Replacing and training new nurses is a costly process. Because of the use of different costing measures (some of which include only the direct costs of replacing staff, whilst
others include indirect costs such as orientation and training of new employees) estimates of the precise cost of replacing a staff nurse vary significantly, from US $10,000–US
$60,000 per nurse (Jones 2004, Hayes et al. 2006, O’Brien-Pallas et al. 2006b). A more recent study by Jones (2008), which adjusts for inflation, estimates turnover costs at US
$82,000–US $88,000 per nurse. Less research on turnover costs has been undertaken in Australia. However, in a recent pilot study of the impact of nurse turnover on patient, nurse
and system outcomes, O’Brien-Pallas et al. (2006b) estimated mean turnover cost for nurses in Australia at US $16,634 per nurse. As well as being economically costly, high rates of nurse turnover are also associated with negative patient outcomes, including decreased continuity of care (Gess et al. 2008). Additionally, nurses working in units with high turnover tend to report higher levels of stress as they may be called on to cover vacant shifts and to
participate in the frequent training and induction of new staff (Erenstein & McCaffrey 2007).