News: Looking after nursing staff is the key to reducing turnover

Empathy, self awareness and emotionally focussed thinking from leaders and managers vitally important to strong mental health and reduced anxiety of workforce.

Looking after nursing staff is the key to reducing turnover, rather than pay, according to a nurse expert on healthcare regulation.

The Nursing Times 19 May 2016


“Evidence suggested that good line management was the most important factor in staff retention” said Ellen Armistead, deputy chief inspector of hospitals at the Care Quality Commission and the Nursing Times Directors Congress.


She went on to say: “There’s so much evidence that the reason you have high turnover isn’t that your neighbouring trust is paying a band higher, it’s whether people like being managed and feel safe in that team….You will keep staff if you look after staff, if you listen to staff,” she said. “All of your recruitment plan credibility has to be underpinned by what does line management look like, what is the leadership of that area and would I want to go and be part of that team.”

She acknowledged that nurse to patient ratios were “one part of the picture” in its assessments on whether staffing was safe, but suggested the CQC attached more importance to the “credibility” of plans for recruitment and retention, and the escalation of concerns.

“It’s how people feel empowered to escalate concerns when there are staffing issues – whether people are encouraged to report staffing as incidents,” she said.

“How do you actually produce a credible set of outcomes that mean something,” she asked. “A lot of data is gathered at ward level but in actual fact how often do you get a holistic picture of how well a patient was cared for – in some areas that’s really easy to do and in other areas it’s harder.”

Ms Armistead identified two areas where nurses could especially “contribute” as dealing with complaints and patient flow through hospitals.

“Most teams deal with complaints very well and we’re able to see complaints are discussed and used as examples of learning and have an impact on service change and delivery,” she said. “But sometimes that’s not always the case.”

“The thing that surprised me… was the difference within services within trusts, the difference from ward to ward, sometimes within the same directorate, and even between teams of nurses in the same ward,” she said.

Ms Armistead said that, generally, intensive care and critical care had “come out of our inspections quite positively”, it being unusual for them to be rated “inadequate” or “requires improvement”.

She suggested the reason was that mandated staffing level guidance and long-standing national standards were in place for critical care, and noted it was a “similar picture” for services for children and young people.

However, she said it was a “mixed picture” for end of life care and also maternity and gynaecology services. “Most units had taken on board the findings of [Dr Bill] Kirkup and done something about that, but we do see quite a lot of variety around safety,” she said.

She added that, despite other failings, trusts were nearly always rated as “good” for being caring. But she questioned whether there was room for improvement.

“The thing for me, as a nurse by background, is caring being ‘good’ is maybe not good enough and we should all really be striving for ‘outstanding’,” she said. “I think we need to start ramping it up a bit now.”

Ellen ArmisteadEllen Armistead

“Where we do see ‘outstanding’ on caring it is generally speaking where the whole multidisciplinary team has the same set of values,” she said. “It’s not just seen as the nurses’ job….One of the things I’m looking to do is to look at how we define caring and how we assess caring,” she told delegates, noting that she intended to review how the CQC rated trusts on being caring.

Original source:

Relevant courses:

1 Communication thumbnail

Using Empathy Effectively to Aid Communication

See dates and location here

INHOUSE training packages available: Contact



2 Complaints thumbnail

Using Empathy to Help Resolve Complaints

See dates and location here

INHOUSE training packages available: Contact

3 EofL thumbnailUsing Empathy to Handle Difficult Conversations in End of Life Care

See dates and location here

INHOUSE training packages available: Contact



4 Mindfulness thumbnailUsing Mindfulness & Emotional Development to promote Staff Well-Being

See dates and location here

INHOUSE training packages available: Contact


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s