When nurses decide to transition from one role to another, it not only causes disruptions to scheduling but also costs employers money.
Exit interviews are a practice some organizations use in their quest to reduce turnover and discern why nursing staff resigns.
However, recruiters and other human resources (HR) professionals might wonder how effective exit interviews are in providing useful information. Do they help reduce turnover?
The answer is no, according to John J. Sullivan, PhD, Professor of Management at San Francisco State University.
“Exit interviews are not helpful when done in their usual manner,” said Sullivan, a well-known HR thought-leader from Silicon Valley. “What are the odds of someone being completely honest on their last day on the job as to why they’re leaving, especially if they still need a reference.”
To be more effective, Sullivan recommended conducting the exit interview post exit and at a minimum, at least two weeks after someone has left. “The key is waiting,” he said.
Stay interviews
Once someone makes the decision to leave his or her job, it’s too late, Sullivan said. “It’s better to talk to people before they leave, when something can be done to change their minds.”
A more ideal approach in retaining nursing staff is to conduct “pre-exit interviews,” also called stay interviews, Sullivan said.
“Preexit interviews are done quarterly in the Silicon Valley,” he said.
And according to Sullivan, there are key questions to ask:
- Why do you stay?
- Is there anything that makes you want to leave?
- Are there any deal breakers?”
Sullivan advises not to wait too long for pre-exit interviews.
You want to speak with your staff before they become too frustrated with their job, whether it’s the work, salary, lack of support, limited opportunities for growth, or their manager, he said.
Scripps Health in San Diego, California discovered exit interviews provided little useful information.
“The information gleaned from exit interviews was redundant info we already had,” said John “Jack” Blake, Assistant Vice President of Human Resources at Scripps Health. “There were no surprises, so the value was not there.”
Engagement surveys
Because of the lack of helpful data collected from exit interviews, Scripps Health began using an annual engagement survey for each employee about 15 years ago, Blake said. The move to engagement surveys helped determine what motivates their nurses and makes them happy with their jobs and what aspects of their work contribute to feeling dissatisfied.
“We became proactive with the use of engagement surveys,” he said. Because of the competitive job market, Blake said the use of engagement surveys helps the organization stay ahead of the curve by cultivating nursing talent, while helping with retention.
Prior to engagement surveys, the organization had a 25% first-year turnover rate. Over time, turnover dropped to the low teens, Blake said. If problems are uncovered, action plans are created to address problems to help reduce turnover.
“It took a lot of work 15 years ago to initiate the process of using engagement surveys,” he said. “However, it’s saved us money in the long run, as each time you lose an employee, the consensus is that it costs the company a total of that employee’s annual salary when they leave.”
Another healthcare organization that uses engagement surveys for their nurses is Regional Health in Rapid City, South Dakota.
“Regional is a Magnet Hospital so we use the NDNQI employee engagement survey every two years,” said Deanna Rice, MSN, MBA, HCA, System Director of Professional Practice and Development at Regional Health. “If we see any patterns emerge with nurses’ feedback, our CNO gets involved. We are very much about being proactive and handling concerns before they become larger issues.”
Exit interview outcomes and other effective strategies
Although Regional Health still conducts exit interviews, Rice said the response rate is low.
“Our exit interview process begins with a phone call two weeks after a nurse leaves,” she said. “About 60% to 70% don’t respond. My theory is this may be due to the fact that we’re the only hospital within 300 miles; there isn’t another hospital across the street to get your next job.”
In general, most of the nursing leadership feels using exit interviews is not a proactive strategy and it’s too late to make a difference; however, some still feel they’re useful, Rice said.
In addition to the engagement survey, Regional also requires all managers to meet with nursing staff every quarter and document the meetings. This results in managers staying in touch and having regular conversations with nursing staff, Rice said.
“Our CNO also holds monthly nursing forums,” Rice said. “She meets with two to three nurses from each department to uncover any work-related concerns ranging from, but not limited to pay rates, patient care, identifying bullies, and management issues.”
The future of exit interviews
UCLA Medical Center is another organization that discontinued the use of exit interviews several years ago, after a low response rate and not receiving enough helpful information, said Stacey Sims, LMFT, SHRM-CP, Senior Consultant, Talent Acquisition at UCLA Health Sciences and the David Geffen School of Medicine.
“We’re in the exploratory phase of using stay interviews,” she said. “While our turnover rate is low, we want our staff to feel valued and stay with us. The move toward stay interviews is one way to achieve that.
According to Sullivan, integrating comments like the following into stay interviews can help you hold on to talented nurses:
- “You’re on our radar.” Explain their commitment to excellence is getting noticed.
- “Thank you.” Show gratitude for their key contributions
- “You’re valuable to us.” Convey their importance to the organization.
- “My door is always open.” Remind them that questions or concerns are always welcome.
- “Tell me why you stay here.” Ask what keeps them at the organization and what would make them leave.
Nurses are critical to healthcare. Show them the impact of their work — patients they saved and who lived as a result of their care — and how they’re an invaluable asset to your organization.
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