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The high cost of complacence: addressing systemic turnover in organizations.

This was originally written from a healthcare perspective, but I am seeing the same degree of complacency across all industries.  The high-turnover, the pain, the frustration is hurting everyone, our operations, and bottom line.  What the heck is really going on?  


We’ve heard about the nursing shortage and nursing turnover for years.  It has now become a larger problem than nurses in hospitals.  Currently, we’re seeing turnover in every aspect of healthcare.  Lately, everyone I talk to about turnover tells me the same thing: no one seems to care.  Stories from others who work in healthcare are equally troubling.  It’s almost as if it’s been accepted as routine.

  • The local orthodontist just shrugs his shoulders when yet another assistant walks out.  He claims that training another one is just the cost of business. 

  • A local hospital CMO had a similar response to the elderly patient who laid in the hallway, on a gurney, for four days.  His rationale: there simply isn’t the staff to transfer him. 

  • The Executive Director of a local skilled nursing facility brings in a team to on-board yet another group of new hires each month, the turnover is that high.  According to her, however, she doesn’t have the funds to identify or fix it.  All the while an elderly patient runs naked through the facility because yet again there are not enough staff to for the patient-census. 

  • A local manufacturing facility has absenteeism, turnover, and quiet-quitting – oops I mean sabotage (see November 6, 2023 – When words matter), to such a degree that they have had to shut down an entire line of production.  The plant director, said there wasn’t anything that could be done. 


Meanwhile, the continuity of patient care, the mis-diagnosed or poorly treated disease process, and the neglected elderly suffer silently through the cost associated with high turnover.  That is just on the patient side.  What about the emotional, mental, and physical health of the team-members who stay and work through the challenges?  What about the pass-through costs of associated turnover to the patient? The community reputation?  Has complacency taken over common sense in healthcare?  What is really driving this problem and what are the solutions?  More troubling, why doesn’t anyone seem to care?  It’s said that “hurt people, hurt people” (author unknown), is everyone simply too hurt, stressed, compassion-fatigued, exhausted or burnt out to care? 


In political science and sociology, there is an event called the J-curve.  Both are two of the five social sciences that make up organizational behavior, or what defines how organizations function.  The J-curve identifies the reasons behind the collective rebellion of individuals who perceive an injustice as once recognized benefits are stripped away.  Will there be a j-curve moment when the pain associated with turnover becomes unbearable to staff and patients?  At what cost will our complacency drive change for which we’re not ready?  At what point will patients move away from healthcare all together, finding benefits outside of a broken system?


If we want to address and tackle the problem of systemic turnover in any organization, we have to understand it at the root cause, identify simple, cost-effective short-term solutions to stop the hemorrhaging, and begin to think strategically about mid- and long-term people-oriented resolutions.  But first, we have to care.


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