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What to know about new nurses: Tackling Turnover

Hiring a competent nurse staff is only half the battle. The other half is keeping them. A new study published in Nursing Ethics found the turnover rates for RNs is 16.5%, with each resignation costing a hospital between $44,380 to $63,400 a nurse. Furthermore, newly licensed nurses scored lower on job satisfaction and were more likely to leave their job within two years.

The Nursing Ethics report found that intergenerational conflict was a big part of nurse dissatisfaction; with millennials, Gen Xers, and baby boomers butting heads at the hospital.

“Younger generation nurses feel like they don’t have power over their practice, they’re not in charge, and that is logical because they are novice practitioners,” study author Charleen McNeill said in a press release. “However, they bring a knowledge of technology that seasoned nurses may lack. In turn, more experienced nurses support the clinical learning and professional role formation of new nurses. Successful nurse-leaders find ways to garner the strengths of each generation of nurses to achieve the best patient outcomes.”

McNeill said instead of looking at it as conflict, nurse-leaders need to leverage the strengths of each generation and determine strategies to empower all generations of nurses. Their research suggested a strong correlation between professional values and career development. They also found that both job satisfaction and career development correlated positively with nurse retention.

“The work culture that leaders create – the environment that nurses are working in – is the most important thing related to retention,” McNeill said. “It’s very expensive to hire new nurses. When we have good nurses, we want to keep them so we need to understand what’s important to keep them.”

For more tips on retention, conflict resolution and recruitment, check out the following articles from our Strategies for Nurse Managers site!

Rock Your Health: Finally – An Easy Way to Get Moving!

Why are we so resistant to exercise?  The CDC says 80% of the US population doesn’t get the recommended amount of exercise for health.  So which group are you in – the 80% or the 20%?  Are these some of your excuses when it comes to exercise?

  • I tried it before and I always stop after a few weeks
  • I don’t feel better right away and in fact, I hurt all over
  • I don’t see the benefits soon enough so why even start again
  • I don’t have the time
  • I’m too tired at the end of the day
  • I’m too busy to fit it in
  • I don’t need to exercise because I am on my feet all day
  • I’ve gotten this far without exercising so why start now
  • I’m too old to start exercising and I might hurt myself
  • I have a health condition and can’t exercise
  • I’m too lazy

Well guess what.  I fall prey to many of those excuses as well, but at one point in my life I realized a huge benefit from regular exercise and I’ve never stopped since.  Yes, exercise became my tool to MANAGE STRESS.  Now that I use exercise as my stress management prescription, I’m much more motivated and have received huge benefits that continue to keep me coming back for more.

  • I get to burn off all the pent up energy that can turn on my body and create pain
  • Moving my body immediately changes my attitude from negative to positive
  • I get to be around other great women who want to feel better which inspires me
  • I feel better being with others
  • I’ve gained many new close friends to share feelings and reduce the anxieties of life
  • We get to laugh a lot because our instructor is so fun and pumps us up
  • My endorphins also get pumped up and I “feel” what others call a “runner’s high”
  • I forget about all the day’s irritations and just focus on my body’s movements.
  • I get really creative when exercising and come up with cool new ideas for my work
  • If I feel any depression at the beginning it all dissipates while I’m working out
  • I feel a great sense of accomplishment at the end and feel relaxed and calm
  • I sleep better

And oh yes – people ask me how I stay so fit and think I am younger than my age.  Now that is the best self-esteem booster of all!

So what are you waiting for?  Stop thinking of exercise as a chore, or torture or a waste of time.  Start thinking of it as a way to reduce stress (who doesn’t experience this daily) and you don’t have to take any drugs either.

JAMA: Nurses key to surviving surgery

A study published in The Journal of the American Medical Association has found that surgery patients in hospitals with better nursing environments receive better care without drastically increasing costs. Researchers found the 30-day mortality rate for postoperative patients was 4.8% at hospitals with more than 1.5 nurses per bed (NPB), while facilities with less than one NPB had a 30-day mortality rate of 5.8%.

