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New Release! Nurse Manager’s Guide to Retention and Recruitment

NMGRRWith the current nursing shortage, recruiting and retaining the best nurses has implications for all levels of practice and all care delivery settings. Nurse Manager’s Guide to Retention and Recruitment is a user-friendly guide for nurse leaders that provides sound theoretical perspectives, evidence-based practices, practical strategies, and tools for achieving the best recruitment, engagement, and retention outcomes for their organization.

In addition, this book includes examples gleaned from the authors’ collective years of experience and expertise in a complex urban healthcare market with large for-profit, not-for-profit, and public (county, state, and federally funded) healthcare organizations and systems.

Click here to order now!

The key to nurse retention

The following is an excerpt from Essential Skills for Nurse Managers.

Put aside all the tips and tools for retention for a moment and remember this:

Of 1,500 nurses surveyed, their #1 incentive was noted to be personal recognition by their manager.

Imagine you are a staff member who helped out the department by covering an extra shift due to a sick call. Sure, at the end of the pay period they will be smiling with the overtime in their check. Do you know what will make them smile just as much, or for some even more? If the next time they worked an envelope was in their mailbox or locker and inside was a single wrapped life saver with a note signed by their manager that simply read:

  • Many thanks for helping out by picking up the extra shift. You are a life saver!

After much conflict in the department related to precepting issues and a lack of interest among the staff to contribute to the ongoing educational needs of the new graduate staff, one employee stepped forward to offer to assist. He understood there was no extra pay differential for taking on this challenge when he agreed to the role. However, that did not matter because he found in his locker an envelope with a single wrapped “treasures” chocolate candy and a note from the manager that read:

  • Many thanks for volunteering to work with our new grads—we treasure you as part of our team!

Sometimes a trip down the candy aisle at the grocery store with a pad of paper is not about the eating; instead, it is about creating a memorable message that means something to an employee. Be sure that part of your retention strategies include your “shining stars.” Many managers assume these high-level performers do not need or desire recognition or praise; this is far from the truth. They may want to be recognized in different ways from the rest of the staff, but they still deserve to be reminded of the vital role they hold in the department. Sometimes the employees we desire to hold on to the most are the ones for which we use the least retention efforts. Do not make this mistake and be alert to the fact that many assumptions are made about top performers.

Rewards for employees should match and be in line with how and what they contribute to the department/organization. Just because employees perform well does not mean they are easy to get along with, welcoming to new hires, etc. And always remember that current performance may not be an indicator for future potential in a “shining star” Schmidt (2010). Be sure to balance your attention and recognition efforts among all of the team members, shining stars or not.

Allina nurses go back on strike

Allina nurses enter their second month of striking after voting “No” the most recent contract proposal.

The nurses at Allina Health hospitals in Minnesota began contract discussions in February, and eight months later, Allina and the nurses have yet to settle on an offer. Allina Health’s 4000 nurses walked out for a week in June to start negotiations, and have been striking since Labor Day.

The dispute started when Allina wanted to eliminate the nurses’ union-backed health plans, with high premiums but low deductibles, and replace them with their corporate plan, saving the company $10 million per year. Both sides have agreed to move all nurses by 2020, but the nurses want input on the plans to ensure they get quality healthcare.

Allina made a new contract offer on Monday, and the nurses voted to reject this latest offer and continue the strike. The Minnesota Nurses Association reports that the offer was largely the same that they rejected in August, while Allina insists that their offer was fair and addressed many of the concerns raised by the unions.

This is set to become the longest strike in state history, and the Star Tribune reports that the strikes have cost Allina more than $40 million dollars so far.

For more information about nurse labor disputes, check out these articles from the Strategies for Nurse Managers’ Reading Room:

Ask the Experts: Nurses strikes

Why do nurses join unions? Because they can

New strategies for the nursing shortage

Hospitals are offering new incentives to get staff involved with recruitment.

We’ve all heard it by now: the nurse shortage is here, and it’s only going to get worse. Between population growth, retirement, and life expectancy increase, reports estimate a three million RN shortage by 2020.

