How to Retain Employees in Healthcare

The idea of employee retention is common for many modern healthcare organizations. Maintaining motivation, high-level performance, and sustainability at the workplace is important. When appropriate working conditions are promoted for employees, people are eager to make significant contributions to their personal growth and professional development. This paper aims to analyze different retention strategies to ensure individuals have enough reason to stay within the same facility. Such characteristics as transparency and fairness should be admitted to creating a positive impression on people. Employee turnover occurs because of ineffective leadership and administration, poorly controlled globalization effects, and the inability to deal with multicultural environments. It does not take much time to fire a person or create the conditions for leaving, but much effort is usually required to make a valuable employee stay. Evaluating such steps as employee engagement, team-building, competition, education, training, leadership, and strategic planning will result in increased retention ratings. The major point of this research project is that retention is achieved when all strategies are professionally and regularly combined but not applied separately. The outcomes of employee retention through fair salaries and cooperation will be observed in improved services, confidence, optimistic collaboration, and a good and sustainable working environment.

How to Retain Employees in Healthcare

The United States has one of the world’s strongest and most effective healthcare systems. Despite the intention to create the best working conditions and offer the highest quality services, some shortages and mistakes are noticed from time to time. Many researchers admit that the COVID-19 pandemic has significantly affected employment levels in the country and worldwide: about 2.7% lower than before the crisis (Frogner & Dill, 2022). Short staffing, shift length, problematic peer relationships, and increased personal obligations are the reasons for nursing turnover (Lockhart, 2020). Other healthcare providers might find additional explanations like the desire to earn more, change working environments, and find new opportunities for professional growth. Modern facilities must know how to retain employees in healthcare because costs to find new employees prevail over costs to protect the current staff. In this paper, attention will be paid to the conditions under which employees prefer to leave their jobs and the strategies to help them stay and develop their skills within the same organizations. Employee engagement, communication, team-building, motivation, training, and leadership are the major approaches to retaining employees and creating positive working environments and high-quality care services.

Reasons for Employee Turnover

The healthcare sector is characterized by constantly changing working environments and the people in it. On the one hand, nurses and other practitioners need to follow regulations, laws, and standards to ensure they offer the best services and exchange sufficient knowledge. On the other hand, the number of patients with different problems and expectations is hard to predict, and employees have to address their personal needs. Despite the primarily chosen purposes, creating a positive work environment for healthcare professionals is an obligatory issue for care improvement and appropriate motivation (Maassen et al., 2021). Unfortunately, it is not always possible or easy to maintain professionalism and quality of the workplace, which provokes unplanned employee turnover. To understand how to retain employees in the healthcare field, it is important to learn the conditions under which the staff decide to leave a facility. Sometimes, the decision to change a workplace is predetermined by financial aspects. In some cases, personal characteristics and differences play a vital role. There are also situations when people cannot control the development of the events and have to deal with the coming problems in a short period.

Administration and Leadership

The most common reasons for healthcare workforce turnover are poor administration and leadership. When people invest in their activities, they expect to gain some benefits with time (Perreira et al., 2018). Still, it is wrong to consider the investment a financial aspect but to admit the worth of investigating other areas like training, communication, and guidelines. When healthcare practitioners cooperate in diverse environments and help different people, they want to have some permanent factors to rely on regularly. In this case, effective and supportive leadership can be a solution. However, when leaders do not complete their direct responsibilities or poorly delegate in hospitals, they challenge nurses and other employees and make them think about available alternatives. Thus, when leaders focus on one point in healthcare and neglect others, a low administration level leads to turnover and underlines the importance of new retention strategies.


Another significant element in the discussion is globalization and its impact on turnover, retention, and the overall healthcare sector. The process of globalization is usually associated with multiple economic, political, and social shifts that affect information interactions, professional ethics, education, and migration (Dorri et al., 2020). Some people share their concerns that globalization creates additional opportunities for healthcare providers or contributes to introducing new challenges and obligations. Employees from different parts of the world try to find the best working conditions and choose facilities relying on their personal preferences and professional needs. Although improved education and experience exchange might help retain employees, the negative impact of COVID-19 as one of globalization’s outcomes cannot be ignored. The pandemic was impossible to foresee, but its fatality ratings touched many nations worldwide because of fast-developing globalization processes (Shrestha et al., 2020). The healthcare industry was damaged, but employees had to continue working to help patients, protect their health, and save lives. Some employees could not continue working for personal reasons, many nurses and doctors did not survive, while others were obliged to leave or follow restrictions.


