Journal of Hospital and Healthcare Administration (ISSN: 2688-6472)

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Strategies to Promote Nursing Retention Among Millennials

Authors: Shannon Harris1*, Lori Prewitt Moore2, Tochie Lofton3

*Corresponding Author: Shannon Harris, DNP, FNP-BC, TTS, CCRN, Nurse Practitioner, Diagnostic Medical Clinic, Mobile, AL. 1700 Springhill Avenue Suite 100, Mobile, AL 36604, Alabama, USA.

Received Date: 16 December, 2021

Accepted Date: 04 January, 2022

Published Date: 08 January, 2022

Citation: Harris S, Moore LP, Lofton T (2022) Strategies to Promote Nursing Retention Among Millennials. J Hosp Health Care Admin 4: 152. DOI:

The effect of registered nurse (RN) turnover causes a profound increase in costs to healthcare facility’s’ margins and a strategies to promote RN retention is essential. In 2021, the nurse labor force shortage has continued to increase with 37.4% of hospitals feeling the squeeze [1]. Healthcare facilities are experiencing an increase in RN position vacancy rates due to the pandemic. The national hospital turnover rate is currently 19.5% and a third of hospitals in the United States are reporting a vacancy rate of greater than 10% [1]. The RN Recruitment Difficulty Index remains elevated at the level of an 89-day period to hire an experienced RN. This finding is evidence that the RN shortage will persist, and RN recruitment will continue to be a challenge for hospitals. Millennials currently represent one quarter of today's population and will represent 75% of the workforce by the year 2030. A Millennial is defined as a person born between the years 1981 and 1996 with a current age of 25 to 40 years old [1]. Promoting retention strategies for this cohort will be paramount for hospital administration to ensure safe and effective healthcare to hospitalized patients in future years.

Millennials in Nursing

It is well-known that most millennials have been exposed to technology during their developmental years and are extremely proficient with all types of technology. This type of technological connection should be considered by nurse leaders to provide open and effective communication involving professional development. Millennials have been shown to be more comfortable with frequently changing jobs when compared to non-millennials. This population has also been labeled the least engaged generation in the working industry generating a turnover cost of $30.5 billion to the United States. This nursing cohort showed higher job satisfaction and were more engaged to participate in position advancement when nursing leaders used this type of communication that millennials in nursing are accustomed to [2]. Healthcare organizations should be proactive and embrace the culture of millennials so that innovative ways can be explored to promote more effective engagement to improve retention.

Strategies to Retain Millennials in Nursing

Increase Technology Usage

The use of texting as a form of communication has shown an increase in stakeholder buy-in and had promoted compliance among patients with diabetes, chronic obstructive pulmonary disease, and obesity [3,4]. TigerText is a Health Insurance Portability and Accountability Act of 1996 compliant platform that can be used to communicate with RNs, physicians, and other healthcare personnel [5]. This type of platform could be implemented for the millennial population to facilitate effective communication with the healthcare. This form of communication could be utilized to expedite orders without delay to improve patient outcomes. This platform could also promote more effective communication between nurse leaders and staff throughout the shift regarding essential factors to maintain continuity throughout the shift. A motivational text could be distributed to staff daily to offer inspiration and promote job satisfaction and retention.

Video Telemedicine 

A patient’s treatment regimen is driven by the healthcare provider. Supportive practice environments can empower nurses to verbalize his or her evidence-based opinion, improve the staff’s perception of the provider/nurse communication process, and increase job satisfaction [6]. The National Academy of Medicine defines the use of telemedicine as the transmission of video and audio communications to healthcare providers at a distance that will aid in diagnosis and treatment in real time [6]. Literature has shown that a telemedicine video review in the intensive care unit offers opportunities to gain quality improvement perspectives and enhance educational disparities [7]. A RN using video telemedicine at the bedside to communicate with a healthcare provider would allow a more in-depth report on a patient’s condition and enhance immediate care if needed. FaceTime is another technological advance that could also be implemented in healthcare facilities to improve communications among millennials and nurse managers.