Faced with these challenges, University of Missouri (MU) Health Care has asked its staff for help in recruiting nurses to their facilities. Instead of offering bonuses and incentives to new hires, MU Health is offering staff members $10,000 for recruiting qualified candidates to its Intensive Care Units (ICU). MU Health hopes to convey respect and value for their employees, improving retention while making the facility more attractive to new applicants. The recruiters also say that sign-on bonuses could lead to job-hopping, rather than encouraging nurses to stay at a facility.

One of the other factors affecting the shortage is a bottleneck around training people to become nurses. The retirement issue applies to nursing school professors as well, and schools are constrained by professor to student ratios in determining how many applicants are accepted.

MU Health Care also hopes to address this issue by helping its staff become educators. They have instituted a residency program that allows trained nurses to collaborate with nursing students at their hospitals. The hospitals provide exposure to nursing students, and they hope to encourage students to stay within their community once they graduate. The Missouri Hospital Association is sponsoring a clinical leadership academy, which will train bedside nurses to become clinical instructors.

In addition to its own programs, MU Health Care encourages employees to go back to school to advance their careers, offering tuition reimbursement for staff members. These creative incentives for employees serve the dual function of retaining current staff while making the facility more attractive to new recruits.

Nurses uniquely qualified for hospital design

The role of nurses has expanded greatly over the past few years, as nurses are moving from the bedside into all facets of healthcare. Hospitals have started to use nurses’ expertise to help design their facilities, with impressive results.

Hospital design can have a profound impact for both nurses and patients, but facilities are just starting to include nurses in the design process. Health Facilities Management (HFM) reports that involving nurses in design planning can help executives and contractors keep patient-care priorities in mind during construction. Seemingly small decisions, like the placement of sinks, computers, or wall outlets, can lead to an increase patient satisfaction. Nurses have been behind some of the pioneering new hospital designs, such as single-occupancy maternity rooms and the acuity-adaptable patient rooms. As one nurse told HFM, “Nurses spend the most time with the patient… we have a responsibility to be the voice of the patient, family and each other.”

Looking out for each other is another great reason for involving nurses in hospital design. A study published by Hassell and the University of Melbourne found that hospitals designed to accommodate nurses have a better chance of attracting and retaining nurse staff. The researchers identified a link between hospital workplace design and efficiency, health and safety for staff and patients, and staff morale. These factors play a significant role in staff retention, and who better to ensure a facility is attractive to nurses than nurse leaders?

Nurse-led design choices improve conditions for patients and nurses, but they can also help the bottom line. Nurses are involved in many different areas of the hospital, and their input can make operations more efficient and affordable. In one example reported by HFM, nurses saved the Parkland hospital project millions of dollars by eliminating unnecessary equipment and cabinetry in emergency rooms.

Both the survey and HFM article note that despite these benefits, nurses don’t always get a voice in hospital design. But as nurse-designed hospitals flourish, perhaps more facilities will involve nurses in design plans.

For more about Nursing and hospital design, check out: Take Five: How renewal rooms revive stressed out nurses

What to know about new nurses: Motivating millennials

Last year, millennials passed Gen Xers in workforce numbers, and now make up the majority of the workers in the  U.S. according to the Pew Research Center. Another study shows that two out of three millennial workers hope to have a different job in five years, and that one in four said they might leave their job to pursue a different career. Nursing is not immune to this trend, so it’s more important than ever to keep your young staff motivated and engaged to prevent short-staffing. Below are some tips for engaging your millennial staff!

Show trust: Millennial workers tend to have an independent streak and want to find their own way; by showing your staff that you trust them to make decisions will bolster their confidence and engage their creativity. If you micromanage young workers, their more likely to pull away from your group and look elsewhere for career advancements.

Provide support and access:  Showing trust does not mean leaving them alone. Millennial workers want to hear feedback from their superiors, and providing frequent in-person contact is very important for their job satisfaction. Make sure you’re willing to listen to them and provide support whenever possible.

Emphasize relationships: Similarly, millennial workers have a strong sense of commitment to others and seek to establish meaningful connections with their coworkers.  Try to cultivate a close-knit staff by encouraging social outings and holding staff events; the unit will work better as a team and young staff will feel more connected to their job.