Finally, promoting a multicultural environment in health care provokes additional controversies among employees. Not everyone is ready to work with representatives of different races and ethnicities. Cultural competence turns out to be an obligatory element in the healthcare system to identify and respect patients’ cultural backgrounds, values, and preferences (Stubbe, 2020). Many employees enjoy the outcomes of improved cultural intelligence and use their knowledge to cooperate with patients and colleagues, while some people cannot cope with the existing diversity. Thus, retention in healthcare might depend on cultural factors closely related to personal demands and expectations.

Strategies to Help Maintain Retention

Employee retention is a serious organizational concern in the healthcare industry because of high costs and unpredictable changes due to employee turnover. Patients and the staff want to cooperate with the same people and not spend much time sharing the same information several times or challenge the quality of work. However, it is not always easy to retain human resources, and leaders or managers should think about the most appropriate strategies in their working plans. First, it is important to focus on employee engagement to prepare them to cope with tasks and predict complications. Then, team-building, communication, and motivation should be added as critical retention factors because employees might prefer different reasons to stay. Competition, education, strategic planning, and leadership contribute to the development of professionals in the workplace. Each strategy has its strengths and weaknesses, and the success of retention depends on how well managers understand their tasks and expected outcomes.


Employee engagement is a crucial factor in the healthcare sector that depends on multiple factors like workload, unstable schedules, and low flexibility. People should be satisfied with the conditions under which they develop their professional skills and complete their tasks. Therefore, the strategy focused on employee engagement is one of the primary changes to be considered. Suomi et al. (2021) admit that healthcare practitioners prefer to work with a sufficient number of patients and obtain adequate earning levels. At the same time, engagement is a two-way relationship between an employee and an employer (Robinson et al., as cited in Suomi et al., 2021). Thus, employee needs and employer resources should be equally examined and explained. Not many benefits would be achieved if the requirements of one group of people only are met, while others should survive under the pressure of someone’s needs. Engagement is related to the enthusiasm promoted within a specific workplace culture.

When people have options to choose from, they are eager to contribute to creating a positive working environment. A friendly atmosphere is based on community support and an appropriate division of labor (Suomi et al., 2019). There has to be a system in which healthcare providers identify their responsibilities and treat each other politely (Perreira et al., 2018). As soon as people get access to a plan of work, they will be able to recognize their feeling and attitudes toward the idea of high-quality health care and decide to stay within the offered system. Developing emotional commitment is a part of the chosen strategy because it affects not only employees but patients (Perreira et al., 2018). When nurses are engaged in their work, they obtain clear information from their patients and strengthen their positions in facilities. Positive emotions, social support, and respect are the steps to promote employee engagement and retain them in health care.

Focus on Teamwork

Another approach to reducing turnover is to understand that cooperation and team-building create a supportive background for employees. Teamwork helps leaders make their decisions and listen to what employees want to achieve or can do at the moment, following the principle of harmony (Astuti et al., 2021). Traditional roles of healthcare providers include patient education, well-being maintenance, and providing clear information about health conditions, diseases, and available treatment plans. As a result, employees are stuck with their routine duties and search for additional opportunities and sources of inspiration. The expansion of regular obligations turns out to be possible with teamwork because people exchange their ideas, observe each other achievements, and assess their skills within a particular environment. Working in a team is associated with promoting respective roles, increased work quality, and a mutual desire for progress (Astuti et al., 2021). People discover new ideas to improve their practice and mutually discuss steps and outcomes, reducing biases and unnecessary judgments.

Each person is a unique source of talents, beliefs, and opinions. When employees decide to quit, they usually mention poor recognition of their contributions as one of the possible reasons (Maassen et al., 2021). Other turnover causes include poor or no work-life balance, bullying, and zero tolerance in interpersonal relationships (Lockhart, 2020). When people start collaborating, they get a chance to study each other and identify personal needs within the same professional environment. Thus, teamwork is a condition under which self-awareness is increased, and mutual support is promoted. Instead of completing specific tasks and striving for personal success, team-building emerges, and the burden of responsibilities is equally divided.

