Why hospital staff leave and how to understand why
Nurses, doctors, technicians and support staff leave hospitals for different reasons. How to run a respectful exit conversation, spot patterns and act.
7 min readRead articleA postnatal care service sends trained women into homes to look after mothers and newborns. This page covers the people side: caregivers, doulas, night shifts and the trust a family places in a stranger.

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Share your requirementsA postnatal care and doula service places trained caregivers in homes for days or weeks after a birth. Some stay at night to help with newborn feeds, some come for the day for massage, bathing and meal help, and doulas offer emotional and practical support through pregnancy and after. The business sells trust: the family lets a woman they have not met into their home with a newborn. The team includes caregivers, nurses or lactation consultants who train and supervise, a coordinator who matches and schedules, and a client care desk. Placements are short, start at odd hours and end abruptly. Quality depends on training that is hard to verify and supervision that is hard to do. See also HR for hospitals.
These are the places the people side of this kind of business tends to give way. The rest of this page works through them.
HR here has to work for each of these groups, not only the office. The set-up below is written with all of them in mind.
GullyHR runs talent acquisition for permanent roles in postnatal care and doula services. For each role we agree the job description with you, find and screen candidates against it, and support the offer through to joining. Tell us the role and the number of people, and we start there.
We recruit permanent employees. We do not supply contract or temporary staff.
Every business interviews, but few have a written process that works the same way for every role and every interviewer. GullyHR designs yours, from the role brief to the offer, trains your managers to run it, and can run it for you on the roles you hand us.
We agree what the role must deliver, the must-have and nice-to-have skills, and how each will be scored.
Screening call, assessment, interview rounds and decision points, sized to the role and the number of people you hire.
Structured questions for each role family and a rating guide, so two interviewers judge the same answer the same way.
A short briefing for your managers on what to ask, what to avoid and how to give a clear yes or no.
Who approves, how the offer is made, and how candidates are kept informed from first call to joining.
A baby arrives early or late, and caregivers wait idle or are asked to start within hours.
A caregiver works through the night in a stranger's home with no one to call.
Women arrive with different experience, and the agency has a certificate but little proof of skill.
The coordinator picks a caregiver by memory, and the fit on language, diet and temperament is hit or miss.
Beliefs about feeding, swaddling or visitors differ by home, and caregivers meet conflict without guidance.
A supervisor can visit few homes, and a problem in a placement shows up through a complaint.
A family likes the caregiver and offers a direct arrangement, and the agency loses both the client and the worker.
Payments depend on the family settling, and the caregiver waits for earnings.
Start with the topics that matter most here: Recruitment and Talent Acquisition; Learning and Development; Health, Safety and Wellbeing. Then work through the rest. Each topic is written for healthcare, not in general.
Requisition to joining, the same way every time.
Training planned from need rather than from the calendar.
Induction, records, incident reporting and follow-through.
How many people, in which roles, by when — and what they will cost.
Structure, reporting lines and who is allowed to decide what.
A first day that is the same for the fifth joiner as the first.
Records, attendance, leave and the day-to-day HR that must simply work.
Salary structure, payroll inputs and a month that closes on time.
Goals, reviews and ratings that hold up in a conversation.
Named backups for the roles that cannot be vacant.
Communication, recognition and the conditions people actually work in.
Two routes — one for complaints, one for conduct — kept separate.
Policies a manager can apply, and obligations with owners and dates.
Who leaves, when, why — and which of them mattered.
Resignation to relieving letter, in a defined order.
Records that survive people, and approvals that do not queue.
A short monthly pack management actually reads.
An HR function that runs the same way every month.
The pieces a postnatal care and doula services business puts in place, in an order that makes each easier. Open any card for the detail.
A pool of trained caregivers on short notice, with a pay rule for waiting days.
A pool of trained caregivers on short notice, with a pay rule for waiting days. The recruitment process keeps it topped up.
Check-in calls, a contact person for each shift and a written escalation plan.
Check-in calls, a contact person for each shift and a written escalation plan. The health and safety work holds the steps.
Feeding, bathing, hygiene and warning signs, with an observed check and a record.
Feeding, bathing, hygiene and warning signs, with an observed check and a record. The learning and development process holds it.
Language, diet, experience and family preferences recorded for each match.
Language, diet, experience and family preferences recorded for each match.
A short guide on respect, boundaries, who decides and when to call the agency.
A short guide on respect, boundaries, who decides and when to call the agency.
Weekly or fortnightly payment independent of when the family settles.
Weekly or fortnightly payment independent of when the family settles. The payroll process covers the schedule.
Before changing anything, find out what is true today. These checks take an afternoon and tell you which of the topics above to start with.
Share your requirementsConfirm with a qualified professional. What applies to you depends on your business, your state and your arrangements, and it changes. This page describes practice. It does not state a legal position.
The services below fit this kind of business best. Each starts by recording where you stand, and every later report compares against that. We do not promise outcomes.
A trained bench for sudden placement starts.
Observed skills sign-offs and a record per caregiver.
Night duty and home safety routines.
Fixed pay dates that do not depend on the family settling.
Start with a free conversation, or see the paid HR Diagnostic.
Understand the hospital, its workforce, current processes and HR challenges.
Find the missing, weak, inconsistent or person-dependent processes.
Create the structure, processes, policies, SOPs, dashboards and systems needed.
Help HR and department managers actually adopt the new system.
Digitise repetitive and approval-based workflows where it is worth doing.
Track hiring, attendance, employee cost, performance, training and attrition.
Strengthen the people-management system continuously, not once.
From the GullyHR blog: one on HR in healthcare, and one on each of the topics this page points to.

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Keep a bench of trained caregivers and a pay rule for waiting days, so women are not left without income when a baby is late.
Observe them on a mock case, use a checklist and keep a record, in addition to any certificate. Clinical content is for a qualified professional to set.
Use scheduled check-in calls, a named contact for each night and a clear plan for emergencies.
Fair pay, prompt payment and a clear conversation on terms reduce it. Confirm what can be written into the contract with a qualified professional.
Give caregivers a short guide on boundaries, a number to call and a coordinator who responds quickly.
We would ask how many caregivers can start at short notice, how skills are checked and when they are paid. A good first project is a bench plan plus a skills sign-off record. Scope is written down before work starts.
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