“It wasn’t just the number of nurses that made the difference. Magnet status hospitals recognized for having excellent nursing programs and cultures do better,” study author Linda Aiken, PhD, RN, said in a press release.  

While there’ve been numerous studies showing the benefits of a bigger nursing staff, the cost of hiring new staff has been an impediment for many facilities. Despite this, better staffed hospitals actually paid less ($163) overall per patient than understaffed hospitals.

What to know about New Nurses: Stuck in Place

The healthcare industry is facing a shortage of nurses as members of the baby boomer generation retire and the industry expands. The upcoming decades are going to be reliant on new nurses to fill the gaps left by their predecessors. As a manager, what do you know about the people that will make up your staff in upcoming years?

Take a map of the U.S. and point to any town with a population of 100 or more. Odds are that within 30 miles of town center you’ll find a post office, a police station, a bar, and a hospital.

Hospitals and healthcare centers are key facilities and can be found pretty much everywhere. Coupled with a growing healthcare industry and more people getting nursing degrees, you would expect that after getting their license most new nurses would flock to big cities and big states for more job opportunities.

A study done by the RN Work Project found that this wasn’t quite the case. Instead, 88% of new nurses find their first job in the same state they attended high school. In fact, 66% of nurses currently work within 100 miles of their high school, with 35% working less than 15 miles away!

There are several factors that a new nurse needs to consider when thinking about moving. There’s economic factors such as the cost of living and average nursing salary in a given state. It may be more feasible for a new nurse to live with their parents and keep their expenses low while they pay off student debt. Then there’s practical considerations like the number of job openings and competition for those openings, particularly considering the difficulty new nurses have finding work. Finally, there’s the social considerations of moving away from friends and family and starting a new career in a foreign environment.

Given the increasing needs for more nurses, this lack of mobility can be an issue for states with fewer nursing programs and smaller nurse populations. A short term solution is to target your job postings at local nurses. If you haven’t already, making inroads with nearby nursing degree programs can help drive more new applicants to your door.

As for long term, you should create some incentives to encourage out-of-state nurses to move to your area. Scholarships and internships for out-of-state nurses can help you recruit and retain new nurses. Starting an off-hours program where locals show newbies and interns around can help them feel more comfortable in a new town.

One big area to look into is tuition reimbursement. As of 2011, only 69% of healthcare facilities offered tuition reimbursement to first time nurses, down from 86% in 2005. Even offering partial reimbursement can make all the difference for a new nurse deciding where to start his or her career.

Rock Your Health: Your 10 Step Guide to a Rockin’ New Year

The word TRANSITION means the passage from one form, state, style, or place to another – CHANGE!  Some of you are cringing thinking about change, but others are thinking – BRING IT ON!  How many transitions are you experiencing right now?  From holiday over-eating to New Year reckonings about weight?  From worrying about money to wondering what else you could do to increase your income?  From working in a job that is not a fit for you to wondering what else you could be doing? From leaving the workforce to enter the world of retirement and not knowing how to adjust? Transitions are everywhere at any time and can be perceived as negative or positive.  I prefer the latter and have some thoughts to consider.

T – Trust your instincts.  Rather than be caught off guard when things change, take the high road and note what your gut is telling you about what it going on. Keep in mind the change you are experiencing might be just what you have been secretly wanting!

R – Reset your eating and exercise program.  Have you been stuck and know you want to get healthier but not sure how to make the first move? I’m sure you have dealt with this before, so reflect on what helped you be successful in the past and recreate those steps.

A – Adjust your thinking from I CAN’T to I CAN.  See yourself healthy, happy and whole.  Send time every day imagining yourself being your best and being grateful for all that you are and have.  Hang up pictures to visually represent what your goals look like so you can start living in that body even before you get there.

N – Notice what you need right now. Go outside right now for a walk.  Yes – right now!  By yourself!  Take a notepad and pen along because great ideas are sure to surface while you are walking and you may want to write them down before you lose them.  Focus as you walk on what you really need right now to move forward thru this transition. This will be your starting point.

