Becker's Hospital Review

44 CMO / CARE DELIVERY The cost of nurse turnover by the numbers By Marissa Plescia T h e COVID-19 pandemic wore down registered nurses, causing many to leave and retire early, leaving vacant spots in hospitals. As a result, hospitals have been paying astronomical prices in turnover costs, according to the "2021 NSI National Health Care Retention & RN Staffing Report." In this report, 226 facilities from 37 states participated and were asked to report data from January to December 2020. e sur- vey covered 501,764 healthcare workers and 144,300 registered nurses. Here are 10 facts and number to know that illustrate the cost of nurse turnover: 1. Since 2016, the average hospital turned over about 90 percent of its workforce and 83 percent of its RN staff. 2. In 2020, the turnover rate for staff RNs was at 18.7 percent, a 2.8 percentage point in- crease from 2019. 3. e average cost of turnover for a bedside RN is $40,038 and ranges from $28,400 to $51,700, causing a hospital to lose $3.6 mil- lion to $6.5 million per year. Each percent change in RN turnover costs or saves the av- erage hospital $270,800 per year. 4. Hospitals in the Southeast had the high- est RN turnover rate of 24.9 percent, a 7.2 percentage point increase from 2019. e Northeast had the lowest turnover rate of 13.2 percent, a 0.6 percentage point de- crease from 2019. 5. Hospitals with 200 to 349 beds had the highest RN turnover rate of 22.9 percent, a 5.8 percentage point increase from 2019. Hospitals with more than 500 beds had the lowest turnover rate of 17.4 percent, a 2.1 percentage point increase from 2019. 6. RN turnover depends on specialty. Step- down had a turnover rate of 24.4 percent in 2020, compared to 18.5 percent in 2019. Behavior health had a turnover rate of 22.7 percent in 2020, compared to 20.6 percent in 2019. Emergency had a turnover rate of 20 percent in 2020, compared to 18.5 percent in 2019. 7. It also depends on tenure. About 24 per- cent of RN turnover are those in their first year. ose with more than five years had a higher level of commitment, accounting for about 14 percent of turnover. 8. e top three reasons for RNs resigning were relocation and career advancement tied for first and retirement as the third reason. is is the first time retirement has been in the top three. 9. e RN vacancy rate is almost a full point higher than 2020 at 9.9 percent, and 62 per- cent of hospitals have an RN vacancy rate of higher than 7.5 percent, brought on by the economy and COVID-19. 10. Hospitals are turning to travel nurses, who receive an average hourly rate of $120 an hour. For every 20 travel RNs eliminated, the average hospital can save $3.1 million. According to Sumner College in Portland, travel nurses made on average $1,673 per week pre-pandemic. Now, they can get more than $4,000 per week in some cases. n As physician tied to misinformation seamlessly renews license, the extent of medical boards' power is called into question By Molly Gamble T he Federation of State Medical Boards warned in July 2021 that physicians could risk their medical licenses by furthering COVID-19 misinformation online and in the media. One physician's experience in Nebraska raises questions about how effectively medical boards can regulate the sharing of misinformation. Lee Merritt, MD, is an orthopedic surgeon who has appeared on talk shows and in lecture venues throughout the pandem- ic, which she contends is a vast global conspiracy to exert social control, among other claims, NPR reported. Despite the federation's July 2021 warning to physician misinformers, Dr. Merritt renewed her medical license in Nebraska in October 2021. "Documents obtained through a public records request by NPR showed it took just a few clicks: 12 yes-or-no ques- tions answered online allowed her to extend her license for another year," according to the report. Critics say the development shows how powerless medi- cal boards are in protecting the public from a small group of physicians who insist on furthering misinformation. Federation President Humayun Chaudhry, DO, told NPR the license renewal process is designed to be easy for physicians. "It's a procedural step that is usually automatic and not even deliberated upon by the board," he said. He said boards don't have the capacity to review the re- newals that come up each year, and that a failure to renew would be equivalent to a license suspension, which can- not be done without due process. Dr. Chaudhry noted that renewals do not prevent boards from taking action. Neither Dr. Merritt nor Nebraska's Department of Health and Human Services, which oversees its medical board, responded to NPR's request for comment. n

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