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Proven retention tips!

The simple act of giving THANK YOU notes to staff has proven to be a positive morale builder and an easy-to-use retention tool. Some managers have the “want to” but complain of “writer’s block.” Here are a few tips to get started!

  • Blue or black ink offers a more professional appearance than other colors
  • Begin with the recipient’s name.
  • Say Thank You.
  • Be specific about the behavior or action you’re recognizing:
    • “The extra hours you stayed over to help…”
    • “Your positive attitude in a stressful situation…”
    • “Your willingness to change your schedule…”
    • “Going the extra mile with [patient], [family], [coworker]”
  • Be sure to mention the positive impact of their behavior or action:
    • “Your work/dedication made this project a huge success”
    • “Your creative thinking saved our department time/resources”
    • “Your faithfulness to follow-through is a great example”
  • Connect their behavior to your organizational mission:
    • “Thanks to you, we’re sure to reach our goals!”
    • “Thanks to your efforts, we’re on our way to achieving _____”
  • Say Thank You again.
  • Close your note with a meaningful sign-off:
    • “Keep up the great work, it’s being noticed!”
    • Cheers!
    • Best Regards
  • Sign your name.
  • To add a special flair, consider including a small treat:
    • Peppermint patty or Junior Mints (You’re worth a mint!)
    • Roll of lifesaver candy (You’re a life-saver!)
    • $100,000 bar (Your efforts are priceless!)
    • Hershey’s Nugget (You’re such a treasure to have on staff!)
    • Almond Joy (It’s a joy to work alongside you!)
    • 3 Musketeers (3 cheers for you/your work)
    • Shoestring licorice (Great job in tying together that project!)
    • Payday bar (Your efforts will lead to great return for patients/our department/ [your organization])
    • M & M’s (Thanks for not melting under the pressure)

Safe Staffing Poll reflects significant need for nurses

As a nurse, the obstacles you face on a daily basis increase the difficulty of your job regardless of the pressure for you to deliver quality patient care. You might feel many of these obstacles are unnecessary and unfair. If the sufficient amount of nurses were employed at your facility– these obstacles might not even exist.

Have you ever wondered how staffing issues at your facility measure up to those around the country? Take a look at the results below from the American Nurses Association’s Safe Staffing Poll that more than 10,000 nurses participated in. The findings emphasize the ongoing need for adequate staffing.

  • 73% of nurses asked don’t believe the staffing on their unit or shift is sufficient.
  • 59.8% of those asked said they knew of someone who left direct care nursing due to concerns about safe staffing.
  • 51.2% of nurses believe the quality of nursing care has declined in their unit over the past year.
  • 48.2% would not feel confident having someone close to them receiving care in the facility where they work.
  • 46% of nurses that were considering leaving their position associated it with inadequate staffing.
  • 36% rarely or never take their full meal break.

Do these results surprise you?

Preparing your business plan

Every business plan begins with a brief executive summary introducing the key components of the project. It is knowing how to tailor it to your audience that will lead to the project’s success.

When writing the executive summary—or any presentation for that matter—learn who your audience is before you begin. Be sure to mold the presentation to your audience’s needs and desires. If you are speaking to the chief executive officer, make sure your presentation solves a problem that directly affects the hospital’s bottom line or addresses specific regulations such as those mandated by The Joint Commission or the state.

Other things to factor into your presentation are relativity and timing. For example, if your hospital chose to close its obstetrics business, then writing a business plan for an obstetrics clinic would be a waste of everyone’s time, plus you would seem uninformed about the hospital. Timing also is important. For example, if you are requesting money, be sure your request does not follow closely on the heels of layoffs or after the executives have just revealed less than satisfactory financial statements to staff.

How have you prepared for business plans?

Quick retention ideas!

This week’s retention ideas:

Suggest that your team create a basket filled with goodies for another department in the hospitaljust to show your appreciation for something they did. Have your entire staff sign the card, they may add comments if they’d like to. The other staff will be shocked and amazed. Other benefits from this one act of kindness may include increased patience & respect between departments, adding value to others’ self-worth, and an improved work relationship!
[Some ideas: snacks such as microwave popcorn, pretzels, m&m’s or cheese crackers; mini cans of soda; a bottle of Excedrin and a bottle of hand lotion]

To increase staff participation and ownership in their staff meetings, post a blank agenda in their lounge a week ahead of each scheduled meeting. Staff can post questions, concerns, or desired discussions. You may even become aware of issues you previously didn’t know about.

