All Entries Tagged With: "nurse retention"
How to get started with a nurse residency program
Want to build a nurse residency program for new graduates but not sure where to start? Kendra Varner, MSN, RN, nurse residency program coordinator for the Kettering Health Network in Dayton, OH, and contributing author to Nurse Residency Program Builder: Tools for a Successful New Graduate Program, offers the following steps to get your started.
What’s the first step?
The first step is support. You need support from above if you want to start a successful program, so make sure you have someone who understands the return on investment who can champion the cause.
Organizational culture is also important. The culture has to support nursing, education, etc. A culture that features low morale, quality, and job dissatisfaction are significant challenges as they tend to perpetuate themselves from one generation to the next (e.g., preceptors demonstrating poor attitudes and low quality care will result in new graduate nurses with the same behaviors). These issues must be addressed by nursing leadership.
If your organization struggles with low patient satisfaction and high nurse vacancy rates, then employee morale may be poor. It’s important to have a positive culture. A good clinical working environment and a nurse residency program will make employment at your organization highly desirable among new graduate nurses in the area. It takes a village to raise a child. The residency program belongs to the entire organization and its success or failure cannot lie with the program leader alone. [more]
Helping new graduate nurses over transition shock: Part 2: The “being” stage
Kendra Varner, MSN, RN, nurse residency program coordinator for the Kettering Health Network in Dayton, OH, wrote in the book Nurse Residency Program Builder, that new nurses go through many experiences as they transition to become competent nurses. In the second part of a three part series, Varner describes the second stage.
Judy Duchscher elaborated on the concept of new graduate nurse shock by describing the transition process as a nonlinear “Process of Becoming” a nurse (Duchscher, 2008). This process has three stages: doing, being, and knowing.
During the “being” or transition crisis phase, the real work of role transition occurs, beginning around the fourth month. During this stage, new nurses have consistent and rapid knowledge, skill, and critical thinking acquisition, but at the same time begin to experience a paradoxical loss of confidence resulting in uncertainty, confusion, and even depression. Consciously aware of competency level and significantly doubting their own abilities, new nurses seek validation of decisions from more experienced coworkers, which may be met with mixed reactions. While examining inconsistencies and inadequacies within the healthcare setting, graduate nurses struggle to reconcile their previously held view of self and the world with current reality, or they cognitively adapt to the change. Described by Bridges (2009) as a psychological wilderness state between identities and realities, this stage is profoundly frustrating, as well as irritating for nurses, impacting both personal and professional lives.
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Helping new graduate nurses over transition shock: Part 1: The “doing” stage
It’s the time of year when hospitals are welcoming new graduate nurses to their units and nurse managers are preparing to help these new nurses make the difficult transition from nursing school to nursing practice.
Kendra Varner, MSN, RN, nurse residency program coordinator for the Kettering Health Network in Dayton, OH, wrote in the book Nurse Residency Program Builder, that new nurses go through many experiences as they transition to become competent nurses. In the first part of a three part series, Varner describes the first stage.
Judy Duchscher elaborated on the concept of new graduate nurse shock by describing the transition process as a nonlinear “Process of Becoming” a nurse (Duchscher, 2008). This process has three stages: doing, being, and knowing. Graduate nurses’ transition begins with the “doing” stage and orientation to the role.
In this stage, graduate nurses can experience a wide range of emotions, including an initial elation over passing the licensure exam and acquiring a staff position, as well as an unexpected grief due to losses associated with changes, such as loss of contact with school friends, as well as familiar routines, and faculty support. Discovering the new practice environment as well as nursing culture to be different from what was experienced at school results in “transition shock,” prompting graduate nurses to learn new skills and engage in behavior adaptation by “acting like a nurse,” focusing upon nursing skill acquisition, such as successful task performance and time management.
Preceptor perspectives: Touch, look, and listen: Incorporate learning styles into orientation
How many times have you tried teaching a new skill to new orientees only for them to not “get it”? What about the hours and energy put in to this effort? If you calculated this up, you may realize just how much effort you really put in to teaching. Chances are, you are not teaching to your orientees’ learning styles.
There are three main types of learning styles: visual, auditory, and kinesthetic. Visual orientees learn by seeing, observing, and picturing things and events. Most people are visual learners. Auditory orientees learn by talking, hearing, and reading. They usually like to talk to themselves as they learn. Kinesthetic orientees learn by actively moving and doing. They often cannot sit still and must move around to keep their attention.
Can empathy be learned?
Of course. That’s how people become empathetic in the first place. Children are not naturally empathetic. They are largely self-centered beings whose main focus is on getting their own needs met at all costs. Much of “growing up” has to do with moving from a role of taking, to one of also giving, of learning to set our own thoughts, feelings, and needs aside sometimes, so we can make space for those of other people. This ability, of course, is the key to feeling and expressing empathy.
But what if a person did not learn these skills as they grew up? What if expressing empathy doesn’t come naturally to them? Are they then hopeless? Of course not. If they want to learn to be empathetic, more often than not, they can.
Behind every healed patient is a critically thinking nurse
A recent opinion piece published on the Atlanta Journal-Constitution’s website brings to patients’ attention what nurses already know to be true. It asks the question: What does it mean to think like a nurse? And the answer is an important one. The article educates readers that it doesn’t take just a degree and a few acronyms behind your name to make a good nurse, it takes critical thinking—using the perfect blend of feeling and fact—to provide proper care to patients.