S – Set goals in alignment with your values to create the life you love.  Have you ever taken the time to really ask yourself what you want? Yes, you know what your mother wants for you, what your kids want, what your partner wants, and what you “should” want.  But what do you really want?  Write down 3 dreams you have for a more complete life and post it where you can ponder it.

I – Integrate all your skills into a single focus.  By now you have probably acquired a lot of great life and work skills that make you the fantastic talented person you are.  During this transition, you might find that it is time to put them all to good use and see what emerges.  Write down a list of everything you are great at – write until you can’t think of anything else – at least 30 things.

T – Train yourself for new skills.  After I had acquired all the skills I thought I needed in life, I opened up myself to what might be next for me – the key – being open to possibilities.  What showed up for me was “wellness coaching”, or some people call it “life coaching”.  When I was searching for “what’s next for me”, a friend coached me and after just 2 sessions, I had a new direction, a plan, and I was on my way again.  I loved the experience so much, I was trained to be a coach as well as a coach trainer.

I – Invite new opportunities.  When I was transitioning out of the workforce and into my own independent wellness business, I needed to figure out how to earn money while still doing the work I am passionate about.  Because I remained open to new ideas, I was presented with a way to help people get healthy as well as make passive income that could grow over time.  The key was to stay open to new ideas and give them a chance to see if they could work for you.

O – Own up to what is best for you. Not sure what direction to take as you transition?  Your guide should be how you “feel” about what you decide to do.  As they say, if it feels right – do it?

N – Now is the time to reinvent yourself.  I wrote a whole chapter on this in the book Wise Women Speak – Choosing Stepping Stones Along the Path.  My gift to you is a free download of this chapter by logging on to my website http://carolebert.com/meet-carol/free-ebook/

Enjoy the process of your transition.  Remember, it’s about the journey not the destination.  Fun times ahead!  Contact me at any time for support – carol@carolebert.com.

What to know about New Nurses: Unemployment

The healthcare industry is facing a shortage of nurses as members of the baby boomer generation retire and the industry expands. The upcoming decades are going to be reliant on new nurses to fill the gaps left by their predecessors. As a manager, what do you know about the people that will make up your staff in upcoming years?  

An experienced RN doesn’t need to worry much about finding work. In 2015, the unemployment rate for RNs was a measly 2%, with the industry expected to increase 19% by 2022.

While this is great news, most of these jobs are going to nurses coming out of retirement. During the recession, many nurses came back to work as pensions lost money and family members lost jobs. The fear of financial instability also convinced many nurses who were close to retirement to keep working.

Like many high-stress fields, healthcare facilities prefer employees with prior work experience. Small mistakes like a forgotten medication or unwritten note can have devastating consequences for patients and managers like to know their staff knows the ropes and can work under pressure.

While the preference for experienced nurses is understandable, many facilities won’t even consider applications from nurses fresh out of school. The RN Work Project found that even though RNs consistently have one of the lowest unemployment rates in the county, unemployment rates for newly licensed registered nurses (NLRNs) roughly tripled between 2005 and 2011, jumping from 15% to 31%.

While job prospects for NLRNs are expected to improve in a few years, many recent graduates are still having trouble finding work. Which is crazy considering how many healthcare facilities are understaffed and that larger nursing staffs have proven health benefits for patients.

In the end, it comes down to if being terminally short staffed is better than hiring a few college grads to pick up slack. Taking the phrase “no new graduates,” out of your job posting will greatly broaden your field of potential applicants, can give a new nurse a much needed chance and ease the burden on your existing staff.

Rock Your Health: Avoid New Year weight gain with a clean sweep!

Weight gain is common during the first months of the year despite our New Year’s resolutions to lose weight. Small yearly weight gains of one to two pounds may be a significant contributor to the high rate of obesity in America, and weight gain over the holiday period may be responsible for much of this yearly weight gain.

A study published in PLOS ONE shows that despite people’s best intentions to eat less in the New Year, they may actually be taking in more calories during the first three months of the year.

