Nurse Manager Retention and

Job Satisfaction
Gray Carlson, Tiffany Linkous, Kelsey McLaughlin, Shannon Richardson, Emily Wilson
Abstract
PROBLEM: Nurse leaders have low work satisfaction and retention rates because of poor work life balance and
challenging staffing issues.

ANALYSIS: Analysis of quantitative and qualitative survey data from nurse manager’s at Saint Mary’s Hospital.

AIM STATEMENT: The aim of this study is to increase nurse manager retention and job satisfaction.

SOLUTION: Establishing 24/7 Clinical Care Leadership (CCL) Nurse Coverage and expanding CCL scope and staffing
decision making capabilities in and outside of unit division will improve nurse manager work-life balance and
overall job satisfaction and retention.

CONCLUSIONS: Increasing CCLs on units will prepare more nurses to be in leadership positions and will make an
easier transition into the manager role. This will increase the work-life balance for nurse managers.
Introduction and Description of Issue
Macro issue:
● Insufficient orientation, ongoing training, fair compensation, and work-life balance contributes to poor nurse manager
satisfaction and retention (Zwink et. al, 2013)
● According to the HealthyNurse Survey, nurse leaders struggle most with maintaining a healthy diet and BMI, reducing
workplace stress, and creating an appropriate work/life balance.” (Nolan, Carpenter, Cole, & Fitzpatrick, 2020)

Micro issue:
● 25% of nurse leaders at SMH perceive their work-life balance, and 25% perceive scheduling and staffing to be the biggest
challenges in their leadership role which leads to lower satisfaction and increased turnover.
● Nurse leaders are required to be “on call” 24/7 with no set schedule and delegation restrictions (IE: staffing after hours)
Data and analysis of this issue: micro level

Results of analysis at clinical site: work-life balance and scheduling/staffing

account are the top challenges for nurse managers (survey data collected from SMH).

Key elements from fishbone diagram: work-life balance, stress, scheduling,

inadequate use of available resources

How these relate to observations made on unit/communication with

stakeholders: stakeholders stated that work-life balance and scheduling
challenges were huge issues and negatively impacted their job satisfaction
Data and Analysis of the Issue
Quantitative data from nurse manager survey at SMH:
Data and Analysis of the Issue- Qualitative Survey
Data
Our survey was anonymous and consisted of 10 questions regarding job satisfaction and retention. We received 17 responses. The majority of the
nurses that responded had >10 year of nursing experience. 13 of 17 nurses responded with “YES” to being in leadership roles prior to being a nurse
manager. 3 of 17 responded “NO” to having necessary tools to help them perform their role as a nurse leader.

Why did you become a nurse leader?

● “To serve others, make a difference in patient care, and to mentor young nurses”
● “Exceptional clinical skills, kinda fell into the position. I initially did not seek it out but was approached about leadership and have stayed
ever since”
● “I reached a point where clinically I was struggling to find joy. The process of advocating for my team became the main satisfaction I had at
work. And I found that I was able to bridge the clinical and administrative worlds in a way to help bedside staff understand the initiatives the
hospital was undertaking. This led to a desire to help my teammates find better fulfillment at work by working on their behalf.”
● “I feel I have the ability to lead and influence a team to assume goodness, deliver compassionate and excellent care, and to meet our
patients where they are”
Should you decide to move from your current position in the next 5 years, what do you think will be your primary influence in that decision?
● 3 of 17 responses were “schedule”
● 5 of 17 responses were “satisfaction”
● We had 6 possible response options for this question and the responses indicate that work schedule and satisfaction were the primary
influences.
Data and Analysis of the Issue- Qualitative Survey
Data continued...
Nurses were asked to rate their challenges from 1-10 with 1 being the most challenging and 10 the least challenging.

Data indicated the three biggest challenges to be 1) work-life balance 2) scheduling or staffing issues, and 3)
recruitment/retention.

Data indicated that the categories developing transformational leadership behaviors, leadership resilience, team
building/trust, knowledge of available resources, understanding financial reports, and having crucial conversations were the
least challenging areas.

