County General Hospital is a 200-bed facility located approximately 150 miles outside Chicago. It is a regional hospital that draws patients from surrounding farm communities. Like most hospitals, County General faces the difficult task of providing high-quality care at a reasonable cost.

One of the most difficult obstacles encountered by the hospital is finding and retaining qualified nurses. The annual turnover rate among nurses is nearly 100 percent. A few of the nurses are long-term employees who are either committed to County General or attached to the community. Employment patterns suggest that many of the nurses who are hired stay for only about six months. In fact, County General often appears to be a quick stop between graduation from college and a better job. Many who leave acknowledge that they were contacted by another hospital that offered them more money. Exit interviews with nurses who are leaving similarly suggest that low pay is a concern. Another concern is the lack of social atmosphere for young nurses. Nurses just finishing college, who are usually not married, complain that the community does not provide them enough oppor- tunity to meet and socialize with others their age. Hospital administrators are afraid that paying higher wages will cause finan- cial disaster. Big insurance companies and Medicaid make it difficult for them to increase the amount they charge patients. However, the lack of stability in the nursing staff has caused some noticeable problems. Nurses sometimes appear to be ignorant of important hospital procedures. Doctors also com- plain that they spend a great deal of time training nurses to perform proce- dures, only to see those nurses take their new skills someplace else.

Turnover is high at almost every facility where nurses are employed. What aspects of nursing make turnover for nurses higher than for many other jobs?

What programs do you suggest County General might implement to decrease nurse turnover? Be specific.

How might County General work with other hospitals to reduce nurse turnover?