Nursing shortage/Nurse shortage/Health care workforce shortage Solution, Nursing recruitment retention, Nursing recruitment and retention strategy

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There are few problems more alarming in this country than the nursing shortage. The implications have far-reaching impact on quality of life and the health of this nation.

Reasons for the Shortage of Nurses

• Bad image of nursing, re-enforced by TV, of being a handmaiden to physicians

• Smaller number of nurses in the workforce

• Nurse workforce growing older

• Weak leadership, poor management styles, and resistance to changing culture

• Increased pressures on nurses in the workforce

• Explosion of career opportunities for women – failing to attract men

• Growing demand for nurses in alternative health care settings

• Frustration with the work environment

Nurse Retention and Recruitment Issues

• More cost-effective to work on retention of nurses

• Costs of about $20-40,000 to replace a nurse who leaves

• Average turnover rate for registered nurses in 2000: 21.3%

• National nursing vacancy rate of about 13% (Nursezone.com)

• 50% of work-life satisfaction determined by relationship with the boss

• Enrollment in RN programs has declined by 50,000 or 22%, since 1993 (2001 Testimony by AHA before U.S. State House of Representatives)

• The number of RN under the age of 30 dropped by 41% from 1983-1998 (JAMA, June 2000)

• Average age of a RN is 43 years old (AHA)

Considerations for Retention and Recruitment Strategies

• Rethink advertising strategy – target and advertise:

• ’Career-focused’ nurses – professional advancement opportunities, facility’s reputation, technological opportunities
  ‘Job-focused’ nurses – flexible hours for working mothers, convenient locations, good pay

• Consider different needs of different generations

• Generation Xer:

  • Value independence, the opportunity to learn and develop their skills, ability to define and solve problems at their own paces

  • Want to have fun and enjoy their work

  • See article written by Greg Smith

• Strategies that focus on truly improving the workplace – things that give job satisfaction, e.g. patient education

Nurse Retention Strategies/Programs

• Pot-luck dinners, ice cream socials, monthly birthday celebrations, Halloween costume contests

• 230 Other energizers and motivational tips

• Magnet hospital status: new designation for ‘nurse-friendly’ hospitals, not purely symbolic but for real changes for a better workplace

• Mandatory nurse-to-patient ratios

• Offering bonuses to nurses who sign up to work there

• Appointments above the minimum rate of the grade: offer pay rates up to 30% higher for individuals with superior qualifications or hard-to-fill specialties

• Higher rates of additional (extra) pay (tour differential, Sunday and Saturday pay, holiday pay, overtime, on-call)

• Recruitment bonuses, relocation bonuses

• Reemployment of civilian retirees

• Travel expenses for interviews and new appointments

• ‘Nursing: The Power to Make a Difference’ recruitment campaign

• Recruitment and Retention Grant Program

• Motivate employees to make contributions to support and enhance organizational goals and objectives: special contribution (e.g. time-off, on-the-spot awards)/ suggestion / gainsharing / honor /non-monetary awards

• Retention allowances

• Specialty certification

• Family-friendly policies: flexible leave, leave sharing, paid time off, on-site day care, subsidized day care

• Non-cash perquisites: close-in parking place, computer upgrade, special work-related software, support staff

• Reducing nurses’ workload so that they can dedicate maximum time to interacting with patients

• Institute for nursing Excellence: rewards outstanding nurses, encourage them to stay in nursing, increase their capability for leadership, enhance their ability to be role models and attract others into the profession

Key Principles:

• Nurses feel importance of their work

• Feel valued for their work

• Feel they have a voice in decision-making that impacts their practice and work life

• Strategies: clinical recognition program, nurse participation in collaborative governance committees

• Giving the responsibilities for retaining nurses to nurse executives:

• Their responsibility to provide challenges, career growth, learning and development, foster pride in the organization’s mission and goals

• Affect many of the reasons why nurses stay or leave e.g. schedule flexibility, security, assignment of meaningful work, sense of control over their own career

• 50% of work-life satisfaction determined by relationship with the boss

  • Tips for retention-focused manager: select and develop people so they grow, create a work environment that people love, have a management style that breeds loyalty

  • Decrease wage gap between various health care providers and design salary and benefit packages to reward professional competency: higher wages, bonuses, flextime, retirement plans, subsidized loans, education packages for worker’s dependents

  • Develop clinical and administrative career ladders for nurses

  • Establish recognition and reward programs

  • Provide health care executives and nurse leaders with skills for valuing employees

  • Create organizational environments where:

  • Treatment if fair and respectful

  • Communication is open

  • Work is important and challenging

  • Schedules are predictable and flexible

  • Opportunities exist to learn and grow

  • Performance id recognized and rewarded

  • Job control is shared with employees

  • Give nurses control over their practice environment – decentralized decision-making at the unit level

  • Retain older RNs in the workforce as preceptors, mentors, in-house consultants, advisors

  • Monitor patient outcomes that are affected by nursing/staffing

  • Encourage hospitals to adopt best practice, e.g. ‘magnet hospitals’

  • Organize nurses’ clinical responsibilities at the unit level to promote accountability and continuity of care

  • Give RN, greater autonomy over their legal scope of practice

  • Re-entry and refresher courses

  • Education

  • Develop career progression initiatives

  • Create and sustain staff development programs and lifelong learning

  • Reach out to youth

  • Work environment

  • Greater flexibility in work environment structure and scheduling programs

  • Reward experienced nurses for serving as mentors/preceptors for new registered nurses

  • Implement appropriate salary and benefit programs

  • Establish appropriate management structures within health care system

  • Provide nurses with sufficient autonomy over their practice in all settings

  • Redesign work to enable an aging workforce to remain active in direct care roles

  • Legislation

  • Technology, Research and Data collection

  • Investigate potential advance using technology to enhance the capacity of a reduced nursing workforce

  • Consistent data collection to enable planning

  • Advances in pay

  • Exemplary job performance and achievements – cash rewards

  • Special advancement for achievements or performance – high level of performance, ability over that normally expected – potential for assumption of greater responsibility

Sources:

Schneider, J: Getting Nurses Back on Board. In: US News, July 28-August 4, 2003

Dozier, M: Students are nurses’ ‘shadows’. In: The Atlanta Journal Constitution, July 10, 2003

Prince Edward Island Nursing Retention and Recruitment Strategy. In: http://www.gov.pe.ca

Developing Effective Recruitment and Retention Strategies. In: www.nursezone.com

Creating Solutions to the Nursing Shortage. In: www.nursezon.com

Nurse Executives Focus on Recruiting and Retaining Quality Nurses at Annual Meting. In: www.nursezone.com

Retention. In: www.op.nysed.gov

Retention: How to make nurses feel valued. In: www.careerone.com.au

Strategies to Reverse the Nursing Shortage. In: www.hospitalconnect.com

‘The Nursing Shortage: Causes, Impact and Innovative Remedies’. In: www.hospitalconnect.com

‘Finding a Cure to Keep Nurses on the Job: The Federal Government’s Role in Retaining Nurses for Delivery of Federally Funded Health Care Services’. In: www.hospitalconnect.com

Recruitment and Retention Strategies. In: www.nursenc.org

Healthcare Workers Stat!