The Purpose of the Report - mproving Employee Satisfaction and Reducing Turnover Rates in Nursing Homes

Nursing job happiness affects the standard of care provided to patients and is linked to lower employee turnover. High-quality customer service can increase employee happiness and motivate them to stay at one station while serving clients for a longer period of time. This study seeks to identify the elements that can enhance nursing home performance and lower turnover rates. Additionally, if employees' requirements are met, the quality of service is likely to increase. To ensure the retention of qualified and experienced nurses, healthcare managers must offer a dependable workplace and generously reward staff. Employee motivation is one of the factors that help in their retention and quality of service offered to clients. In nursing homes, there is a need for quality care and nurses must be treated well to increase their moral. Some of the factors that can help in improving quality, job satisfaction, and lowering of turnover rates include

Giving nurses with monetary rewards

Reducing their working hours

Continuous retraining of the worker

Offering/paternity maternity leaves

Ensuring job security

Initiating residency programs


Recommendations for increasing employee job satisfaction, improving quality of services, and lowering turnover rate include

Paying salaries that reflect the employees' effort

Reducing the number of hours worked per week and overtime

Continuous retraining

Offering of maternity and paternity leave

Initiation of residency programs

Ensuring job security

Letter to the Decision-maker

Name of sender



Name of the decision-maker


Dear Sir/Madam

Re: Proposal to Improve Employee Satisfaction and Reduce Turnover Rates in Nursing Homes

I hereby request for acceptance of my proposal on reduction of nurse turnover in nursing homes. It is of great concern due to its adverse effects on the health of patients as well as job satisfaction and wellbeing of the nurses. The aim of this proposal is to study factors that can increase satisfaction of nurses and how to solve such issues to ensure that the healthcare providers are comfortable. In this proposal, I am intending to use scholarly journals to identify issues leading to low motivation of nurses in nursing homes and ways of solving them. The primary research will include phone interviews with 10 nurses in 2 nursing homes to know their views about their working conditions. The report will give recommendations for giving incentive and improving working conditions of nurses to improve their overall performance.

The proposal will help in understanding the reasons for high turnover rate of employees in nursing homes and ways of reducing it as well as understanding the challenges the nurses face at work and ways of motivating them such as through monetary rewards. The research will need resources such as money for phone calls and other research procedures amounting to $2000. It will also require a period of 6 months to complete the entire process and come up with the necessary recommendations. The study will take six months to complete and will highlight the recommendations on ways of improving satisfaction of nurses and reducing their turnover rate. The proposal will be delivered by September 12, 2017 in printed form to the decision-making committee for approval.




1.0 Introduction 7

2.0 Objectives 7

3.0 Methodologies and Procedures 9

4.0 Budget 9

5.0 Findings and Discussion 9

5.1 Benefits of Rewarding Nurses with Money 9

5.2 Benefits of Reducing Daily Tasks and Reducing Overtime 10

5.3 Benefits of Ensuring Continuous Retraining 11

5.4 Effects of Offering Vacation and Maternity/Paternity Leave 11

5.5 Benefits of Initiating Residency Programs 12

5.6 Impacts of Ensuring Job Security for Nurses 12

6.0 Conclusion 13

Recommendations 13

References 15

Report on Improving Employee Satisfaction and Reducing Turnover Rates in Nursing Homes

