A hospital should track both: total turnover counts all departures, while voluntary turnover focuses on employee-initiated exits. Each measure answers a different workforce question, and neither explains by itself why people leave.
What does each turnover measure show?
Total turnover helps with staffing plans: a medical-surgical unit still needs replacement coverage when nurses resign, retire, or relocate. Voluntary turnover can help leaders examine preventable strain, particularly when departing employees mention scheduling, workload, or limited support. Compare units and time periods alongside vacancies, staffing mix, and employee feedback.
When you review a rise in resignations, Choose Your Attitude can help you notice your reaction and choose a constructive response without minimizing staffing problems. The figures are a prompt for inquiry, not a verdict on a unit or its leader.
How should leaders use both rates?
Define the same period and employee groups for each calculation, separate voluntary exits from all departures, and record reasons when known. Look for patterns by role and unit, then choose one practical issue to address, such as giving schedules earlier or improving shift handoffs. Set a date to revisit the pattern and see whether the response helped.
Questions like this one, and many more about hiring and retention, are explored in the FISH! Philosophy upgraded trial, which gives your team 30 days of access to the FISH! film and its digital guides.
