PNP 6023 Module 4 Volunteer Program Design Example

Why Hospice Volunteers Stay or Leave: Redesigning Recruitment, Training and Retention for 160 Volunteers Across Six Rural Counties

Student Name

American College of Education

PNP6023: Organizational Board and Volunteer Development

Module 4 Assignment

Instructor Name

November 2, 2026

Introduction

The hospice in northeast Iowa depends on about 160 volunteers who sit with patients, give family caregivers a few hours of rest, help with bereavement support, sew memory quilts and staff the office. Volunteers are also a regulatory requirement: Medicare's conditions of participation require hospices to use volunteers in patient care or administrative roles for at least five percent of the patient care hours provided by paid staff and contractors. The program is valued, but it is leaking. Of the 52 volunteers who completed training in the last two years, 19 left within twelve months. This paper diagnoses why, then redesigns recruitment, training, placement, support and recognition.

Why Volunteers Leave

Exit conversations and a short survey of current volunteers point to four reasons. First, a gap between expectation and assignment: several volunteers trained to sit with patients spent months answering phones because patient assignments in their county were scarce. Second, distance: volunteers in the outer counties sometimes drove an hour to a patient, unpaid. Third, emotional load without support: volunteers who sat with patients at the end of life described feeling alone afterward, with no one to talk to. Fourth, invisibility: volunteers rarely heard what difference their work made, and recognition consisted of an annual dinner. Most departures were not about lost interest in hospice; they were about a program that did not match what volunteers came for or support what they encountered.

What Motivates Volunteers

Clary et al. (1998) proposed a functional approach to volunteer motivation, naming six needs volunteering can meet: acting on one's values, learning, being with others, building a career, easing one's own troubles and feeling better about oneself. They found that recruitment messages matched to a person's motives were more persuasive, and that volunteers whose motives were met reported greater satisfaction and intended to continue longer. The hospice's volunteers show all six. Retired nurses and church members often volunteer to express values. Nursing and social work students volunteer to gain understanding and career experience. Many volunteers who lost a family member in hospice care volunteer partly to make sense of their own grief, a protective motive that needs particular care.

Recruitment Redesigned

Recruitment will move from a single general appeal to messages aimed at specific motives and roles. For values-motivated prospects, recruitment through congregations and service clubs will emphasize presence and dignity at the end of life. For students, partnerships with two community colleges and a regional university will offer supervised hours and a reference letter, addressing understanding and career motives. For bereaved family members, the hospice will wait at least a year after a loss before inviting them and will screen gently for readiness. Recruitment will also target the three outer counties directly, through county fairs, libraries and churches, so that volunteers live near the patients who need them.

Training and Placement

Training currently takes sixteen hours over two Saturdays at the main office. It will be redesigned as six hours of online modules on hospice philosophy, confidentiality, infection control and communication, followed by a six-hour in-person session held in each region, which shortens travel and lets volunteers meet others nearby. Training will end with a placement conversation in which the coordinator matches each volunteer's motives, schedule and comfort with end-of-life care to a role. Volunteers who want patient contact but live where assignments are scarce will be offered respite visits for family caregivers or telephone companionship calls while they wait, so that no one trained for patient care spends months doing work they did not seek. Volunteers will also be able to change roles after six months, which lets a nervous new volunteer start in the office and move toward patient care when ready.

Support for End-of-Life Work

Volunteers who sit with dying patients need support that office volunteers do not. Each patient-care volunteer will be paired with a hospice social worker or chaplain for a brief call after a patient dies. A monthly volunteer circle, held by video and in person in two regions, will offer a place to talk about difficult visits. Volunteers will be told plainly during training that grief after a patient's death is normal and that stepping back for a time is acceptable. These steps respond directly to the third reason for leaving and to the protective motive that brings some volunteers to hospice.

Recognition and Feedback

A review of research on volunteer coordination found that the way organizations manage and treat volunteers, through their practices, structures and culture, shapes volunteers' experience and commitment (Studer & von Schnurbein, 2013). A national survey of charities likewise linked volunteer recognition, along with training and support, to better retention (Hager & Brudney, 2004). The hospice will therefore add recognition that is frequent and specific. Family thank-you notes that mention a volunteer will be shared with that volunteer. A quarterly newsletter will tell short stories of volunteer contributions, with families' consent. Staff will be asked to thank volunteers by name in team meetings that volunteers attend. Mileage reimbursement, now offered only for trips over thirty miles, will extend to all patient visits, which addresses distance and tells volunteers their time is valued. The annual dinner will continue, but recognition will no longer depend on it.

Cost and Value

The redesign costs money, but less than the turnover it addresses. Extending mileage reimbursement to all patient visits will cost about $11,000 a year at current volunteer travel levels. Online training modules, built once with a regional hospice association's template, cost about $3,500 to adapt. Volunteer circles and after-death calls use existing social work and chaplain time, about two hours a week in total. Against these costs, each volunteer who leaves in the first year represents sixteen hours of staff training time lost, along with recruitment effort and, for patient-care volunteers, the time families wait for a companion. Keeping even eight more volunteers a year would recover the cost in staff time alone, before counting the value of their service hours to patients and families.

Measures

Five measures will track the program: first-year retention of newly trained volunteers, with a target of 80% within two years; the share of volunteers placed in their preferred role within thirty days of training; volunteer satisfaction, measured annually; volunteer hours as a percentage of paid patient care hours, to be kept comfortably above the five percent Medicare minimum; and the number of volunteers in each of the six counties. The coordinator will report these to the board twice a year, alongside the program's estimated cost savings, which Medicare also expects hospices to document.

Conclusion

The hospice loses more than a third of new volunteers in their first year because assignments do not match what volunteers came for, distances are long, emotional support is thin and recognition is rare. A redesign built on the functional approach to motivation targets recruitment to specific motives and counties, shortens and regionalizes training, matches placements, supports volunteers through patients' deaths and makes recognition frequent and specific. Five measures will show whether it works. Module 5 combines the board and volunteer work into one development plan.

References

Clary, E. G., Snyder, M., Ridge, R. D., Copeland, J., Stukas, A. A., Haugen, J., & Miene, P. (1998). Understanding and assessing the motivations of volunteers: A functional approach. Journal of Personality and Social Psychology, 74(6), 1516-1530. https://doi.org/10.1037/0022-3514.74.6.1516

Hager, M. A., & Brudney, J. L. (2004). Volunteer management practices and retention of volunteers. The Urban Institute.

Studer, S., & von Schnurbein, G. (2013). Organizational factors affecting volunteers: A literature review on volunteer coordination. Voluntas: International Journal of Voluntary and Nonprofit Organizations, 24(2), 403-440. https://doi.org/10.1007/s11266-012-9268-y