Contributing Editor
If you listen to real news radio on any given day, there’s usually mention of the stock performances, averages and the ups and downs of the economy. Somewhere in that information will be mention of job growth. There may also be mention of it being an “employer’s market” or a “job seeker’s market.” That topic — the employer versus employee — is an important one to focus on. While it’s understandable that a job marketplace suffering from high unemployment could be considered an employer’s market — they have a larger pool of applicants to pick from, that group also knows there’s greater competition, so it may not negotiate as aggressively — it should be understood that the employer isn’t necessarily a clear winner. There may, in fact, not be a winner.

First, consider — you’ll be taking a chance on an unknown. How much effort will be required to get to know the potential employee before making the decision to bring them on board? How much profit will be lost for each day you’re without? How many customers will be disappointed with the experience they’ve had with your understaffed organization?

Next, if you’re replacing and not expanding staff, consider what you may be losing. Even if the new hire is a good hire, how long will it take to get to the level of institutional knowledge your departing employee would be taking away? Even things as simple as knowing where to find files or reports can save countless hours — and you know the adage and formula…time equals money.

There’s also the risk of potential burnout among your remaining staff as they struggle to pick up the work added to their list. So what’s a company to do? The answer is easy — match the value of the employee with the value of the benefits (salary, health insurance, profit sharing, flextime, etc.). The answer is easy, but the background work can be challenging. It requires a careful look at the actual expenses of each program you’re running and the expectations of the profitability or value from the position you’re encouraging someone to stay in.

Make sure to balance the costs of increasing benefits against the other costs you’ll encounter with a new hire — the upfront costs of attracting talent is a starting point. So, online job postings, paying a placement firm or talent agency, any costs for administrative work involving adding new people to existing plans — things add up quickly. And keep in mind the increase to employee benefits doesn’t necessarily carry a dollar amount.

For instance, a 2009 study conducted by SuccessFactors, a group that explores employee retention and other like-issues, says key factors in driving a nurse away from a job include lack of recognition for a job well done, lack of direction and support from upper management and low collaboration with co-workers. All these things could cost money to address, but some investigation on a facility’s part is likely to turn up low-cost or no-cost solutions.

Fortunately, there is an incredible amount of information available via studies from organizations and industries of every stripe that will help you to determine your employee’s value and your compensation packages, to determine if the two are compatible. In fact, in a decade-old survey of 610 CEOs by Harvard Business School, the cost of a new hire can often be substantially higher than retention. According to the report from that survey, the average typical mid-level manager takes about six months to reach their break-even point — that is, the point where the money a company invests in the employee is at the same value level as the return the employee is giving.

Smart companies get to that break-even point much faster by working to put processes into place to help the new hires get up to speed faster. Those smart companies would have also exhausted all other options that would have precluded requiring a new hire. If it was a question of a raise, for example, would bumping up the salary of the on-staff employee break the bank? If it takes roughly six months for a middle manager to hit the break-even, but the previous employee was at that point — or even worse, if they were strong drivers of profitability, then you may have lost six months of profit.

For specialties like health care, which require specific, focused skills and technical knowledge, the break-even point might be even further out. A number of studies on the cost of nurse turnover give estimates at (an admittedly wide-ranging) $22,000 to $64,000 per nurse. And losing two nurses goes beyond doubling that number if you keep in mind the previously mentioned problem of the additional workloads and stress on remaining staff.

To top all the troubles off, there’s no guarantee the situation won’t repeat itself after the new hire builds his or her value through the knowledge and skills they acquire while working for you.

However, the solution doesn’t need to be as extreme as that introduced by Gravity Payment’s CEO Dan Price, where he announced that the minimum wage of any employee at his 120-person company would be $70,000 (he took a pay cut from $1.1 million to that same $70,000 to help fund the change). But there does need to be a solution introduced. It’s just smart business.