1.0 Introduction

Job satisfaction is very vital for all nursing home workers since it determines the quality of services rendered to patients and employee turnover. Dissatisfied staff may indicate signs of unreliability and poor work ethic including absenteeism and lateness to work. They can also be aggressive towards their colleagues and patients due to stress related issues. Job satisfaction is associated with quality of services offered in the centers and lack of it may lead to increased patient mortality (Castle, Degenholtz & Rosen, 2006). High quality customer care improves employee satisfaction and encourages them to remain in one station for a longer time. According to research preceptors play a big role in enabling transition from a student nurse to a professional with experience (Watkins, Hart & Mareno, 2016). According to Watkins, Hart and Mareno (2016) preceptors increase staff retention rate by 15 to 37 percent since NLRNs have high confidence and are more competitive. They also feel more psychologically empowered as they perform their duties leading to increased job satisfaction and enhanced quality care. For nurses to have morale to work they need to be trusted and rewarded well in form of money since it strengthens their commitment to their organization and improves job satisfaction as Hsu, Chiang, Chang, Huang and Chen (2015) argue. It is clear from studies that healthcare facilities with high nurse retention present fewer medical errors and offer high quality services to their patients Hsu, Chiang, Chang, Huang and Chen (2015). Healthcare administrators have a role of providing a trustworthy place of work and reward employees generously to ensure retention of skilled and experienced nurses. Lack of motivation may lead to poor quality of services provided in nursing homes leading to poor health and increased mortality rate.

2.0 Objectives

Nursing homes are important institutions in today's society when terminal illnesses such as cancer and diabetes are on the rise. Patients in their last stages need quality care and great attention to ease their physical and psychological pain. This study aims at providing readers and policy-makers with facts about the state of nursing homes and the problems they face due to reduced motivation of the nurses. It will also focus on ways of improving conditions in nursing homes to reduce staff turnover rates, improve nurse satisfaction, and quality of life. The recommendations will help in boosting overall performance and promote the well-being of individuals in the care centers and the staff. There is great amount of stress and compassion fatigue among staff members due to overworking and compensations and benefits have not been good enough in improving employees' job satisfaction (Todaro-Franceschi, 2013). Preceptor-ship and training for new employees are not always adequate to prepare them for tasks ahead. Therefore, this report is aimed at improving employee job satisfaction and decreasing turnover rates through measures such as offering money rewards, reducing daily tasks, continuous retraining, vacations, ensuring job security, and initiating residency programs.

CNA-turnover-graphic from My Parent is Going to the Nursing Home - How Do I Choose the Best One?. (2017). Osterhout & Mckinney, P.A.

3.0 Methodologies and Procedures

The primary search will involve phone interviews with 10 nurses in 2 nursing homes to know their views about their working conditions. The report will suggest a recommendation that aims at giving incentives and improving working conditions of nurses to improve their overall performance. Secondary research will involve analysis of multiple scholarly journals on nurse turnover and job satisfaction in nursing homes and the impact on the quality of service.

4.0 Budget

The resources needed include money for phone calls, stationery, and other research procedures amounting to $2000. Availability of internet to enable location of scholarly sources is also a necessity. The research will take 6 months to complete the entire process and come up with the necessary recommendations

5.0 Findings and Discussion

The findings of the proposal include

Benefits of rewarding nurses with Money

Benefits of reducing daily tasks and reducing overtime

Benefits of ensuring continuous retraining

Effects of offering vacation and maternity/paternity leave

Impacts of ensuring job security

Benefits of initiating residency programs

5.1 Benefits of Rewarding Nurses with Money

Rewarding employees is very important since it improves their morale and offers job satisfaction. This reduces their rate of turnover and an institution can remain with its staff for a long time. Reward can be defined as a system that enables exchange of services between workers and employers (Hsu, Chiang, Chang, Huang & Chen, 2015). Money is an excellent incentive to reward nurses in nursing homes since it motivates employees to adhere to the norm of the organization that has employed them. Poorly paid staff is difficult to manage due to hardships associated with inadequate funds to cater for their financial needs. The amount offered must reflect their work and abilities, experience, skills, and hours worked. Rewards can cause employee dissatisfaction especially in the nursing profession making them to offer low quality service to patient due to dissatisfaction and lack of motivation. If the monetary incentives are inadequate nursing homes will keep on losing experienced nurses as they quit for other well-paying jobs. Research reveals that highly paid employees love their job, dedicate time on improving the welfare of the patients, and support their organization (Hsu, Chiang, Chang, Huang & Chen, 2015). Workers in nursing homes should be given adequate monetary rewards to reduce their turnover, improve quality of service, and increase job satisfaction.