Self-Care Regimen

The use of mindful-based yoga has been shown to promote health and well-being of healthcare professionals. Yoga is an inexpensive resource that can be implemented for millennials in healthcare to promote healing environments and holistic care for their patients. Offering 15 minutes of standing, video yoga during the RN shift or providing this self-care modality after the RN shift has been shown to decrease the negative effects of nursing burnout and stress [8]. Can simply adding 15 minutes of yoga promote increased job satisfaction and retention?

Support Animals

Emotional support comfort dogs have been utilized in police and fire departments to decrease stress and promote positive engagement in the workplace. Emotional support comfort dogs have been successfully used in the hospital setting to increase staff morale, decreased stress, and increased job satisfaction [9]. Literature has shown that healthcare staff are satisfied with emotional support comfort dog visits, have requested more emotional support comfort dog visits, and reported an increased sense of well-being [10]. The implementation of emotional support comfort dogs for RNs could increase job satisfaction with millennials and increase nursing retention among this cohort.

Retention Committees

The profession of nursing can be both emotionally and physically demanding. Stress and burnout leading to job dissatisfaction has been a problem among the nursing profession prior to the Covid-19 pandemic [11]. The cost effectiveness of implementing easy interventions to address nursing turnover and retention is not well studied in the literature [11]. The development of a retention committee where members encourage nurses to express concerns could lead to an increase job satisfaction and retention. This committee could be comprised of RN representative from each department who would represent RN concerns or innovative ideas from each hospital area. Open communication and the ability to express concerns often and openly would allow staff engagement, shared decision making, and a feeling of value.

Value of Recognition

The DAISY (disease attacking the immune system) foundation was formed in 1999 by the family of Patrick Barnes. Patrick died at 33 years of age with complications related to idiopathic thrombocytopenic purpura. His family was so impressed with the nursing care that he received, they felt moved to create the nursing DAISY Award. This innovative award has been used by 4,600 healthcare organizations worldwide [12]. All hospitals should provide patients and families access to surveys regarding nursing care and inform them that RNs can be nominated for the DAISY award.

Nurse leaders can benefit by having surveys in the patient’s room to capture immediate feedback triggered by positive nursing care experience. Families and patients can express gratitude or concerns regarding the patient and family healthcare experience. This expression can be acknowledged in real time instead of looking retrospectively at the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Nurses will appreciate this immediate feedback and early feedback will allow time to adjust if needed to increase patient and family satisfaction prior to discharge [13].

Nursing Turnover Costs for Hospitals

The cost of a bedside RN turnover can range from $28,400 to $51,700 with an average of $40,038 [1]. A hospital can lose $3.6– $6.5 million annually with high RN turnover. Each percentage point of RN turnover that increases or decreases will affect the hospital net profit margin by $270,800 a year [1]. Paying travel nurses $80-100 an hour more than regular employees can cause animosity among staff and cause RNs to feel like a non-valued member of the healthcare team. If hospital administration could increase RN The cost to a healthcare facility is approximately $40,000 to onboard or train a new nurse. retention and decrease the use of 20 travel RNs, an average of $3,084,000 annually can be saved [1].

The cost to a healthcare facility is approximately $40,000 to train a novice nurse. The national average hourly pay for a new graduate is $32 per hour [1]. The approximate orientation time is 10-16 weeks for a new graduate which also involved the added cost of mentoring and preceptor pay. Therefore, two nurses are being paid to do one job during this orientation time. Focusing on retention should begin during the orientation period to promote new employee buy-in, improve job performance, and increase job satisfaction.


Strategies for retention among millennial nurses should be the highest priority for hospital administration to halt the excessive turnover rate and decrease repetitive orientation costs. The implementation of innovative technology for millennials will improve commination and improve hospitalized patient outcomes. Promoting strategies to retain nurses among the millennial population would cause hospitals to save money and increase retention. Developing and implementing retention strategies for the millennial nurses will decrease healthcare facility costs and ensure safe and effective healthcare to hospitalized patients in future years.


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