Our good intentions may be resulting in us buying more healthy foods, but we are also buying the same unhealthy foods and therefore eating more of both. For me, that means we need to do a clean sweep of all the unhealthy stuff before re-stocking with the healthy choices.

This clean sweep needs to happen at home and at work. A good first step is to team up at work and re-start the New Year with new food choices that support healthy lifestyles and focus on using healthy foods for celebrations and not always cakes!

Contact me if you want for find out how to do a Clean Sweep. carol@carolebert.com

Trust your nurses, everyone else does

Nursing has once again been named the most trustworthy profession in America. In their annual, “Honesty and Ethics rankings,” Gallup Polls found that 85% of Americans rated nurses’ honesty and trustworthiness “very high,” or “high.” The runner-up, pharmacists, only received a “highly trusted” score of 68%.

As a manager, you should take confidence in the fact that the general population places more trust in your nursing staff than they do physicians (67%), high school teachers (60%), police officers (56%), or even clergy (45%).

“It’s essential that we leverage this trust to lead and implement change in the healthcare system,” said Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, president of the American Nurses Association (ANA) in response to the poll, “Hospitals, healthcare systems and other organizations are lacking an important perspective and can’t make fully competent decisions if they don’t have registered nurses at the board table or in the C-Suite.  That’s why ANA is a member of the Nurses on Boards Coalition, working to place 10,000 nurses on boards by 2020.”

This is the 14th year straight that nursing has taken the top spot since being added to the list in 1999. The only thing that’s ever interrupted nursing’s winning streak was the one-time inclusion of firefighters to the list in the wake of 9/11.

Side note: it shouldn’t be a surprise to anyone that car salespeople (8%), telemarketers (8%), Congress members (8%), and lobbyists (7%) were voted the least trusted professions in the country.

Rock Your Health: Asleep at the wheel?

Are you and your nursing staff ready for a nap after lunch? Why do we get so sleepy after we eat and can’t seem to think straight? And what did we eat that causes this feeling?

The latest information might interest you. Low glycemic food has a positive effect on brain function after a meal. In a recent study of normal weight adults, a meal consisting of low-glycemic carbohydrates improved cognitive function after meals better than a high glycemic meal. (A Nilsson et al. Effects on cognitive performance of modulating the postprandial blood glucose profile at breakfast. European Journal of Clinical Nutrition (2012) 66, 1039-1043.)

Looks like the guilty party is eating high glycemic foods. The whites: White bread, white pasta, white rice, white potatoes, and, of course, the usual processed fast foods and sweets.

Want some help finding low glycemic tasty alternatives? Check out this website www.glycemicindex.com.

What to get your nurses this year

The holidays are well and truly upon us, which means across the world people are panicking as they realize they haven’t bought any presents yet.

The holidays are a busy time of year for healthcare professionals, with nurses trying to balance an increased workload with holiday obligations. A few simple gifts can do wonders for morale and show nurses that they are appreciated for their work.

And if you miss the holiday deadline? Hand out presents on New Year’s. It’s a federally recognized holiday and gives you more time to buy.

  1. Keep Calm I’m a Nurse T-shirt

So nurses can go off the clock and still let the world know who’s boss. You can buy them on an individual basis or buy them in bulk for your staff.

  1. Coffee

Give the gift of caffeine. Either gift cards to Starbucks or (if you have $100 to spare) a Keurig brewing system for the nurses’ lounge.

  1. Scrubs Season One

Good for some laughs and to remind everyone that you work in a much less dysfunctional hospital. Or that you do, but at least your janitors aren’t actively conspiring against you.

  1. Chicken Soup for the Nurses Soul by Jack Canfield

Stories from the frontlines of nursing. Some are funny, some are uplifting, and some are moving. A good read for both new and veteran nurses.

  1. “Do not disturb: Nurse sleeping” sign

Need I say more?

  1. Things that they would like

This is your chance to show your nurses that you really know them. A running joke in the hospital, fixing something that’s been broken a long time, or something particular to your area. Be creative! And always leave the receipt in the wrapper.