Losing rookie nurses is expensive. Here's Sanford Health's plan to make sure they stay

SIOUX FALLS, S.D. — It is expensive to lose a nurse. Even the rookies.

When a nurse leaves a job at Sanford Health, the turnaround costs run up to $70,000 said Meghan Goldammer, senior vice president of nursing and clinical services.

Finding nurses isn't easy, either. So the regional health provider, which employs 8,200 nurses, is committed to keeping the ones they have, starting with the rookies.

Sanford Health has launched a year-long retention program for new nurses, an effort meant to support them in their new jobs and jumpstart long-term careers with the organization.

“That was some of the impetus of this program, is really investing in our new nurses’ success so they’ll spend the rest of their careers here," Goldammer said.

The program currently includes 300 nurses that work in Sanford's large hospitals, with localized monthly training taking place at the organization's large health care facilities in Sioux Falls, Fargo and Bismarck in North Dakota and Bemidji in Minnesota.

The program will include three training cohorts of nurses a year, matching the pace at which nurses graduate and take board exams.

Sanford, like other health care organizations, is facing a nurse hiring crunch that isn't going away, Goldammer said. Health care providers are dealing with more patients in aging Baby Boomers. Meanwhile nursing schools, struggling to hire and replace faculty, aren't keeping up with the demand for new nurses.

Sanford has a big additional challenge. Its regional footprint is in the Upper Midwest, which further shrinks the pool of potential applicants.

"This is isn't necessarily a destination area in the country like Florida or Arizona, so most of the people who come here that haven’t graduated from a program from here, are originally from here or have family," Goldammer said.

All new nurses have a standard on-the-job orientation, a standard 4-6 months of training where they work. Then, new nurses can often hit a lull that could frustrate them or cause them to decide to leave the Sanford job or their career, Goldammer said. The residency program is meant to extend past training new nurses how to assess patients, and admit or discharge them.

"The nurse residency system is above and beyond that," Goldammer said. "It’s really a professionally developed evidence-based program that will be accredited to help transition the new nurse graduate into her first professional role."

Goldammer said Sanford will run the program for a year, then seek accreditation for it before scaling it up to include nurses at Sanford clinics, smaller rural hospitals and Sanford's senior care facility wing, the Evangelical Lutheran Good Samaritan Society.

The residency training, conducted via monthly seminars, keeps the same group of new nurses together and trains them in areas such as leadership, professional nursing role and quality outcomes. Curriculum topics include critical thinking, critical reasoning, patient safety, interprofessional communication, evidence-based practice, patient and family centered care, and also address what progression as a professional nurse looks like.

In the past, nurses might plan on being nurses the rest of their careers. Today, that's not the case, Goldammer said. So Sanford wants nurses to know what opportunities are out there for them.

"It may not be at the bedside taking care of a patient. And we find a lot of value in that," Goldammer said. "We see our new nurses as our next leaders, really. And that could be in administration, in our quality programs, in risk management. There’s a role for nurses across health care settings, and a lot of people are looking for what those opportunities are.”