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Introduction
Nursing and social worker professions have challenging and unsuitable working conditions that lead to high turnover rates. CHE Behavioral Health offers digital therapy services aimed at behavioral and mental health. CHE employs licensed clinical social workers and psychiatric nurses to offer psychological therapy to their patients through digital communication. However, the facility has a high turnover rate of nurses and licensed social workers. Behavioral health nursing or psychiatric nursing has a challenging work environment that leads health professionals to quit. Psychiatric nursing has exposure to patients’ alleviated levels of aggression, violence, and unpredictable behavior.
Nursing practice has a high-paced environment that leads to high levels of burnout. Unpredictable patient behavior and response to treatment lead to a high-stress environment that affects the health professionals’ psychological well-being. Additionally, high workloads could promote turnover due to long working hours, sleep deprivation, stress, and mental health problems and affect the work-life balance of the nurses and social workers. Nurses at CHE Behavioral Health organization must dispense medication, communicate with patients’ online, and collect health reports (CHE Behavioral Health Services, 2021). High worker burnout due to challenging work environments and workloads contribute to the high turnover at CHE Behavioral Health. A study by Richardson (2019) indicated that poor wages play a role in high nursing turnover due to a discrepancy between nursing expectations and rewards. Other opportunities and financial impacts also contribute to the high turnover at CHE Behavioral Health.
Increased nurse turnover rates in the facility lead to the loss of experienced and valuable talent in the organization, with numerous effects on the organization, the staff, and patients. Regular staff replacements are expensive and affect the organizational culture and reputation. Work-related stress, demanding work environments in behavioral nursing, and poor pay affect the staff’s well-being. The staff left after turnover is susceptible to losing morale, confidence, and belief in the organization, compromising their job satisfaction and performance. Patients risk poor services, injuries, and mistakes due to inexperienced and depressed care providers.
Interventions to Resolve the Problem
CHE Behavioral Health Services needs to tackle the challenging working environment, workload, nursing burnout, and poor compensation to mitigate the high turnover of nurses and licensed social workers. To do so, the facility should embrace education programs on dealing with challenging behavior, introduce stress management policies, provide competitive compensation, improve the staff ratio, and develop a shared governance program that will give nurses and social workers a voice in policies, workflows, and scheduling. High turnover rates not only affect nurses and licensed social workers but also lead to lofty costs in recruitment for organizations and affect the quality of therapy for the patients.
Embracing education programs on challenging behavior is an intervention for stress related to unpredictable patient behavior typical in behavioral nursing. Developing nursing healthcare education will enable nurses to manage the diverse mental health challenges and understand the corresponding behavioral cues of the patients (Tsaras et al., 2018). Education programs also implicate nurses’ communication and interpersonal skills essential for online coordinated psychological therapy, such as in the CHE Behavioral Health facility. Stress management policies will navigate the poor mental well-being of professionals in the organization. Stress policy in health facilities supports medical workers experiencing stress-related problems susceptible to quitting and risky behaviors.
Improving the staff ratio will address the high workload, a factor for the increased turnover. The number of nurses should always correspond to the number of patients admitted to the program (Bergman et al., 2022). A shared governance program should be introduced at CHE Behavioral Health Services to give nurses a chance to express their grievances regarding schedules, working environment, and workflows. Competitive compensation rates will breed high satisfaction and attract high talent. Efficient communication on worker welfare will enable the management to meet the nurses’ physiological and emotional needs and minimize conflicts for job resignation.
Proposal for Addressing the Problem
First, I recommend formal and informal education programs to harness the nurses’ professional and soft skills. A combination of formal lectures, tutorials, simulations, and practical demonstrations is an effective tool in providing extensive knowledge on care and treatment for different psychological problems. The formal education includes duties and functions in psychological therapy in various disciplines designed to enhance the nurses’ and licensed social workers’ composure. Formal education should also develop effective communication with the mentally challenged and nursing ethics. Informal nursing education methods should promote self-directed learning based on the patients’ needs (Tsaras et al., 2018). I propose team-building activities and watching video methods of informal education that enhance how the patients interact with patients, among themselves, and in different situations. Introducing formal and informal education development programs will curb job-related stressors contributing to the turnover rate.
