Breaking the Home Health Nurse Turnover Cycle

Home health care is one of the fastest growing industries in the U.S., with employment in the sector projected to grow at a rate of 33 percent through 2030—much faster than the average projected employment growth rate of 7 percent.1

With more care shifting to the home, along with the unprecedented increase in the number of people over 65 due to the aging baby boomer population,2 demand for home health care services has never been greater. Yet at a time when the industry most needs a robust and reliable workforce, it continues to be hindered by high nurse turnover.

Home health agencies have been facing this challenge for a number of years, with staff attrition rates spiking during the pandemic. Although nurse turnover rates have been improving since then, they’re still concerningly high at 28 percent in 2023.3 In this article we’ll take a look at the primary drivers of nurse attrition, how it affects patient care and organizational stability, and what can be done to stop the cycle.

Why Turnover Occurs

From high expectations to an unpredictable setting and isolation on the job, home health nursing can be an inherently stressful role even when other working conditions are good. But many home health nurses face additional workplace stressors that can lead to diminished job satisfaction, emotional exhaustion, and eventually resignation from a particular agency—or home health care in general.

Poor Work-Life Balance

Home health nurses often manage complex caseloads and travel long distances between patient homes. When combined with scheduling inconsistency, excessive workloads, and tight time constraints, nurses can experience burnout.

Insufficient Support and Resources

Organizational support is essential for nurses to perform their jobs effectively. Reduced staffing, inadequate equipment and supplies, and insufficient training and education—including career development and access to crucial refresher skills in the field—can contribute to job dissatisfaction and turnover.

Inadequate Pay

When home health agencies are disrupted by high turnover, they face higher costs. In turn, this can affect their ability to offer a competitive salary to existing nurses, who might begin looking elsewhere for higher pay.

Technological Challenges

If software platforms and other important tools that nurses rely on are cumbersome or difficult to navigate, nurses might feel frustrated, lose valuable time, and be unable to care for patients as effectively as possible.

Workplace Violence and Aggression

Because home health nurses typically work independently in patients’ homes, they’re uniquely at risk for any threatening behavior that might occur. Being aware of this possibility and taking steps to mitigate it can help ensure nurse safety and confidence.

Lack of Career Development Opportunities

Opportunities for career advancement and professional growth are important factors for nurse retention. Home health nurses might seek opportunities for further education, specialization, or career advancement that aren’t readily available within their current organization.

Unhealthy Workplace Culture

A supportive and collaborative work environment, effective communication channels, and strong leadership are essential for fostering employee engagement and loyalty. When those elements aren’t present, engagement and morale can diminish.

The High Cost of Burnout and Resignation

The consequences of nurse burnout are profound and far-reaching. When nurses experience chronic emotional exhaustion, it jeopardizes their own well-being while also compromising patient safety and outcomes. The risk of medical errors rises as employees experiencing burnout struggle with focus in the face of high stress.

On top of that, when nurses resign, the resulting vacancies can mean that existing nurses must take on higher patient loads, creating a vicious cycle that contributes to additional stress for employees and reduced clinical capacity for agencies.

This high turnover cycle results in increased costs for home health agencies, from recruiting and training new staff to dealing with potential medical errors associated with burnout. According to the 2022 NSI National Health Care Retention & RN Staffing Report, the average cost of replacing a nurse is $56,300.4

Solving Nurse Turnover by Setting Nurses Up for Success: How MedBridge Helps

MedBridge In-Home Essentials is a comprehensive end-to-end onboarding and training platform that supports nurses and staff from day one and beyond, helping to boost staff retention and improve outcomes. In-Home Essentials disrupts the cycle of high nurse turnover with:

Better Standardized Onboarding

When home health nurses resign from an agency, they’re most likely to do so within the first six months,4 which underscores the need for a good onboarding experience. A structured, effective onboarding process helps new hires feel valued and welcomed, reducing feelings of being overwhelmed by a difficult, high-responsibility job.

In-Home Essentials addresses many of the root causes of turnover by improving job preparedness with:

High-Quality, CHAP-Verified Onboarding
Bring new hires up to speed quickly with comprehensive onboarding and compliance training.

Comprehensive OASIS Training
Establish a strong foundation for accurate OASIS data collection and continually refresh knowledge with integrated training, assigning, and management tools.

Skills & Competency Manager
Motivate staff and ensure efficient, high-quality care by identifying key skill gaps and assigning targeted training.

Better Support at the Point of Care

Imagine you’re a nurse who has just arrived at the home of a patient who needs a complex wound dressing that you haven’t performed in six months. You can’t access your agency’s procedure manual online and your manager isn’t available, so you search YouTube, deep down feeling diminished in your confidence and skillset. You want to provide the best care, but you don’t always have the support and resources you need to feel prepared for every situation.

Unfortunately, this experience is all too common for home health care nurses and can quickly lead to burnout. But now, there’s a better way to support your nurses and help them deliver outstanding care: The MedBridge Clinical Procedure Manual, the only tablet-first point-of-care skills resource for home health nurses and clinicians.

Clinical Procedure Manual allows home health nurses to search for and easily find the skills guidance they need from anywhere—even a patient’s driveway. All procedures are aligned with evidence-based research and professional guidelines.

Better Ongoing Education and Career Development

According to a Glassdoor Employment Confidence Survey, nearly four in five employees prefer additional benefits such as career development programs over a pay raise.5 Ensuring that your nurses have access to ongoing skills training can significantly improve competency and motivation.

In-Home Essentials allows you to support your nurses throughout their entire career journey with:

Clinical Procedure Manual
Boost nurse competence and confidence with innovative and engaging clinical, soft skill, and career advancement education.

Superior Ongoing Training and Mentorship
Support nurses across the spectrum of experience with the highest quality education, from foundational course series to live webinars, microlearning, and audio-only podcasts.