I've met many of today's influential nurse leaders, human resource professionals and healthcare executives, and I've spoken to hundreds, perhaps thousands, of industry experts.
I've often wondered why these industry power houses all struggle with the same nagging issue – recruiting and retaining skilled nurses – and why they repeat the same disastrous mistakes. I recently discovered the answer to my question during a seminar by LeAnn Thieman, author of the best seller "Chicken Soup for the Nurse's Soul," during the Texas Organization of Nurse Executives Annual Conference.
The presentation inspired me to write "7 most common nurse retention mistakes," bringing together inspirations from the many experts I've met, including Thieman. I hope this simple, but meaningful guide helps organizations find practical solutions to the real problem of hiring and retaining quality nurses.
How many of the 7 most common mistakes can you recognize in your organization?
1. Inadequate staffing levels
Many hospitals today are struggling to find and retain nurses. The reasons are many: staffing cutbacks in the 1990s used to offset rising healthcare costs, a shortage of teaching nurses at colleges, and sometimes even less interest in the profession by Millennials. Despite the cause, the outcome is the same whenever there is a prolonged period of unequate nurse staffing levels. As existing staff members absorb the work load, stress increases and job satisfaction declines, resulting in greater turnover. And so the cycle continues. We've been contacted by hospitals that have tried for years to maintain proper nurse-to-patient ratios, but despite their efforts, the problem is worsened. They're frustrated; nurses are unhappy, and patient satisfaction sufferers, along with patient safety.
With all its complexities and constant change, today's healthcare environment requires a new approach. One focused on a multi-faceted recruiting and retention plan that begins by defining the proper nurse staffing ratios for your facility, sets recruiting and retention goals and uses proven short-term and long-term recruiting methods.
2. Training programs that miss the mark
Many clients find that although they have training programs in place, results are mixed. Nurse trainees are not as productive or satisfied with their new positions as hoped. Why? It may be because training is not sufficiently customized to prepare nurses for the full-range of duties and expectations that will ultimately determine success at their organization.
What better way to learn this than from a co-worker and fellow nurse currently succeeding in the job. I recommend our clients adopt a nurse preceptor program. Begin by asking yourself, "Who in my organization do I want more of?" Then narrow your candidate pool by determining who has the temperament to teach. These are your preceptors. They are strong nurses who willingly participate.
Keep in mind, a good nurse is not necessarily a good trainer. We teach all our nurse placements specific communication skills and learning applications to prepare them for preceptor roles. Look for these skills in your employees or consider training for them. Then, do not forget to adjust your preceptors' workloads to account for their new responsibilities, so they do not experience rapid burnout.
3. Cultural calamity
Every organization has dominant values, beliefs and attitudes that define it and guide its practices. A worker who believes in those values strengthens the organization, as well as fellow co-workers. But, one who is out of step with company culture will bring down morale and inhibit your nurse team's effectiveness. In a high-stress, fast-paced environment where co-workers rely on a fully functioning team, cultural fit is critical. So, whether you're onboarding staff or relying on an agency to train traveling or international nurses, look for both a strong clinical and cultural program matched to your organization. Ask how nurses on assignment are trained, so you know they will fit smoothly into the US healthcare system and understand the needs of American patients. Are your nurseries on assignment prepared to effectively address Americans' health concerns and expectations of their healthcare providers? Do they understand the role of relationships and empathy?
Ensuring cultural alignment to your organization will strengthen your nurse team's performance and bolster long-term retention.
4. Lagging compensation and career opportunities
Not everyone is motivated by money, but recruiting and retention problems are all but guaranteed if your surcharge compensation package does not keep pace with market competitors. Keep in mind, compensation means different things to different people. So, whether it's salary, bonuses, flex schedules or time-off, know what your competitors are offering and match or except that to ensure you do not lose your best nurses.
5. Strategic planning that is not
The best nurseries are usually the hardest to recruit, and even tougher to retain. You need a plan. Engage all stakeholders in developing your strategic solutions, especially nurses on the floor. Think beyond your standard approach. Consider all options before deciding what works best for your organization. Are hiring bonuses viable? Will they help build a long-term, stable nurse team? What role will international nurses play? How will you measure the effectiveness of your strategies?
6. Boomers versus Millennials
By now, we all know that these two very different generations communicate, work and think, well … very differently. But, what does that mean to your organization and how have you prepared your nurse team? Developing relationships outside of our comfortable, niche groups is not natural for most adults – especially Boomers. After all, we've spent a lot of time developing certain styles and patterns, and we appreciate those that think the same. Without sufficient motivation, that will not change. Boomers must look beyond "the lack of work ethic" they see in younger counterparts, and Millennials must think beyond "Boomers just resisting change." To maximize each generation's contribution, your organization must help facilitate the dialogue that fosters understanding and appreciation for each group's contribution. Only then will you have a fully functioning, cross-national team.
7. Overly aggressive competitors
A client located in one state complained to me that, when he thinks he's winning the nurse-shortage battle, a competitor from a neighboring state stakes out in a nearby hotel, and recruits and interviews his nurseries – offering hiring bonuses and better work schedules. My response to that is refer to items 1 through 6 above.