I recommend a stress therapy policy for psychiatric nurses and social workers at CHE Behavioral Health Services. Stress can lead to detachment from work; without control, it potentially leads to turnover (Gutsan et al., 2018). Nurses’ therapy will enable the health workers to maintain good psychological health critical for job satisfaction. Also, stress management will support the medical workers reset and recalibrating their alarm systems, improving work resilience. Developing a happy and positive workplace through stress therapy will lead to a conducive working environment and minimize turnover. The facility can also adopt team-building activities such as exercising, allowing nurses to connect and spend time outdoors.
CHE Behavioral Health Services can improve its staff-patient ratio to reduce the increased workload. I propose a psychologist-to-patient ratio of 1:2 per shift. According to Gutsan et al. (2018), the recommendable minimum nurse-to-patient ratio for psychiatric care is 1:3. Since the behavioral nursing profession is technically challenging, the workload for nurses should be monitored by evaluating care workloads (Bergman et al., 2022). The facility should classify patients based on direct care requirements to avoid burdening nurses with work. Establishing a provider-to-patient ratio and classifying patients according to their care needs will mitigate workload and enhance nurses’ satisfaction.
Establishing a shared governance program allows nurses and licensed social workers to give their recommendations or express complaints on schedules, working environment, and workflows. The program will enhance communication that will enable the management to understand and resolve the sensitive issues motivating the psychiatric workers to resign. Effective communication through the program will also enable CHE Behavioral Health Services to predict turnover and understand the nurses’ expectations. The communication training and the inclusive governance program will create a culture of information sharing, build trust and develop a more enjoyable working environment for the healthcare workers.
I also propose competitive salaries and benefits to establish long-term relationships with the medics, preventing turnover motivated by low wages and searching for better opportunities. Developing skills, mental health, working environment, and communication without sufficient pay are not all effective in reducing nursing turnover. High turnover rates are costly to CHE Behavioral Health Services due to recruitment and losses associated with patient turnover due to poor services. Offering competitive salaries and benefits demonstrates goodwill and concern for the professionals, improving nursing retention rates (Richardson, 2019). Dissatisfaction in nursing, particularly psychological nursing, is mainly caused by low salaries considering the multiple tasks associated with the job.
Conclusion
The high nurse practitioners and licensed clinical social workers turnover rate at CHE Behavioral Health is a critical organizational problem affecting performance, quality of therapy services, cost, retention of experienced talent, and ability to perform. Challenging work environments, poor communication, increased workloads, and low salary and benefits are the factors that cause the high turnover rates. CHE Behavioral Health ought to optimally respond to the high turnover rate to mitigate the high cost of recruitment and the risk of poor quality services and avoid loss of culture and reputation.
The nurses are presented with diverse mental health issues that lead to emotional strain, adding to the stressors in acute psychiatric settings. Behavior variation in psychiatric therapy subjects the nurses to feelings of anger and frustration that motivate a high turnover rate. Nursing burnout is mainly to poor staffing ratios that cause demanding workloads on individual nurses and social workers. Considering the challenges in the Nursing and social work professions, there are high expectations on wages and benefits that should be satisfied by offering competitive compensation rates. Therefore, nurses quit in pursuit of more lucrative opportunities. High nurse turnover at CHE disturbs hospital services, staffing, managerial processes, profitability, and costs.
The proposed intervention includes adopting education programs on challenging behavior, introducing stress management policies, providing competitive compensation, improving the staff ratio, and developing a shared governance program. Education programs will improve the working environment by teaching the nurses and social workers necessary adaptation skills. Stress management policies should maintain the psychological state of the workers, whereas competitive salaries and benefits will enhance nursing retention. Improving the staff ratio will reduce the work burden, and the shared governance program will allow the health professionals to communicate their grievances.
References
Bergman, A., Song, H., David, G., Spetz, J., & Candon, M. (2022). The Role of Schedule Volatility in Home Health Nursing Turnover.Medical Care Research and Review, 79(3), 382-393.
CHE Behavioral Health Services. (2021).Telehealth Mental Health Services.
Gutsan, E., Patton, J., Willis, W. K., & PH, C. D. (2018). Burnout syndrome and nurse-to-patient ratio in the workplace.
Richardson, V. A. (2019).Reducing the cost of healthcare facilities by decreasing nursing turnover(Doctoral dissertation, Walden University).
Tsaras, K., Daglas, A., Mitsi, D., Papathanasiou, I. V., Tzavella, F., Zyga, S., & Fradelos, E. C. (2018). A cross-sectional study for the impact of coping strategies on mental health disorders among psychiatric nurses.Health psychology research, 6(1).
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