Effective Leadership and
Management in Nursing
EIGHTH EDITION
CHAPTER
20
Managing
Absenteeism,
Reducing Turnover,
Retaining Staff
Learning Outcomes
1. Explain absenteeism.
2. Discuss ways to manage absenteeism.
3. Describe how nursing turnover affects
the organization.
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Learning Outcomes
4. Explain voluntary turnover.
5. Discuss what organizations can do to
improve retention of nurses.
6. Discuss what managers can do to help
retain nurses.
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Absenteeism
• Two kinds:
– Voluntary
– Involuntary
• Measured in terms of:
– Total time lost
– Absence frequency
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Motivation
• Employee motivation to attend is
affected by:
– The job itself
– Organizational practices
– Absence culture
– Generational differences
– Management
– Personal characteristics
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Managing Absenteeism
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Child care center
Transportation assistance
Health promotion
Programs for alcohol and drug abuse
Coaching
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Managing Absenteeism
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Job enrichment
Stress reduction
Making excellent attendance the norm
Advancement opportunities
Improved coworker relations
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Managing Absenteeism
• Selecting employees who will be
satisfied and committed
• Role modeling
• Discussing attendance during
performance appraisal
• Rewarding good attendance
• Enforcing absenteeism policies
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Cost of Turnover
• Cost of hiring and/or temporarily
replacing a nurse is sizable
• Effects on nurses who remain at job:
– Morale
– Overtime
– Postponement of new ventures
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Cost of Turnover
• Positive aspects of turnover
– Performance may improve
– Administration may be challenged to
improve work environment
– Newly hired nurses may be more
enthusiastic
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Turnover Factors
• Did the employee leave of her or his
own accord, or was the person asked to
leave?
• Was the employee who left performing
at an exceptional or mediocre level?
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Turnover Factors
• Did the employee leave for career
development or because of
dissatisfaction with the organization?
• Will the employee be easy or difficult to
replace?
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Turnover
• Reducing turnover and retaining staff
begins with recruitment and selection
• Length of stay at previous jobs is an
indicator of how long an individual will
stay at this job
• Perceptions of ease and desirability of
movement influence turnover
• Job satisfaction influences turnover
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Ease of Movement
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Education
Area of specialization
Age
Geographic mobility
Contacts at other hospitals
Transportation
Job openings at other organizations
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Job Satisfaction Factors
• Relationships with nurse manager,
staff, patients, and physicians
• Shift worked
• Fit between nurse values and
institutional culture
• Expectations of practice setting
• Compensation level
• Equal/fair rewards and punishments
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Criteria for Healthy Work
Environment
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Skilled communication
True collaboration
Effective decision making
Appropriate staffing
Meaningful recognition
Authentic leadership
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Improving Salaries
• Salary compression
– Results in salaries of long-term
employees being at or below that of
less-experienced nurses
• Pay scales must reflect achievement
and accomplishment
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan
Strategies to Retain Staff
• Provide a realistic job preview to new
hires
• Facilitate movement within the
organization
• Improve work environment
• Coordinate with other managers to
influence organizational policies
• Adapt to turnover rate
Effective Leadership and Management in Nursing, Eighth Edition
Eleanor J. Sullivan