Communication Improvements

The development of work attitudes cannot be ignored in retaining employees, and communication strategies are constantly implemented to support people with different personal characteristics and needs. On the one hand, a positive working environment is based on the possibility of communicating different outcomes, procedures, and resources (Perreira et al., 2018). People want to know what they can do to achieve their goals by talking about the current state of affairs. On the other hand, internal communication allows healthcare practitioners to recognize their feelings, share information, and underline the worth of emotions at work (Suomi et al., 2021). It means that cultural intelligence and control are expected while talking. In both cases, communication appears to be an obligation and some kind of expectation for employees. When people are deprived of time or communication opportunities, they misunderstand their tasks, make guesses, and follow wrong judgments, leading to medical errors, low-quality care processes, and turnover. Communication improvements are necessary strategies to establish the necessary contacts and ensure that enough information that is critical for treatment is available.

It is also important to understand that communication in the healthcare sector should occur between healthcare providers (therapists, nurses, administrators, etc.), patients, family members, and leaders (employers). Recognizing different communication lines is a good way to reduce employee turnover and enhance professional relationships in the workplace. Communication between superiors and subordinates, patients and healthcare providers, and co-workers positively affects performance and reduces pressure levels (Astuti et al., 2021). Each type has its goals, and employees must understand what information to share, what facts to disclose, and what opinions to reveal.

Competition and Motivation

When a person decides to leave a current place of work, there should be enough clear reasons for this step, and an inappropriate impact of competition or poor motivation may become a significant contributor. Modern organizations address various sources and ideas to motivate employees, including autonomy, competence, salary/pay scales, and various reward approaches (Al-Qathmi & Zedan, 2021). If transparent and fair conditions are neglected, burnout and turnover emerge because employees want to see their work appreciated. Therefore, people need clear rules and regulations to organize their work and assess their results. Competition between groups or individuals is a strategy that is rooted in society and promotes excellence and perfection (Shkoler & Kimura, 2020). When people compete, they encourage self-development and define new professional interests and goals, distracting them from the idea of turnover. Thus, retention may be achieved if a healthcare facility properly recognizes and respects a fair, competitive advantage. Competitive salaries, financial rewards, regular meetings, and other benefits will raise the interest of a worker to consider retention as the only option to achieve higher gains and use these options as appropriate motivation.

Education and Training

In addition to creating a positive environment for competition and communication, employee retention depends on the level of education and training. Al-Qathmi and Zedan (2021) admit several important reasons for turnover, namely negative supervisor attitudes, lack of independence, and insufficient training and education opportunities. In addition to flexible work hours and salary rates, people want to be sure that they can develop their skills and increase knowledge levels, promoting and gaining additional benefits. The continual education and training strategy helps healthcare providers improve their personal and technical skills. Employees understand what they can do to improve care quality, employers discover what affects job satisfaction, and patients benefit from high-quality care. Multiple training programs should be available for workers, not at the expense of their days off or vacations, not to overwork and lose interest. Participants should focus on their analytical skills, critical thinking, decision-making, and problem-solving. When they have a professional source of knowledge improvement, they would hardly decide to change a place. Thus, education and training should be the major parts of any retention strategy.

Strategic Planning

Retention should not only address the prevention of turnover but also the improvement of the already offered approaches. Thus, strategic planning can be an interesting way to help employers attract employees and develop a positive vision for the future. Regular discussions, human resource practices, employee engagement, and education should be planned to ensure there is enough space for each step and activity (Suomi et al., 2021). An ordinary plan means the creation of tasks and order in every activity, while strategic planning is based on the future perspective of each decision. In the healthcare sector, strategic planning covers patients’ needs, employee satisfaction, and benefits for employers to control finances and not lose valuable resources. Retention of employees will be strategically planned if employers learn how to invest in human resources, choose managers, and maintain communication at all levels. Motivation, satisfaction, and education are strategically combined to create a properly planned workplace (Shkoler & Kimura, 2020). In this case, goals and objectives will be clarified, and the most appropriate cooperative methods will be chosen.

Effective Leadership

Finally, any strategy depends on how well leaders are able to cooperate and introduce the most effective decisions for their followers. Maassen et al. (2021) define leadership as any formal and informal activities in a facility to affect change and achieve excellence in practice. This perspective means that time and money invested in an idea or a person bring positive outcomes (Perreira et al., 2018). All strategies mentioned above can hardly work if there is no professional leader in an organization. Therefore, it is correct to say that leaders must demonstrate compassion, respect, and transparency in their decision-making and attitudes toward subordinates.

