The Calm before the Storm: Combating Nurse Leader Turnover Post COVID

By: Jamie L. Brennan, RN, MSN, CMSRN, NE-BC

It may come as no surprise that healthcare organizations experienced more turnover in the year 2020 than any other year. Throughout 2020 and continuing into 2021, many nursing leaders experienced the stress of a pandemic, staff burnout, anxiety and death in ways that most could have never imagined they would in their career. With COVID admissions decreasing in many healthcare organizations, nursing leaders experience what many may consider to be signs of post-traumatic stress disorder (PTSD). Signs of PTSD include: intrusive thoughts, sleep disturbances, hypervigilance, “brain fog” and flashbacks to the time when they were feeling most stressed during their job. As a nursing leader, juggling the day to day responsibilities of leading a team who experience these symptoms as well as experiencing them personally can lead to significant burnout. The natural transition for organizations is to get back to “normal,” but in considering what has happened in the past 12 months, there is no normal. It is important for organizations to be aware that jumping back into what we thought we were can lead to stress and anxiety for those who were in the thick of what may be the worst year that many clinicians have experienced in their careers. Establishing what a new normal looks like for not only front-line staff but primarily focusing on nursing leaders is essential in decreasing turnover in this essential position. As many of you may have experienced and are probably guilty of saying, “I’m fine” has become a normal response to “how are you,” especially among healthcare leaders. It is essential to begin meaningful conversations with your leadership team and not just ask the question, but mean it. Encourage your leaders to set boundaries between their personal life and their work life and allow them to enforce those boundaries without fear of retribution or guilt for not “being on call 24/7.” It is impossible for a person to function 24/7 and achieve a work-life balance, and as leaders, it is our job to ensure the boundaries are respected. Offering therapy services and mental health assistance is surrounded by a stigma, especially in healthcare, and we have the ability to speak up and allow our staff to “not be OK.” As leaders in organizations, the few things that we can control in supporting our staff to prevent burnout and ultimately decrease turnover may seem minimal, but are extremely impactful.

1.)    Be an active participant in your leader’s success: Create an atmosphere that allows for open dialogue, understanding and balance. Has your leader been trained? Do they have the ability to ask questions?

2.)    Encourage breaks during work hours: Allowing your leaders and their staff to know the importance of breaks and the risks of overworking themselves is essential to ensuring balance. Although the expectation of ensuring breaks is typically focused on front-line staff, does your manager take breaks? Do they know it’s OK and should be encouraged?

3.)    Improve workflow: Take suggestions seriously, step back, review the validity of non-negotiables. Do they make sense? Is it something that is “nursing,” or is this something that should be handled by another department leader?

Focusing on leadership development, mental health and realistic expectations can mean the difference between having a leader to grow and having a vacancy to fill. Focus on addressing the things within your control and give your leaders “permission” to create a balance that will ensure their success and the success of your organization. Be realistic, be supportive and be successful.