[ShayRN]

I am a fairly new unit coordinator. I got the job in January and really love the unit, it is a great group of people. However, we no sooner get our nurses trained and then we lose the "older" nurses. It isn't like they are leaving because they hate the unit, they are leaving to go to the intensives (we are a telemetry unit,) or to advance themselves. I can't hold that against them, but it is very frustrating. I have tried doing things to bring the unit closer. I don't tolerate verbal abuse by patients, familys, co-workers or physicians. I put together a skills day in March so that everyone would have their profiencys done when it is time for their evaluations. Myself and the other two coordinators on the unit actually pick up extra and have come out on weekends and holidays (suppose to be a perk of the job, that we have them off) to cover short shifts. AND this week we are holding the units first family picnic. My thinking is that it is harder to leave a friend than a co-worker. I have people tell me all the time what a fair boss I am, yet I just got informed on Friday that we are losing another nurse. She has only been off orientation for 8 months. HELP!

[rn/writer]

Have you done any exit interviews with the nurses who have left? The exodus might not have anything to do with you or the unit itself. If you hadn't implemented the things you have, you might have lost even more. Then again, maybe there are problems that a nurse with nothing to lose anymore will be able to fill you in on.

Also, ask the current staff what is important to them. Try not to sound too desperate or they might exploit your willingness to accommodate, but if you tell them you are asking merely to take matters into consideration, you might find out what motivates them.

It sounds like you have tried to implement some good changes and foster cameraderie. If all managers were as caring and concerned, the health care world would be a better place.

Good luck,

Miranda

[canoehead]

Have a brainstorming during a staff meeting about retention of nurses and how to make the unit better. they might have some good ideas. I bet they would welcome a break from training new staff too.

[Angie O'Plasty, RN]

Well, think about it--ICU has a different patient load than tele, better pay, less burden to the nurse, correct?

After preceptoring and having to take as many as 12 patients, doing Charge for not a whole lot more money (yet being responsible to all those patients, my staff, and staffing for the next shift), I could see why they'd leave.

Not enough compensation for more headaches, more responsibilities. I didn't become a nurse so that I could see my patients for a total of one hour and spend six charting, nor did I become a nurse so I could interrupt a med pass to deal with a late call-off. And all of that so I could go home still wondering like a new grad, what I might've missed.

Sorry this post kinda turned into a rant, but throughout hospital managements, the more experienced bedside nurses are simply not valued and there is no incentive to stay, but plenty to leave that bedside.

[UnewmeB4]

I sometimes think that it is because they just use the tele unit to get their feet wet before progressing to ICU. Once they are comfortable with all the heart treatments, meds,rhythms,etc. they feel confidant enough to go to ICU. Some are looking for the challenge, some are looking for respect, some for only 2 pts/nurse, some for sicker pts who are on the vent and can't complain and less visiting hours to interrupt their work.

[mydesygn]

Originally Posted by UnewmeB4

I sometimes think that it is because they just use the tele unit to get their feet wet before progressing to ICU. Once they are comfortable with all the heart treatments, meds,rhythms,etc. they feel confidant enough to go to ICU. Some are looking for the challenge, some are looking for respect, some for only 2 pts/nurse, some for sicker pts who are on the vent and can't complain and less visiting hours to interrupt their work.

It is becoming rare to find a unit with a lot of long term nurses. Sometimes there is very little you can do. You can work at a nursing positon for many years and the job you do is no different than a new grad. You get to a point where you need to find new challenges or very your routine or advancement. I agree with the previous poster related to ICU but I do beleive in general, there is not much value placed on seniority. You still work weekends, don't make that much more than new grads, mangement considers nurses pretty exchangeable. In all honesty, most people don't spend a lifetime with a single employer (2-5 years is about avg for an exceptional unit).

[llg]

Great thread ... great responses....

It illustrates some of the complexities of the "nursing shortage." As the OP has shown, people don't just leave because the unit managers are evil, lazy tyrants as some people like to suggest. Nurses have other reasons for leaving that are often beyond the control of the frontline unit manager.

It might help the OP to re-think the role of her unit within the hospital system. We have such a unit at my hospital -- a general med-surg unit to which new grads often come to get good experience before moving on to a more specialized unit and/or ICU. Rather than bemoan that phenomenon, the unit embraced that identity and even began to market itself as such. They re-organized their care-delivery model to better fit having a high percentage of new grads ... they used nurses with 1 year of experience or more as immediate resources for those new grads, giving those 1-year nurses a good introduction to precepting. They emphasized the importance of precepting and mentoring for their senior nurses and tried to recognize and reward them for taking on those roles. etc. etc.

In other words, the unit leadership knew which battles it could win and which ones it couldn't. They kney they would always have a lot of new grads coming and leaving after a relatively short time. Rather than beat their heads against a wall trying to change something they couldn't change ... they re-built their unit in a way that would take that fact into consideration. They invested heavilty in educational programs, in providing support for new nurses, and in recognizing and rewarding the preceptor role.

It's not a perfect unit ... but it IS working. By marketing themselves as the place where a new grad can get that "year or two of good experience" they usually hire enough new grads to keep themselves reasonably staffed. A few of those stay longer than a year or two. By acknowledging that they will always have a "young staff," they have been able to secure the resources and set up the systems to provide good care in spite of the turnover.

It's a thought ...

llg

[SmilingBluEyes]

Originally Posted by Angie O'Plasty, RN

Well, think about it--ICU has a different patient load than tele, better pay, less burden to the nurse, correct?

After preceptoring and having to take as many as 12 patients, doing Charge for not a whole lot more money (yet being responsible to all those patients, my staff, and staffing for the next shift), I could see why they'd leave.

Not enough compensation for more headaches, more responsibilities. I didn't become a nurse so that I could see my patients for a total of one hour and spend six charting, nor did I become a nurse so I could interrupt a med pass to deal with a late call-off. And all of that so I could go home still wondering like a new grad, what I might've missed.

Sorry this post kinda turned into a rant, but throughout hospital managements, the more experienced bedside nurses are simply not valued and there is no incentive to stay, but plenty to leave that bedside.

Sadly, this is all-too-common. It's enough to make many leave not only a unit, but nursing----forever.

[SmilingBluEyes]

Just a thought; what is your organization doing to RETAIN nurses, (or not) that say, the competition has not thought to do----(or maybe IS).

Seems hospitals are GREAT at recruiting people-----few give as near much effort to their retention. Stupid, if you ask me.

[Works2xs]

Originally Posted by SmilingBluEyes

Just Seems hospitals are GREAT at recruiting people-----few give as near much effort to their retention. Stupid, if you ask me.

Especially if you compare the costs of retention programs vs. recruitment. Just the admin burden of advertising, paying recruiters, signing bonuses, conducting interviews, etc. is considerable. Then throw in the extras for orientation periods, overtime, temp hires, etc. Seems that the funds you could use for improving morale (seminars, longevity bonuses, other incentives) would be relatively smaller. I wouldn't be surprised if some manager/administrator is looking at different pots of money instead of the total cost, i.e., don't have a "retention" budget so they can't do it versus having a "fat" recruiting budget. If they could just look at the aggregate costs to the unit....