Recruitment and Retention Strategies
By Lisa Durben BSN, RN, C
Assistant Nurse Manager, NICU
Recruiting and retaining nurses are key issues facing all health care organizations. With our work force aging and the costs associated with turnover increasing, it is important to have strategies in place to recruit and retain quality employees. Along with the costs of losing experienced nurses, high turnover creates the need to prepare constantly-changing novice staff. “The quality of patient care resides in the experience and knowledge of the bedside nurses.” (VanOyen Force, 2005).
The bedside nurse is considered to be human capital (a valuable asset). As with any asset, human capital must be assessed, developed, nurtured, and evaluated for performance. Salaries need to be competitive and schedules need to balance work and life. Tuition reimbursement and flexible benefit packages are also important considerations. “Skills, experience and knowledge have economic value to an organization. As employee value increases, so does your organization’s capacity.” (White, 2006).
A number of work environment factors have been shown to optimize performance and employee satisfaction, including:
♦ hiring the right people
♦ providing a continuous learning environment for new as well as seasoned staff
♦ providing managers with leadership training that fosters empowerment and clear communication of the organization’s values.
Hiring the right people
One part of the recruitment/retention puzzle is hiring the right people – making sure that the people being considered for employment will fit in with the organization’s mission and values. “Conduct interviews to identify that the candidate has the necessary skills for the role, but more important, that he or she can represent the position’s behavioral responsibilities. Ask behavioral-based questions. Using this method, employers can glean valuable information regarding an applicant’s work ethic and core values.” (Hader, 2005).
Getting other staff involved in the interview process may be helpful since they have a vested interest in their potential co-worker. “By engaging staff members in choosing their colleagues, you’ll promote shared governance and decision-making.” (Hader).
Keeping the right people
Now that you have hired them, how do you keep them? The highest rate of turnover for newly hired employees occurs in the first month. (Conroy, 2006). Orientation with acclimation to transition thus becomes an important component of retention; a good start can make a lasting impression. A model based on the novice-to-expert continuum can be very helpful, with clear expectations and goals outlined in the clinical, technical and interpersonal areas for each level of expertise. (Benner, 1984). “New nurses see knowledge and experience as synergistic, with meaning attached to knowing and understanding rather than just doing.” (Boswell et al, 2004)
Integrating new staff into the unit
Equally important is integration of new staff; a bridge is needed to complete the transition into the unit and the organization. This can be accomplished by assigning a post-orientation mentor as an ongoing resource for the new nurse. “Increased support of more experienced nurses and preceptors is beneficial in helping new nurses gain confidence in their skills to be competent caregivers.” (Boswell et al). With confidence and increased competence come job satisfaction and increased productivity. Continuing education and job enhancement opportunities need to continue throughout an employee’s tenure. Support for advanced education or certification through reimbursement or bonuses as well as clinical ladders can provide opportunities for promoting professional growth.
The role of leadership
Another important factor is the role that management or leadership plays in nurse retention. “It is often through nursing leadership that structural empowerment factors are allowed to filter through to staff nurses at the bedside.” (Manojlovich 2005). Structural empowerment factors include access to opportunity, information, support, and resources.
With this empowerment comes self-sufficiency and autonomy. All these factors are in the manager’s power to control and provide. “Therefore, the professional practice of the staff may depend in part on nurse executives’ and unit-based managers’ ability to provide an environment more conducive to professional practice.” (Manajlovich ).
One way to provide this professional environment is through shared governance groups that can address clinical practice, incorporating evidence-based practice into unit policies and procedures. Having sharp-end nurses participating actively in developing clinical practice can go a long way toward fostering autonomy. “Consider restructuring nursing departments to provide participatory management styles, like shared governance…to enable a spread of formal power that supports nurses’ control over their work environment.” (VanOyen). Control fosters autonomy, which in turn fosters professional accountability. When nurses have professional accountability, we are well on our way to achieving efficiency and quality patient care. These leadership qualities and characteristics need to circulate from the top down, with training for managers in communication, job coaching, and participatory management and empowerment strategies.
Recognition and reward
Last but not least, recognition programs are needed to reward excellence in practice. It isn’t always about the money. “Recognition of seniority, experience, and education certifications as well as daily performance increase nurse retention.” (VanOyen). Once these strategies for recruitment and retention are in place, they need to be advertised to seek potential candidates. Job fairs at colleges and in communities are one venue. Collaborating with nursing schools on observational and clinical experiences is another opportunity for student nurses to see what we are about. Ads in professional journals highlighting our mission, values, accomplishments, professional opportunities, and recognition programs can also be helpful. Investing in human capital is a long-term investment that starts with hiring practices and strategies and continues through the employee’s tenure. Given proper support, the rewards are tremendous.
References:
Benner, P. (1984) From Novice to Expert. Menlo Park: Addison-Wesley.
Boswell, S., Lowry, L. & Wilhoit, K. (2004) New nurses’ perceptions of nursing practice and quality patient care. Journal of Nursing Care Quality 19(1), 76-81.
Conroy, A. (Feb. 18, 2006) Recruitment and Retention lecture.
Hader, R. (2005) How do you measure workforce integrity. Nursing Management 36(9), 32-37.
Manajlovich, M. (2005) The effect of nursing leadership on hospital nurses’ professional practice behaviors. Journal of Nursing Administration 35(7/8), 366-374.
VanOyen Force, M. (2005) The relationship between effective nurse managersand nursing retention. Journal of Nursing Administration 35(7/8), 336-341.
White, K. (2006) Better manage your human capital. Nursing Management 37(1) p 16-19.
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