The article says it’s really a mixed bag. That education, training, experience, intuition, being able to adapt to different situations, and the ability to navigate all of these under pressure, are at the heart of being a good nurse.
A tough economy forces nurses to make hard decisions
There’s no denying it’s hard out there on the job front. As companies nationwide are continuing to cut budgets, thousands of Americans are still bidding farewell to steady employment, and life doesn’t seem to be any different in our hospitals. It’s no shock that hospitals aren’t excluded from the pool of organizations that need to tighten their financial belts, but the question is whether these institutions are asking their nurses to sacrifice too much in order to make ends meet.
Chained by large budget restrictions, hospitals are cutting back in areas that put strain on nurses. Earlier this year, Cambridge Health Alliance in Boston gave nurses the option of an early retirement to maintain full benefits, or otherwise be subject to a 40% cut in their retirement health benefits.
Nurses at the Charlie Norwood VA Hospital in Augusta, GA, are planning a protest next week because of an $8 million budget deficit. The hospital’s budget problems, they say, have forced nurses to work 16-hour shifts, and have slowed the rate of hiring and cut back on equipment budgets. This leads to tougher working conditions, a higher nurse turnover rate, and could ultimately decrease patient care.
Seven strategies to prevent nurse burnout
In a recent post, I discussed the issue of nurses being double at risk for a heart attack. This statistic comes from a study conducted by Danish researchers (the full study can be found here) and was conducted over a 15-year period. In addition to this finding, a British study tracked 6,000 workers for 11 years and found those regularly working more than 10 hours per day had a 60% higher risk for heart disease than those who only worked seven hours daily.
A recent column on HealthLeaders Media discussed seven strategies to reduce nurse burnout that I want to share here.
The strategies come from a study conducted by Milliken, Clements, and Tillman in a 2007 study called Nursing Economic$ (free login required). The study says to prevent burnout, organizations need to employ a nurse-centered stress management program AND an executive support system. Too often, stress reduction programs fail because they aren’t relevant for bedside nurses or because bedside nurses do not receive support for such programs from leadership.
The following strategies were found by this study and others to be effective:
1. Stress reduction classes: Offer live classes and computer-based sessions about self-care stress reduction techniques. Be sure to tailor the sessions so they make sense for busy staff nurses. For example, a session filled only with strategies that aren’t applicable to the nurse environment won’t be as helpful as one that includes easy-to-implement techniques such as deep breathing that can be performed during a quick meal break. Encourage nurses to participate by raffling off gift certificates for massages.
2. Create a space for relaxation: Social support has been shown to reduce the effects of stress, and senior leadership can help foster opportunities for nurses to interact by providing a place for them to meet. The break room can be more than a place to scarf a quick sandwich and managers should encourage staff to take breaks together when possible to build a sense of community.
3. Mentor and buddy programs: Having someone to vent to and engage in joint problem-solving can mitigate the effects of stress. Encouraging mentor and buddy programs also boosts nurse engagement and helps in long-term retention and professional development. [more]
June 1 nursing strike postponed; National Nurses United prepare for June 10 strike
June 10 could mark the largest registered nurses strike in U.S. history if nurses from California and Minnesota cannot reach an agreement in contract negotiations. Originally scheduled for June 1, nurses in Minneapolis and St. Paul, MN, rejected pension and labor proposals from the hospitals, and believed there was no other option but to strike the day after their contracts ended.
Now, as many as 25,000 nurses are set to strike on June 10 over patient safety in U.S. hospitals. Thirteen thousand nurses in California and 12,000 in Minnesota are set to strike, even though each strike was not coordinated to fall on the same day. All of the nurses are members of the National Nurses United, the nation’s largest professional association and union for nurses. The nurses are also members of the California and Minnesota Nurses Association.
In honor of Nurses Week: 10 Reasons to Become a Nurse
I would like to introduce Jennifer Johnson, who will be a guest blogger on the topic of nurse practitioner schools among other hot topics in nursing. Welcome Jennifer to the Leaders’ Lounge!
Here is a list of 10 reasons to become a nurse:
- To meet a critical need. There is a great need for qualified nursing professionals to fill vacant positions at healthcare facilities across the country. According to the American Association of Colleges of Nursing, the nursing shortage is only expected to increase.
- To ease pain and suffering. Nursing is the sort of profession where one’s daily responsibilities directly contribute to helping patients improve their condition. Rarely a day goes by where a nurse is not making someone’s life better and taking steps to improve someone’s health. Whether you’re a military nurse caring for wounded soldiers in the field or an oncology nurse preparing a patient for chemotherapy, your work makes a difference. For this reason, many nurses find their work very rewarding.
- Nurses are in-demand and will be for years to come. A good RN doesn’t stay unemployed for long in the U.S., and it’s likely to stay that way well into the future
- To teach patients how to live a healthier lifestyle. Patient education is a huge part of being a nurse. Not only do nurses educate patients on how to appropriately manage their diseases and conditions, but they also encourage them to make lifestyle changes that can contribute greatly to the patient’s overall health.
- Nurses can specialize. If you have a passion to work with a particular population group, such as newborns, children, or the elderly, you will have the opportunity to work specifically with those patients. Over time, nurses gain the skills necessary to become certified in a specific area and can seek out work in areas that are of particular interest to them. [more]