Something to ponder this week: 10 years from now, what will your staff remember about you?

Learning a new definition of health

Starting next week, I will be carrying two courses at a time, and I am told it can be done. I have spoken to several other classmates who have management jobs, families, etc., and some of them are actually taking a bigger course load. I don’t think I will ever go there. Just the thought makes my critical thinking skills kick in and ask, “Are you nuts?!”

The three credit course I am in the midst of is related to public health nursing, and I know what you are thinking-the same thoughts I had as I poured over the course objectives. With a bottle of Phenergan at my side, I was ready for boredom and nausea. What I found was an inspiring faculty member whose pointed questions got me thinking about healthcare and how it is delivered to the patient, the family, and the community. The course puts an emphasis on the effects of prevention on public health and assessing the health care needs of communities. Think of all the times staff approach you whining on and on about non-compliant patients. The course delves into the compliance obstacles for some of our population, such as making bad choices in their lives.

The most important questions we had to ask ourselves is to define the word health: What does it mean to each of us? Now I am asking you for your definition of health, and also your staff’s definition. Mine is printed below:

Health: A state of wellness for that individual

I anxiously await my grade for my mid-term paper, which brought back memories of why I do not work the night shift anymore. My final paper is due mid-June and no, I have not started it yet. For my final exam, I have to find a grant available for a vulnerable population we identify in our mid-term paper. Can someone please help me? I feel ischemia creeping into my brain. What was it I identified? Can Phenergan ever be used to help brain perfusion? Hmmm…..

Budgeting for orientation, education, and training

Do you get a little stressed out when it comes time to budget for orientation, education, and training? You might find it helpful running through these questions beforehand:

1. How many orientees does the hospital expect this year?
2. How long is orientation for experienced hires? For new graduates?
3. How many education days does the hospital provide for each staff member?
4. How many mandatory classes does the hospital require each employee take?
5. How many outside training classes does the hospital pay for per employee each year?
6. Does your hospital pay for staff meeting attendance for days the employee is out?

How do you plan your budgets?

Quick, effective retention tip!

Here is a quick tip I have used and found to be highly effective in promoting staff engagement, which is a huge factor in retention:

Ask your DON or VP to stop by and compliment your staff, or a staff member, on something they have accomplished. This lets them know that you have been speaking about them in a positive light to YOUR boss, who is someone they probably don’t see very often!

And here are a couple quotes to bring home the tip:

“Setting an example is not the main means of influencing others, it is the only means.”
– Albert Einstein

“I think one’s feelings waste themselves in words; they ought all to be distilled into actions which bring results.”
– Florence Nightingale

MRSA me, what are we to do?

By Sheila Gerald, RN, CIC, CLNC

The average person trembles with fear when he or she hears the word staph or MRSA, and most healthcare workers are sick of multiple drug resistant organisms (MDROs) making their daily service more challenging.

Many infection control experts will agree that MDROs have rocked our world for the past 10 years in dramatic ways. We now have to use resources for increased compliance monitoring, surveillance, and tracking. And let’s not forget about the increased need for education. How many times must we say “gel in-gel out,” “glove/gown each time,” only to get those phone calls over and over reporting it not being done?

I have a question: Why haven’t hospitals addressed this problem? Why not simply tell the public, “No, you can’t bring that child in to visit,” “No, you can’t go in the room without a gown/glove/mask,” “No, you can’t come in if you are sick,” and “No, we won’t do your surgery until you have your blood sugar under control, have lost weight, and have stopped smoking,” which all increase the risk of a poor outcome. Can you imagine the outcry from the public if we put our foot down, instead of catering to the general public’s desire to be in control?

Would we truly see some dramatic improvements if the Healthcare Infection Control Practice Advisory Committee (HICPAC) came out with stern guidelines making contact precautions the new standard precautions? After all, when you start checking for colonization you wind up putting the majority of people who are admitted under the contact precautions umbrella. How much would we save in resources if we just put all admitted patients in precautions and forego the screening? Yes, the studies have shown these people get seen less often, but what if it became the norm to gown and glove upon entry to every room and continue the hand hygiene before and after contact with the environment of care?

