Understanding Nursing Staff Attrition in Ambulatory Care: LHC Cohort Discussion

In a recent cohort discussion hosted by the Nashville Health Care Council’s LHC Cohort, prominent healthcare leaders shared their insights into the reasons why nursing staff leave ambulatory care settings. The conversation featured valuable perspectives from Michele Hasselblad, Vice President & Chief Nursing Officer of Adult Ambulatory Operations Nursing at Vanderbilt University Medical Center (VUMC), and Nancy Muldowney, Clinical Nurse Manager – BCBST, Provider Network Management. This discussion shed light on the multifaceted challenges facing ambulatory care and offered strategies for retaining nursing talent.

Core Reasons Nurses Transition Out of Ambulatory Care

1. Retirement: A recurring theme in the discussion was retirement as a primary reason for staff departures. Michele Hasselblad explained that many experienced nurses transition to ambulatory care later in their careers, seeking the autonomy and flexibility it offers. However, as these nurses approach retirement age, their exit from the workforce becomes a notable factor in staff turnover.
   
2. Career Pathing and Autonomy: The level of autonomy and the range of roles available in ambulatory care are significant draws for nursing staff. Nevertheless, if nurses feel their career options are limited or if they desire a change in their professional path, they might seek opportunities elsewhere. Hasselblad emphasized the importance of career pathing—regular discussions about career development can help keep staff engaged and motivated by aligning their roles with their evolving interests and career goals.
3. Burnout and Career Transition: Burnout remains a critical issue, exacerbated by increasing patient needs and an aging population. Nancy Muldowney noted that while nurses are generally highly committed to their profession, severe burnout can lead to early retirements or transitions to different roles. For example, some nurses might shift from hospital settings to ambulatory care to achieve a better work-life balance.

Flexibility and Remote Work in Ambulatory Care 

The discussion also addressed the impact of remote work on nursing roles. Michele Hasselblad pointed out that while some nursing functions, such as triage, can be performed remotely, many roles require in-person patient interactions. The pandemic accelerated the adoption of remote work, with organizations seeing an increase in their remote workforce. Despite this, many nurses expressed a strong preference for returning to in-person work due to the value they place on direct patient contact and team collaboration.

Ambulatory Care and the Important Role of Career Pathing

Career pathing emerged as a key theme in the conversation. Both Hasselblad and Muldowney stressed the need for organizations to support nurses in navigating their career trajectories within their current institutions. By offering opportunities for role changes or specializations and providing clear pathways for advancement, healthcare organizations can enhance staff satisfaction and reduce turnover.

The cohort discussion highlighted several factors influencing why nursing staff might leave ambulatory care, including retirement, burnout, and the desire for career growth. By addressing these issues through effective career pathing, flexible work arrangements, and supportive management practices, healthcare leaders can better retain their nursing staff and ensure a stable and engaged workforce.

The Nashville Health Care Council’s LHC cohort discussion provided valuable insights into the complexities of staff retention in ambulatory care and underscored the importance of proactive measures to support and retain nursing talent.

The Next Generation of Healthcare Leaders 

Leadership Health Care’s mission is to cultivate talented healthcare professionals into the industry leaders of tomorrow. LHC aims to provide young professionals with ongoing opportunities to develop their knowledge of the healthcare industry through educational events and networking opportunities. Fill out this form to learn more about LHC.