Lippincott Nursing Pocket Card

Nurse Engagement and Retention Strategies


Nurse Engagement and Retention Strategies


Nurse engagement and retention are important considerations for nurse leaders as staff dissatisfaction can lead to nurses leaving their place of employment, or even the nursing profession. According to Schroyer et. al (2016), the cost of turnover can be as much as $82,000-$88,000 per new nurse for orientation. The American Nurses Association (ANA) (2019) reports “With more than 500,000 seasoned RNs anticipated to retire by 2022, the U.S. Bureau of Labor Statistics projects the need for 1.1 million new RNs for expansion and replacement of retirees, and to avoid a nursing shortage.” These startling figures demonstrate the need to prioritize nurse retention and develop ways to engage nurses in their current positions to prevent turnover.



Nurse engagement

  • Nurses’ commitment to and satisfaction with their jobs (Dempsey and Reilly, 2016)
  • Must also consider the nurses’ commitment to the organization and to the profession

Nurse retention

  • Focus on prevention of turnover and keeping nurses within their organization (Jones and Gates, 2007)
  • Beneficial to quality patient care and safety, higher patient satisfaction scores, and nurse safety

Risk Factors (Bugajski et. al, 2017; Tyndall et. al, 2019; Phillips & Harris, 2017; Schroyer et. al, 2016)

Factors that can contribute to a lack of nurse engagement and reduced nurse retention include:

  • Lack of educational training
  • Absence of leadership support
  • Stressful patient workloads
  • Limited staffing availability/overtime
  • Restricted job growth
  • Diminished job satisfaction
  • Disputes with management
  • Unsupportive coworkers
  • Low salary
  • Aging workforce
  • Toxic work environment or incivility

These negative factors can lead to:

  • Staff turnover
  • Overtime hours
  • Prolonged unit vacancies
  • Poor quality of patient care
  • Low patient satisfaction
  • Higher patient ratios
  • Nurse burnout/distress
  • High costs for new nurse orientation

Millennial nurses are particularly at risk for turnover. Although they tend to be engaged, they are more likely to move onto a new role due to available opportunities. Personal attention and feedback on their work can help improve or maintain engagement and retention of this generation of nurses.

Steps and Strategies for Nursing Administrators (Koppel et. al, 2017; Tyndall et. al, 2019; Scruth et. al 2018; Phillips & Harris, 2017; Schroyer et. al, 2016)

Nurses who are engaged, especially new graduates, are more likely to stay with an organization longer than two years. Nurse engagement and retention should always be on the minds of those in leadership. Blegen et. al (2017) found that Magnet hospitals had a 92% retention rate compared to the 77% rate of non-Magnet hospitals for new nurse graduates.

The following strategies should be considered to improve nurse engagement and retention:

  • Flexible work hours (i.e. 12-hour shifts)
  • Develop workplace culture
  • Develop a healthy working environment
    • Utilize skillful communication
    • Encourage collaborative relationships
    • Institute staff recognition
    • Prioritize effective decision making for the unit/department
    • Value leadership
    • Ensure appropriate staffing levels
    • Foster emotional intelligence
  • Increase leadership engagement and provide support to staff
  • Make leadership visible and available to staff on the unit
  • Discuss opportunities for growth within the organization
    • Career ladder program
    • Role transitioning
    • Tuition assistance program for advancing education
  • Provide educational opportunities for leadership to learn more on these topics
  • Conduct unit staff meetings to discuss any unit issues or concerns
  • Provide mentorship programs and preceptors for new graduate nurses to the organization
    • Reduces orientation costs
    • Increases leadership and problem-solving skills
    • Increases morale and retention


Collaborating with other leaders and educating one another on ways to connect with staff, be present and supportive, and ensure that staff find meaning and purpose in their role can enhance engagement and retention. It is important to display engaging behaviors, effective communication, and promote a healthy work environment for the staff. Provide guidance, support, and resources to help staff thrive, be engaged, and successful.


American Nurses Association (ANA). (2019). Practice and policy workforce. Retrieved from

Blegen, M., Spector, N., Lynn M., Barnsteiner, J., & Ulrich, B. (2017). Newly licensed RN retention: Hospital and nurse characteristics. The Journal of Nursing Administration, 47(10). doi:10.1097/NNA.0000000000000523

Bugajski, A., Lengerich, A., Marchese, M., Hall, B., Yackzan, S., Davies, C., & Brockopp, D. (2017). The importance of factors related to nurse retention: Using the Baptist Health nurse retention questionnaire, part 2. The Journal of Nursing Administration, 47(6). doi:10.1097/N NA.0000000000000486

Dempsey, C. & Reilly, B. (2016). Nurse engagement: What are the contributing factors for success? The Online Journal of Issues in Nursing, 21(1). doi:10.3912/OJIN.Vol21No01Man02. Retrieved from Periodicals/OJIN/TableofContents/Vol-21-2016/No1-Jan-2016/Nurse-Engagement-Contributing-Factors-for-Success.html

Jones, C. & Gates, M. (2007). The costs and benefits of nurse turnover: A business case for nurse retention. The Online Journal of Issues in Nursing, 12(3). doi:10.3912/OJIN.Vol12No 03Man04. Retrieved from ANAPeriodicals/OJIN/TableofContents/Volume122007/No3Sept07/NurseRetention.aspx

Koppel, J., Deline, M., and Virkstis, K. (2017). The Case for Focusing on Millennial Retention. The Journal of Nursing Administration, 47(7/8). doi:10.1097/NNA.0000000000000495

Phillips, J. & Harris, J. (2017). Emotional intelligence in nurse management and nurse job satisfaction and retention: A scoping review protocol. JBI Database of Systematic Reviews and Implementation Reports, 15(11). doi:10.11124/JBISRIR-2016-003300

Schroyer, C., Zellers, R., & Abraham, S. (2016). Increasing registered nurse retention using mentors in critical care services. The Health Manager, 35(3). doi:10.1097/HCM.000000000 0000118

Scruth, E., Garcia, S., & Buchner, L. (2018). Work life quality, healthy work environments, and nurse retention. Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 32(3). doi:10.1097/NUR.0000000000000376

Tyndall, D., Scott, E., Jones, L., & Cook, K. (2019). Changing new graduate nurse profiles and retention recommendations for nurse leaders. Journal of Nursing Administration, 49(2). doi:10.1097/NNA.0000000000000716. Retrieved from Fulltext/2019/02000/Changing_New_Graduate_Nurse_Profiles_and_Retention.9.aspx