Improving nurse retention with stay interviews.

mock code blue in hospital

The ongoing shortage of experienced nurses and high turnover rate show no signs of stopping. According to NSI’s 2020 National Health Care Retention & RN Staffing Report, a clear indicator of the RN staffing crisis is the rising vacancy rate. Currently, this stands at 9% across healthcare organizations and has increased since last year. On top of this, registered nursing is looking to be one of the growth occupations through 2026. The national Bureau of Labor Statistics projects the need for at least 200,000 additional RNs per year which does not include the as-yet unknown impact of COVID-19.

NSI also reports that staff RN turnover remains steady at 15.9%. The cost of replacing each of these nurses averages $44,375, with specialty nurses and experienced nurses costing up to $56,000 to replace. As well as the cost of exiting nurses, there is the time it takes to recruit replacements. Currently, it takes 81 days, or nearly 3 months, to replace an experienced nurse.

To combat this, managers are looking for new ways to retain good nurses. One solution? Stay interviews.

Stay Interviews – What are they?

 According to the Society for Human Resource Management, stay interviews for nurses are simply one-on-one interviews between a manager and a valued employee. They are done to help managers understand why high potential employees stay and want to keep working for the organization. Similarly, these interviews can tease out what might cause key nurses to leave and lead to engaging these employees before they become dissatisfied. In an effective stay interview, nursing managers ask everyone the same questions in a casual and conversational manner, typically taking less than half an hour per nurse.

And while the input of important employees is priceless, everyone can benefit from a stay interview, says Amy Polefrone, CEO of HR Strategy Group. When done across all nurses in an organization, managers may find that employees all site the same reasons for staying and wanting to leave.

Why are stay interviews becoming popular?

 Dr. John Sullivan, an HR thought leader, has been promoting stay interviews for decades and the practice is gaining momentum according to the Society for Human Resource Management. Now with the rising costs of RN turnover and the impending mass retirement of Baby Boomer nurses, healthcare organizations are listening. Stay interviews for nurses can keep the best, brightest, and reliable staff members invested in their work, saving managers from the hassle of recruiting, hiring, and training costly replacements or relying on expensive travel nurses.

Who else uses stay interviews?

 Any organization can use stay interviews to keep in tune with their employees, but they are especially useful for industries with high turnover such as retail and hospitality says Kim Littlefield, Senior Vice President of Keystone Partners, a career transition and leadership development firm. Nursing, with its high turnover and nationwide staffing deficit, is a field that can especially benefit from these meetings so that managers can engage staff members before they want to leave.

What benefits do stay interviews deliver?

For now, most of the reports of the effectiveness of stay interviews for nurses are anecdotal as only 27% of companies currently use them. One person who has been keeping track of actual results is Dick Finnegan, CEO of C-Suite Analytics. He claims that a Florida hospital and a retirement community each decreased nurse turnover by 70% by implementing stay interviews.

However, even without hard data, it’s easy to see quick results from the process of doing stay interviews. Gathering information from key employees that the organization does not want to lose can shed light on trouble spots and give managers input on what they are doing well. This way, hospitals and managers can benefit from keeping the knowledge base of older nurses, and prepare for the future by retaining promising new nurses.

Furthermore, stay interviews establish a culture of trust between the employee and manager, which can increase job satisfaction, performance and retention. According to Pamela DeLoatch at, stay interviews identify issues to address before they become deal-breakers, saving money and time otherwise spent recruiting.


To start:

As stay interviews for nurses are first and foremost simple and honest conversations, managers can start by setting the tone. An example from Sullivan begins by stating, “Thanks for taking the time to have this discussion. As one of our key employees, I want to informally pose some simple questions that can help me to understand the factors that cause you to enjoy and stay in your current role,”

To explore why they stay

The goal is to collect real-time information on what matters most to nurses and then individualize your retention strategies.

  1. Tell me specifically, what factors cause you to enjoy your current job and work situation? What do you look forward to each day when you commute to work? This can include people, job, rewards, tasks and skills, coworkers, management etc., and as a result, they contribute to your staying at our firm as long as you have. Help us identify the factors that make you more passionate, committed, and loyal to your team and the organization.
  2. If you have ever been asked by a close friend or have been contacted by an external recruiter, can you tell me what reasons you gave them for wanting to stay at this organization?
  3. Do you feel that you are currently doing “the best work of your life?” Can you list for me the factors that could contribute to you” doing the best for your life?” (Note: this is the No. 1 key retention factor for top performers according to Sullivan) Possible further probes may be:
  • Tell me more about why that is so important to you.
  • Is that the only reason you stay or are there others?
  • If you narrowed your reasons to stay to just one, what would it be?
  1. Do you feel that your work makes a difference to the organization, to patient, and to the community? Do you also feel that your coworkers think that you make a difference? (This is the No.2 key retention factor for top performers.)

To explore why they’d leave

According to Ilan Mochari from, this section of the stay interview can begin by inviting nurses to open up and speak honestly. He gives the following question as one approach:

  1.  “Think back to a time in the last 12 months when you have been at least slightly frustrated or anxious about your current role. Can you list for me the frustration factor or factors that most contributed to those feelings? Can you also help me understand what eventually happened to lower that frustration level?”

It’s also helpful to gather informal information from nurses who have already left. Try asking current employees the following:

  1. If you’ve had conversations with other nurses who have considered leaving or who have actually left our firm, did any of the reasons that they provided for leaving cause you to at least partially nod in agreement? Can you list those reasons and tell me why they seemed to be at least partially justifiable as a reason for leaving to you?

To close the stay interview

 It’s important to wrap up the interview on a positive note. Managers can show that the nurses’ concerns and opinions are understood and valid by summarizing the main reasons they gave for staying or potentially leaving the organization. The Society for Human Resource Management recommends something along these lines: “Let me summarize what I heard you say about the reasons you stay at [Organization Name] as well as reasons you might leave. Then, let’s develop a plan to make this the best place for you to work.”


Managers can uncover a goldmine of valuable and actionable information with these six stay interview questions and less than 30 minutes per staff member. Sullivan suggests holding interviews once a year, during a slow period; that way, leaders can quickly take what they’ve learned and implement solutions around that information.

The perennial staffing concerns for nurses are nothing new and most likely not changing. The additional stress and workload spike as a result of covid has also had a negative impact.

Organizations need to develop new strategies for reducing turnover and improving the workplace for nurses. Several Xapimed clients have identified stay interviews as a simple and inexpensive way to garner feedback from their clinician staff. They quantify and track their Stay Interview programs using the Xapimed platform.

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