5.2 Benefits of Reducing Daily Tasks and Reducing Overtime

Nursing profession is an involving career that requires full commitment and dedication of time and resources to promote the health of patients. In nursing homes, most of the patients cannot support themselves and rely on the nurses and other professionals to help them in performing tasks such as bathing and feeding. This means that the nurses may be overworked if the institution has less number of workers. Fatigue impairs their ability to offer quality service to the patients leading to medical errors. Every worker needs enough time to rest and sleep to improve performance, which can be achieved by employing more nurses to work in shifts. Quality should be considered during hiring so that each staff can work for lesser number of hours. Overworked employees may suffer physical and psychological problems interfering with the overall performance (Farquharson et al., 2013). Daily tasks should be reduced for each nurse to enable them have some time with their family and do other personal tasks. Working overtime should also be reduced to ensure that employees do not suffer prolonged fatigue and interfere with performance (Todaro-Franceschi, 2013). Even if the workers earn extra money after exceeding their time at work other factors such as health benefits should be put into consideration. A tired nurse may be moody throughout the day affecting job performance and risking the lives of the patients

5.3 Benefits of Ensuring Continuous Retraining

Commitment that nurses show to their patients is very important in promoting their health. Continuous learning is necessary to prepare employees of any organization to enable them achieve its goals. Nurses working in nursing homes require skills to handle patients admitted in the center especially in the Intensive care unit (Chen, McCann & Lateef, 2015). The rapid change of technology, practice, and equipment calls for continuous learning to ensure competency of nurses. Each should be allowed to take topics of choice such leadership, clinical practice, workplace violence, and policy among others. It helps them to be up-to-date with evidence-based practices and clinical developments to achieve better outcomes. Employers should invest in professional development of every nurse by committing resources, time, and funds for continuous education, promotion of job satisfaction among the employees, and reduction of turnover. Education should be provided free of charge since it may be quite costly for individual employees to pay. This will give everyone a chance to have equal access to quality education that will allow them to offer services of high quality. In addition, it gives them skills to manage their lives and reduce stress cases.

5.4 Effects of Offering Vacation and Maternity/Paternity Leave

Nurses should always be given job-protected maternity and paternity leave to promote economic and health security of the pregnant mothers and the babies. According to the Family and Medical Leave Act (FMLA) signed in 1993 employees should be allowed 12 weeks unpaid leave when they are giving birth or adopting the child (Harbour, Owens, Shultz & Weime, 2015). This is possible for firms that employ 50 workers and meet the right working-hour required per week. Employees who are offered paternity and maternity leaves can bond well with their families, which can improve their psychological well-being by reducing their stress levels. This can also improve job satisfaction since the employees appreciate services and opportunities offered by their employer improving their performance. Employee motivation is very important since it encourages them to work hard and love their jobs. As a result, they remain in one workstation for a long time and reduce turnover rate. In this case, the quality of services offered is guaranteed and patients receive quality care.

5.5 Benefits of Initiating Residency Programs

The residency program in nursing enhances nursing as a discipline to acknowledge skills, knowledge, and ability to engage with the patient in the context of family and community. Outstanding nurses have the knowledge, skills, and abilities to connect with the patient as well as the family by way of the holistic involvement as Castle, Degenholtz and Rosen (2006) argues. They also offer direct care as well as attaching the patients to a variety of clinical resources before, during, and after the patient are attended in any one setting. Nurses require much more experience beyond what is academically laid down and nursing residency provides both formal and informal set of learning aspects that focus on institutional and departmental practices. These practices assist nurses to learn the policies of the institutional procedures, care standards along with introducing them to the key persons and structures essential to execute the routines of the organization and the department as well. Besides, residency program improves competencies in nurses enabling them to improve quality of service to patients. Furthermore, if well executed residency programs are capable of helping advance nursing's contribution thus progressing health through deepening the purpose and mission of the organization. It also leads to job satisfaction and reduces turnover rates since nurse's benefit from additional programs that help in acquisition of new kills.

