STAFF HIRING AND RETENTION: Healthcare Workforce Strategies

[NRSKarenRN, BSN, RN]

From Healthleaders.com August Magazine:

Finding and keeping healthcare workers is a persistent problem for health leaders, with average turnover rates running more than 20 percent for all staffing positions in the industry, according to one study. HealthLeaders assembled a group of healthcare human resources experts to discuss successful approaches being used to recruit, retain and motivate emrecruit, retain and motivate employees.

Staff Shortages: Cause and Effect

While the nursing shortage often grabs the headlines, hospitals also are experiencing shortages of pharmacists, lab professionals, radiologists, nursing assistants, phlebotomists and food service and housekeeping personnel. The causes of the staffing shortage vary from facility to facility, but higher salaries paid by retail pharmacies and specialty hospitals and care centers are often cited as potential culprits. Stressful healthcare job environments that result in burnout also contribute to the situation. Behavioral issues, including rudeness and demeaning or condescending behavior, can destroy a healthcare team. A new era of expectations exists for physicians and their relationships with nurses. Personnel shortages, especially among nurses, sometime cause bed closures, ED diversions and canceled surgeries. One study found a direct relationship between staffing, length of stay and case-adjusted morbidity. As turnover increased so did the latter two factors.

Recruiting: Finding Good Healthcare Staff

Offering bonuses to entice new employees is a short-term solution because organizations that use bonuses often have a much higher turnover. Many recruiting efforts are under way, including collaborations with colleges and universities to expand healthcare programs and funding faculty positions. Other more innovative programs include hands-on healthcare career exploration tours for youth and nursing co-ops where high school juniors and seniors are paid student rates to do nursing-assistant work. The nurse manager is a critical position because these workers have a direct responsibility to focus on retention and recruitment.

Retention: Holding on to Your Workers

Many hospitals are focusing more on staff retention than on recruitment. Staffs are being offered flexible work hours and varied internal career-development services. Some hospitals are re-basing their compensation programs to pay more salary for jobs that require staff to work holiday, weekend and off-shift or quality-of-life hours. Improvements in career ladders help staff retention, allowing employees to move up in their respective fields. To retain employees, hospitals have implemented listening and communication programs, executive visibility programs and more staff recognition programs.

Long-Term Thinking: Coping with the Staffing Crisis

Health leaders need to reintroduce people to what healthcare really is. For instance, many teachers and counselors do not recognize all the current career opportunities in the industry. Federal and state governments could positively impact the future if they provided more money for education and training to help relieve the personnel shortages in healthcare. While many state governments are trying to help with staffing issues, the effort at the federal level has been disappointing. Mixed opinions exist about the potential for collaboration among healthcare organizations to address staffing. Some doubt collaboration will occur due to individual organizations' vested interests, while others are optimistic, particularly in the area of collaboration within human resource groups.

Read the roundtable discussion at:

http://www.healthleaders.com/magazine/roundtable1.php?contentid=47340

[Ms. Pomfrey]

I am interesting in the quote "Offering bonuses to entice new employees is a short-term solution because organizations that use bonuses often have a much higher turnover."

Is there any place that gives the statistics/citation for that? It would certainly influence my choice of a job when I graduate, as a bonus would have to be balanced against the high turnover and what it suggests about a hospital.

Ms. Pomfrey

[sjoe]

"Retention: Holding on to Your Workers

Many hospitals are focusing more on staff retention than on recruitment. Staffs are being offered flexible work hours and varied internal career-development services. Some hospitals are re-basing their compensation programs to pay more salary for jobs that require staff to work holiday, weekend and off-shift or quality-of-life hours. Improvements in career ladders help staff retention, allowing employees to move up in their respective fields. To retain employees, hospitals have implemented listening and communication programs, executive visibility programs and more staff recognition programs."

And no mention in this collection of "solutions" of competent, skilled, well-trained managers and supervisors. Nor of effective nursing input into ALL facility policies. Nor of simply treating nurses as professionals and as human beings--partners in the healthcare endeavor.

Obviously, just one more ineffective and pointless set of group-think, "don't upset the applecart," thoughts from one more set of "experts," IMHO.

[Pete495]

Many Hospitals are not focusing on Retention AT ALL. That is half the problem. That is why older nurses are leaving the field, and why the turnover rate is so high. This bit about hospitals working on retention is a bunch of hogwash in my opinion, because if adequate retention were taking place, there wouldn't be a national shortage of nurses. Recruitment effort is held to the highest degree because it's easier to hold on to a nurse for 1 to 2 years, and expect the people that are there longer to just stay loyal because they've been there such a long time. And hospitals shouldn't be focusing on paying more for holidays worked. They should be rotating people on holidays so that they can spend time with their families, or giving senior people more options for holiday time off. LISTENING AND COMMUNICATION PROGRAMS!!!!!HAHAHAHHAHAHA. I laughed my ass off when I heard this. My hospital has this as well, and you know what comes out of it. ZIP, ZADA, ZILCH. It's so much crap you could landscape all of Florida with.

The good thing is that I can keep a sense of humor about it.

[oramar]

It is fascinating what a person on inside can see that is not obvious to others. I work on a unit which has a turnover rate that is much lower than rest of institution. I can't help wondering if upper levels of managment are aware of this and asking themselves why. I see and hear such toxic things going on on other units. My nurse manager has a lot to do with the low turn over rate. However, it seem to me that when she gets any kind of input from above it is in the form of harrassment about things like budget over runs and petty issues like time clock problems. This seems like a shame to me.

[ainz]

I read and hear nurses complaining so much about the working conditions and administration. I firmly believe the morale or culture or working conditions or whatever you want to call it is influenced most by the front-line manager, that would be the unit nurse manager. This is where all of the issues about job satisfaction really start.