The link between leadership and retention is currently discussed in many academic projects. For example, Astuti et al. (2021) suggest that leaders and employees must think positively to avoid or manage conflict. According to Suomi et al. (2021), leadership should nurture employee engagement and understanding of employee-centered approaches. In addition, leading people implies support, team-building skills, administration, and management of all activities at the workplace (Maassen et al., 2021). Strong leadership improves culture, strengthens profitability, and maintains motivation and inspiration at different levels. Leaders usually prefer their work styles addressing their knowledge, skills, and resources and following their organizational goals and expected outcomes. If retention is one of the purposes, effective leadership is an appropriate strategy to be implemented.

Effective Working Environments

Employee retention is the major outcome of the offered strategies and steps in the healthcare sector, which is usually characterized by establishing effective working environments and appropriate conditions for practitioners. Employees need to understand that their contributions bring benefits not only to their organizations but to their professional development and growth. As a result, a positive workplace is created to support people and show that their job is valued. However, retention is not a single process that happens due to one or two steps being taken. It is a long-lasting strategy that requires investigating resources, possibilities, and expectations within a single unit (Al-Qathmi & Zedan, 2021). Then, it is important to compare different hospital environments and determine if a competitive advantage may be achieved. When people do not spend much time searching for the best job but concentrate on their current workplace, they can analyze all aspects and create the most appropriate environment for them. In addition to addressing retention as an outcome, one should consider retention as a way to improve working conditions and gain independence in the chosen practice.


Today, healthcare services mostly depend on the level of administration and the ability of employees to collaborate and professionally solve problems. Safety culture is one of the reasons for many nurses to stay within a particular hospital because they can learn from their mistakes, examine the staff, and learn about local patients and their needs. However, successful care processes are delivered not only by nurses, and the role of administrators, technicians, and other employees should be mentioned, proving the worth of collaboration (Astuti et al., 2021). Low turnover rates mean that people get more chances to know each other and understand professional needs and personal interests. It is easy for employees to communicate, exchange information, and predict what demands or achievements may be associated with their work. High-level collaboration is probably one of the most valuable results of retention for employees. Instead of learning new rules, standards, and obligations, they contribute to the already created environment and use each other’s strengths to hide the weaknesses of the organization, if any.

High Care Quality Levels

In the healthcare sector, one of the essential goals for employees to achieve is to ensure that all patients obtain the required level of care and appropriate services. Employee turnover means that people are not satisfied with the amounts of work, the lack of flexibility, and poor employment conditions. Increased concerns about burnout, retention, and work quality are frequently observed in the post-pandemic era (Frogner & Dill, 2022). It is hard for ordinary workers to deal with shortages in human resources and equipment, which directly affects service quality. Retention seems to be one of the easiest solutions for modern organizations to contribute to care quality positively. There will be no need to hire and train new employees, and savings could be spent on treatment, not on unnecessary and usually unpredictably search processes. Retention through addressing the necessity to improve health care becomes a solid motivation for truly devoted nurses and other healthcare practitioners.

Conclusion and Recommendations

Employee retention brings a number of positive outcomes to modern healthcare organizations. In addition to an increased number of satisfied, motivated, and well-trained employers enjoy the possibility of creating a positive working environment, improving care services, using resources, and choosing the right people for available jobs. Thus, it is important to understand how to retain employees in health care under the pressure of globalization, multiculturalism, and administrative innovations. Employee engagement, education, communication, team-building, leadership, motivation, and competition are the elements of the most effective strategies. It is not enough to choose one idea and follow it precisely but to combine recommendations and check what approaches bring the necessary results. Individuals should be eager to stay within their facilities to apply and develop their skills and knowledge and stabilize care services. Retained employees know more about the peculiarities of their organizations, their professional obligations and tasks, and the expectations of local citizens who use services. Retention is a good solution to improve finances, reduce administrative tapes, and create the best working conditions for people.

Considering recent findings in the healthcare sector, two main recommendations can be given. First, it is expected to promote cooperation between all departments at all levels. Healthcare practitioners must exchange their knowledge, share information about patients and services, and support each other. Team-building is a solid background for other strategies for retaining employees. When a person has a preferred team for work, there are more changes for him/her to stay and contribute to organizational progress and personal development. The second recommendation should include financial changes and stabilization for employees. Most people are interested in their emotional well-being at their chosen workplace. However, despite the existing opinions about healthcare altruistic intentions, people need fair salaries and expect their work to be recognized and appreciated. Thus, rewards, stable wages, and rational treatment are the steps to retaining employees in the healthcare field. People choose jobs to earn a living, and many turnover reasons are related to low financial support. Retention will be successfully promoted if the financial and organizational needs of employees are properly evaluated and met.


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