Miami-based Nicklaus Children’s nearly halved its nurse turnover rate in three years. One of their most powerful strategies for achieving that result was being “extremely responsive to nurse feedback.”
At its peak, nurse turnover was at 23.2% in 2021, but by the end of 2024, the system’s turnover rate had dropped to 12.7% (the national average is 16.4%).
There were a lot of contributing factors to the drop in turnover from Nicklaus Children’s creating a more robust nurse pipeline to improving professional development opportunities. But some of the biggest improvements came from their chief nursing officer’s open office hours and “Take Your CNO to Work” initiative.
Every month, Shannon Odell, MSN, RN, spends a few hours during the day and night shifts holding open office hours.
“These conversations are informal,” she told Becker’s. “I listen, take notes, and then debrief with unit leaders to identify and address any challenges.”
Ms. Odell also spends a few hours each month shadowing a staff nurse in a program called “Take Your CNO to Work.” They work side by side to care for patients, allowing Ms. Odell to observe their daily workflow and challenges.
Both of these tactics have given Ms. Odell a chance to address challenges she may have never learned about otherwise.
For instance, one of her cardiac ICU nurses recently walked in during open office hours to talk about an ongoing frustration. Often enough, nurses would be on their way to work in traffic when they would get a call from the hospital: they were being placed on-call or they weren’t needed for their scheduled shift after all.
“Especially for night shift nurses who sleep during the day in preparation, getting a last-minute call-off was deeply disruptive,” Ms. Odell said. “We realized we weren’t affording them the same courtesy we expect from them — like advance notice for call-outs. We analyzed the staffing office workflows, added FTEs to provide 24/7 staffing office coverage, and adjusted processes to give nurses better advance notice.”
Another program that was conceived from the input of nurses is called LENS, or Leadership Exploration Nurse Shadowing. Nurses who are interested in pursuing leadership positions — including nurse managers, clinical education specialists, or even CNOs — are given a chance to shadow a leader with that title while getting paid.
“Many go on to pursue leadership roles,” Ms. Odell said. “It’s a simple, impactful way to show nurses you’re invested in their future.”