5.6 Impacts of Ensuring Job Security for Nurses

Security refers to a state of feeling safe and being free from harm and any danger or fear, doubt and anxiety. In careers, job security may refer to having no doubts or anxiety of losing one's job. Contract employees are more insecure than permanent ones since they may lose their jobs immediately their contract expires. Organizations that do not employ their staff on full time basis record a high turnover rate compared to those that prefer permanent workforce. Job security enhances the provision of quality services to the patients and the organization and increases job satisfaction (Liu & Wang, 2016). This means that an employee can work without fear of demotion, salary reduction, retrenchment, or losing the job. In addition, it allows a worker to concentrate in doing the assigned tasks instead of walking around searching for organizations that can guarantee them reliable employment. The quality of services offered is compromised if workers fear to lose their jobs and miss some sessions as they go out to look for promising jobs. For a nursing home to retain its workers and improve their morale, the management must consider the needs of every worker and make policies that help in solving any issues that may compromise the quality of services rendered.

6.0 Conclusion

Nurses perform an important role in the society by taking care of patients in hospital and nursing homes. Their motivation is very important to improve the quality of services they give to their clients and reduce turnover. Several measures are needed including paying them well and guaranteeing their job security to enable them to have a comfortable life. The work of nurses is very demanding, thus motivating them through various incentives such as retraining can help in improving job satisfaction.


Employers especially in nursing homes should ensure that their employees receive salaries that reflect the nature of their work including overtime.

There is a need to reduce the number of hours worked per week for every nurse to allow them quality time with their families.

Continuous retraining of nurses is necessary since it keeps them updated with the latest technology and information of patients' care.

Every employee should be allowed maternity and paternity leave during birth and after adopting a child to give them enough time to bond.

Some employees in nursing reside in places far away from their working stations and have to commute daily to work. Initiating residential programs will enable the nurses to live near their places of work and save them commuting costs.

Job security helps workers to work in one place for a longer time since they do not have to look for greener pastures. Nursing homes should employee permanent and pensionable employees to improve performance and help in reducing turnover rates.


Castle, N. G., Degenholtz, H., & Rosen, J. (2006). Determinants of Staff Job Satisfaction of Caregivers in two Nursing Homes in Pennsylvania. BMC Health Services Research, 6(1), 60.

Chen, E., McCann, J. J., & Lateef, O. B. (2015). Attitudes Toward and Experiences in End-Of-Life Care Education in the Intensive Care Unit: A Survey of Resident Physicians. American Journal of Hospice and Palliative Medicine®, 32(7), 738-744.

Farquharson, B., Bell, C., Johnston, D., Jones, M., Schofield, P., Allan, J., ... & Johnston, M. (2013). Nursing Stress and Patient Care: Real‐Time Investigation of the Effect of Nursing Tasks and Demands on Psychological Stress, Physiological Stress, and Job Performance: Study Protocol. Journal of Advanced Nursing, 69(10), 2327-2335.

Harbour, A., Owens, T., Shultz, R., & Weime, N. (2015). Is a National Policy for Paid Parental Leave Possible in the United States?.

Hsu, C. P., Chiang, C. Y., Chang, C. W., Huang, H. C., & Chen, C. C. (2015). Enhancing the Commitment of Nurses to the Organization by Means of Trust and Monetary Reward. Journal of Nursing Management, 23(5), 567-576.

Liu, S., & Wang, H. (2016, January). Organizational Justice and employees work outcomes: the Mediating Effects of Job Security. In Academy of Management Proceedings (Vol. 2016, No. 1, p. 15605). Academy of Management.

My Parent is Going to the Nursing Home - How Do I Choose the Best One?. (2017). Osterhout & Mckinney, P.A. Retrieved 11 February 2017, from

Todaro-Franceschi, V. (2013). Compassion Fatigue and Burnout in Nursing. Critical Care Nurse, 33(1), 76.

Watkins, C., Hart, P. L., & Mareno, N. (2016). The Effect of Preceptor Role Effectiveness on Newly Licensed Registered Nurses' Perceived Psychological Empowerment and Professional Autonomy. Nurse Education in Practice, 17, 36-42.

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