I think it is time to change our norm and stop whining and moaning about it. Our germ cheese has been moved and we have hemmed and hawed long enough! If we are to survive and if we expect our patients to survive this germ war, we must change the way we practice healthcare.

How do you feel about current infection control practices? What changes would you make?

Sister Nurse: The other side of the bed

By Karen L. Madsen, MSN, APRN-BC

Blog admin note: While different from most blog posts on, this is a captivating, inside look at nursing today. It is, at the same time, a look through a professor’s eyes and through a mother’s eyes. The article first appeared on and was quickly picked up by Comarow on Quality, the U.S. News & World Report blog on medical safety and quality.

I don’t like this side of the bed. No, I take that back. I loathe this side of the bed. It scares me, it makes me angry, it makes me cry. I have no control over this side of the bed, I have little identity, I don’t have much of a voice. All this and more ran through my mind as I sat at the bedside of my 15-year-old daughter recently. It had been a long time since I had been part of the patient equation of the hospital rather than the nurse. It was just as much fun as I remembered.

Our daughter, Grace, is our baby, the youngest of our four children. Grace is a typical teenage girl. She slams doors, she cries at the drop of a hat. She grazes all day rather than sitting down to a meal. She is funny and emotional and dramatic, and she is a world class champion at texting on her cell phone. All of our children have been blessedly healthy, but Grace is our emergency room child. You know, she is THAT child, the one who falls, who hits her head, who goes through a fence on a horse, the one who had more stitches by age 5 than her other three siblings had, combined, by age 20!

A few weekends ago, she came home from a school-sponsored trip on a Saturday afternoon unexpectedly pale and pouty. She can be dramatic, but is rarely pouty. I should have known then something was up or something was wrong. Her group had stopped for lunch at KFC and then she had ridden in the back of a school bus home for about 90 minutes, so I wasn’t overly surprised or alarmed when she complained of feeling nauseated. I checked her forehead with the inside of my right wrist, my trusty mother thermometer. No fever. It was Saturday afternoon and I wanted to spend some time with my husband doing something we liked to do to relax. So, I basically told her to suck it up and quit whining.

We walked around a couple of flea markets and hit the grocery store for supper supplies. Once we were home, she took a nap and woke feeling a little better. Later that night, she had several episodes of vomiting and I began to think food poisoning rather than a virus was affecting my girl. Still, she had no fever, no localized pain, certainly no pain on either side of her abdomen. “Relax,” I thought, “there are a million viruses out there right now. She’ll be better in the morning.”

And she was. Or at least I believed she was. As we had been up late the night before, both she and I slept until around noon. She woke up, ate a bite or two of breakfast, and had another nap.

It was another story when she woke about 5 p.m.

Read the rest of Karen’s two-part column.

Take a survey on the image of nursing

What is your perception of the nursing profession? How would you compare this image to the image five years ago? How about 10 years ago? Have we made any strides? If not, why?

The nurse leader is in a pivotal position that affects the image of nursing. Nurses need to mentor staff, motivating them to advocate for a true representation of nursing. These nurses should be taught the skills to mimic this in their own work environment.

In preparation for an upcoming book on the image of nursing, Shelley Cohen, RN, BS, CEN, is referencing a web link below that will direct you to a quick survey consisting of related questions. Forward it to other managers and staff so they, too, can respond with feedback on the issue. We will report on the results on the blog when they become available.

In the interim, between now and when the book publishes at the end of this year, here are some tips on how you as the manager can influence the image of the nurse:

  • Share results of the survey with your staff and work as a team to develop a specific unit plan to improve the image of your nursing staff
  • Discuss information about the Center for Nursing Advocacy with staff and encourage them to write letters and emails when they see media misrepresenting the nursing profession
  • Get involved in community projects, such as BP screenings, health fairs, and speaking at schools
  • Identify unacceptable behaviors and hold staff accountable for them
  • Dress in a professional manner at all times
  • Encourage staff to validate their nursing expertise through the documentation process

To complete the brief 10 question survey, please click below