Talk about the future: Millennial workers are not likely to wait around for career advancements. If you can outline a career trajectory in your facility and help them get there, your young staff will be much happier in their position. Try to keep bureaucratic road blocks to a minimum, and you could have a future nurse leader for your hospital.

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Combating depression in nurses

Nurses are twice as likely to experience clinical depression than the general population. Why aren’t we talking about it?

The Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative (INQRI) found that 18% of nurses exhibit symptoms of depression, compared to the 9% found in the general public. Nurses are happy to talk about their staff shortages or their back problems, but we almost never see serious discussions about mental health issues.

Minority Nurse suggests that nursing culture exacerbates the depression issue. Nurses take great pride in their survivability and toughness; they often see trials facing new nurses as a proving ground, a way of weeding out those who are not cut out for the job. This leads nurses struggling with depression to bury their feelings and work twice as hard, which will make things worse in the long run.

There’s also the idea that mental health issues are seen as a weakness. Nurses rely on each other to be reliable and trustworthy, and someone who is struggling might be easily dismissed as unreliable. This puts their job at risk, and can affect their relationship with peers. Additionally, the nurse mentality is to put the care of others first; many nurses might not release why their suffering, as they so rarely address their own needs.

If admitting they have a problem or asking for help is often the last thing a nurse wants to do, how do you help them? The process starts with nurse managers. Educating managers about the warning signs of depression, and they in turn train their staff to recognize the condition in themselves and their peers. Coming up with strategies to help depressed nurses that aren’t punitive and making sure their staff have resources available to them can help alleviate the fears associated with mental illness.  Showing the staff that it’s okay to talk about mental illness and that asking for help isn’t a sign of weakness will help change the “tough it out” culture of nursing.

Addressing mental health issues can help improve nurse retention as well. Instead of “weeding out” the weak links, supporting new nurses through a crisis and encouraging them to get help will keep them at their jobs longer, and make them better nurses for the rest of their career.

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Featured Webcast: Millennial Nurse Retention

Millennial Nurse Retention: Bridging the Generation Gap

In 2015, the number of millennials in the workplace surpassed baby boomers as the largest segment of workers. This future generation of nurses has very different career expectations than the generations before them. Millennials expect more feedback, greater collaboration, interaction with nurse leaders, an 8-hour workday and better work-life balance. Unlike their parents, they rarely intend to stay with one employer for their entire career—or possibly even more than a few years.

The shift in attitude has many organizations struggling to retain millennials and learning to adjust management strategies to accommodate their unique style. Join Kathy Bonser, Vice President of Nursing and CNO at SSM Health DePaul as she discusses the importance of leveraging the differences to create a win-win environment for staff and frontline leaders.

Take part in this live 60-minute webcast to:

  • Uncover how making changes in leadership behaviors can bridge the generation gap
  • Discover new onboarding processes that support the growing millennial workforce
  • Devise a structured approach to providing regular employee feedback
  • Understand the importance and value of engaging millennials early and often

For more details or to register for the webcast, please visit The Health Leaders Media store.

What to know about New Nurses: Tips for getting and keeping RNs in a rural hospital

The nursing shortage is becoming a major issue again and rural hospitals are being hit hardest. Nurses tend to stay local when possible, so rural hospitals can have a hard time attracting new nurses to move to their area without the benefits and salary of urban hospitals. Below are some suggestions on how to improve your odds of attracting (and keeping) star graduates at your rural hospital.

Moving to a rural hospital can be intimidating for a new nurse, working in relative isolation without the support system of a larger hospital. Provide mentorship and regular training programs to help ease the transition and boost the young nurse’s confidence. Schedule shifts alongside experienced RNs whenever possible to give them a sense of security.

Being a smaller hospital has some benefits as well. Emphasize the intimacy of a small hospital community and offer manageable patient-loads.

Provide leadership opportunities and a clear path for advancement. Residency programs, teaching opportunities, community wellness programs, and tuition reimbursement can be a huge draw for ambitious young nurses.

Developing a strong staff that provides outstanding care will make your hospital even more attractive to new nurses, hopefully leading to a consistent cycle of new talent into your rural facility.

For an in-depth report on the challenges facing rural nursing, check out: Healthcare in the outlands.

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!