From data that was used for this project, nurses in one of study stated, "we have to be all things to all people", and another
mentioned, "I feel like I never get a down day".
Root Cause
Work Life Balance:
● Being on call 24/7
● No set hours

Scheduling or Staffing:
● Receiving after hour calls that could be delegated to CCL
● Being the only person able to make a final say on scheduling and staffing

**25% of Nurse Managers from survey results reported Work Life Balance being a challenge for the role.
Proposed Solution
Hypothesis: Establishing 24/7 Clinical Care Leadership (CCL) Nurse Coverage and expanding
CCL scope and staffing decision making capabilities in and outside of unit division will improve
nurse manager work-life balance and overall job satisfaction and retention.

Logistics: Identify current staff that show potential for leadership roles, Orient floor nurses to
CCL role, present change of responsibilities/job descriptions to current CCL nurses.
Stakeholders: hospital administration, nurse managers, floor staff, CCL’s

Potential costs: increase amount of staff receiving pay increase for CCL role

Timeline: introduce new 12 hour shift CCL coverage to current nursing staff in June 2020.
Continue to educate and implement via staff preceptorship, staff meetings, and orientation.

Data Collection: Pilot unit with CCL coverage for every 12 hour shift. Initial survey before and
after implementation and measured at 3 months. Repeat at 6 months.
Evidence
“Creating essential infrastructures that support nurse managers
can help increase their satisfaction and retention. Studies on
healthy work environments found that the organizational
framework must include shared leadership, participatory
management, relationship building, role development, evaluation
of expectations, and empowerment.” (MCcright, Pabico, and Roux,
2018).
Conclusion
In conclusion, having additional CCLs, will place more nurses in leadership positions and will allow for an easier
transition into the nurse manager role when the opportunity is presented.

Having a familiar face (CCL) take over the nurse manager position may decrease floor nurse turnover due to the
already established rapport and trust between personel.

Establishing a 24/7 CCL coverage role will create a more supportive environment for nurse managers, will allow for
shared leadership and responsibility on the unit, and provide opportunities for career growth.

Having additional CCLs will potentially lighten the workload of nurse managers and improve their work life balance.
Nurse Management Retention and Job Satisfaction
Kelsey McLaughlin, Tiffany Linkous, Shannon Richardson, Gray Carlson, Emily Wilson
Bon Secours Memorial College of Nursing
Abstract Data and Analysis of the Issue Proposed Solution Conclusion
PROBLEM: Nurse leaders have low work satisfaction and In conclusion, having additional CCLs, will place more nurses in
retention rates because of poor work life balance and ● Quantitative and Qualitative data from nurse Hypothesis: Establishing 24/7 Clinical Care Leadership (CCL)
leadership positions and will allow for an easier transition in to the
challenging staffing issues. manager survey at SMH. Nurse Coverage and expanding CCL scope and staffing decision
nurse manager role when the opportunity is presented.
making capabilities in and outside of unit division will improve
ANALYSIS: Analysis of quantitative and qualitative survey data nurse manager work-life balance and overall job satisfaction and
retention. Having a familiar face (CCL) take over the nurse manager position
from nurse manager’s at Saint Mary’s Hospital.
Evidence: may decrease floor nurse turnover due to the already established
AIM STATEMENT: The aim of this study is to increase nurse “Creating essential infrastructures that support nurse managers rapport and trust between personel.
manager retention and job satisfaction. can help increase their satisfaction and retention. Studies on
healthy work environments found that the organizational
framework must include shared leadership, participatory Establishing a 24/7 CCL coverage role will create a more supportive
SOLUTION: Establishing 24/7 Clinical Care Leadership (CCL)
management, relationship building, role development, environment for nurse managers, will allow for shared leadership
Nurse Coverage and expanding CCL scope and staffing decision
making capabilities in and outside of unit division will improve evaluation of expectations, and empowerment.” (MCcright, and responsibility on the unit, and provide opportunities for career
nurse manager work-life balance and overall job satisfaction and Pabico, and Roux, 2018). growth.
retention.

CONCLUSIONS: Increasing CCLs on units will prepare more

Logistics: Identify current staff that Having additional CCLs will potentially lighten the workload of nurse
show potential for leadership roles, Orient managers and improve their work life balance.
nurses to be in leadership positions and will make an easier floor nurses to CCL role, present change of
transition into the manager role. This will increase the Root Cause responsibilities/job descriptions to current
CCL nurses.
work-life balance for nurse managers. Work Life Balance:
References
Introduction and Description of the ● Being on call 24/7 Stakeholders: Saint Mary’s Hospital, McCright, M., Pabico, C., & Roux, N. (2018). Addressing manager retention with
nurse managers, floor staff, CCL’s, registered
● No set hours the pathway to
Issue Scheduling or Staffing:
nurse
excellence. Nursing Management, 6-7.
Macro Description: DOI-10.1097/01.NUMA.0000542293.75001.38
● Receiving after hour calls that could be
● Insufficient orientation, ongoing training, fair compensation, and
delegated to CCL Potential costs- increase amount of
work-life balance contributes to poor nurse manager satisfaction and staff receiving pay increase for CCL role Nolan, S., Carpenter, H., Cole, L., & Fitzpatrick, J. (2020). How do the health
retention (Zwink et. al, 2013) ● Being the only person able to make a final say behaviors of nurse leaders measure up? American Nurse Journal, 15(1), 30–31.

on scheduling and staffing Seabold, K., Sarver, W., Kline M., and McNett, M. (2020). Impact of intensive
● According to the HealthyNurse Survey show that nurse leaders leadership training on nurse manager satisfaction and perceived importance of
struggle most with maintaining a healthy diet and BMI, reducing
work-place stress, and creating an appropriate work/life balance.”
Timeline- introduce new 12 hour shift competencies. Nursing Management, p. 34-42.
CCL coverage to current nursing staff in June
(Nolan, Carpenter, Cole, & Fitzpatrick, 2020) **25% of Nurse Managers from survey results 2020. Continue to educate and implement via Sherrod, D., Hull, K. J., & Goolsby, P. D. (2011). Extend your career shelf life.
reported Work Life Balance being a challenge for staff preceptorship, staff meetings, and Nursing Management (Springhouse), 42(12), 49–51. doi:
Micro Description: orientation. 10.1097/01.numa.0000407588.71290.dd
● 25% of nurse leaders at SMH perceive their work-life balance, and
the role.
25% perceive scheduling and staffing to be the biggest challenges in Zwink, J. E., Dzialo, M., Fink, R. M., Oman, K. S., Shiskowsky, K., Waite, K., …
their leadership role which leads to lower satisfaction and increased Data Collection- Pilot unit with Le-Lazar, J. T. T. (2013). Nurse Manager Perceptions of Role Satisfaction and
Retention at an Academic Medical Center. JONA: The Journal of Nursing
turnover. CCL coverage for every 12 hour shift. Initial
survey before and after implementation and Administration, 43(3), 135–141. doi: 10.1097/nna.0b013e318283dc56
● Nurse leaders are required to be “on call” 24/7 with no set schedule
measured at 3 months. Repeat at 6 months.
and delegation restrictions (IE: staffing after hours)
Questions?
References
McCright, M., Pabico, C., & Roux, N. (2018). Addressing manager retention with the pathway to

excellence. Nursing Management, 6-7. DOI-10.1097/01.NUMA.0000542293.75001.38

Nolan, S., Carpenter, H., Cole, L., & Fitzpatrick, J. (2020). How do the health behaviors of nurse leaders measure up? American Nurse
Journal, 15(1), 30–31.

Seabold, K., Sarver, W., Kline M., and McNett, M. (2020). Impact of intensive leadership training on nurse manager satisfaction and
perceived importance of competencies. Nursing Management, p. 34-42.

Sherrod, D., Hull, K. J., & Goolsby, P. D. (2011). Extend your career shelf life. Nursing Management (Springhouse), 42(12), 49–51.
doi: 10.1097/01.numa.0000407588.71290.dd

Zwink, J. E., Dzialo, M., Fink, R. M., Oman, K. S., Shiskowsky, K., Waite, K., … Le-Lazar, J. T. T. (2013). Nurse Manager Perceptions
of Role Satisfaction and Retention at an Academic Medical Center. JONA: The Journal of Nursing Administration, 43(3), 135–141. doi:
10.1097/nna.0b013e318283dc56