For Retention

BrnEyedGirl, BSN, MSN, RN, APRN · Jul 15, 2008

Wow,..I've been at my current hospital for over 10 years and there are probably hundreds that have been there longer than I have,...sounds like a great idea but they'd have to have several of these "retreat homes" !!!!

santhony44, MSN, RN, NP · Jul 15, 2008

I'd say it sounds pretty good to me. There might be other reasons, though, that a facility would not want to get into "ownership" of facilities, even temporarily. I don't see why a facility couldn't reward longevity with extra vacation days, matching R&R funds, or something similar.

I've long been of the opinion that far too many facilities put far too much emphasis on recruitment and not nearly enough on retention. I don't know if that's purposeful or just an oversight, but I think in the long run your patient care would be vastly improved with a good mix of us "oldies" and new blood.

My belief is that if you start at the top and create a culture in which wisdom and experience is valued while continuing to give your staff the opportunity to learn and grow, you won't, for the most part, be stuck with a bunch of "old" folks who are grumpy, set in their ways, and haven't had a new idea in 10 years. I'd like, for example, to see a culture in which acquiring a BSN, Master's, or even doctoral degree isn't an automatic signal to get kicked up the "ladder" into administration. Encourage your nurses, with scheduling and financial assistance, to get as much education as they wish, with no pressure to leave the bedside. Can you imagine, a hospital boasting "25% of our bedside nurses have Master's degrees!"

And, of course, recognize additional education, certifications, and so forth, with pay incentives.

And scheduling- encourage retention with creative scheduling options. Recognize that, as nurses move through their careers and their lives, their needs change in regards to scheduling. And, yes, recognize seniority with scheduling privileges. I think newer people can deal with that, if they know that their time, too, will come. With creative scheduling options, let it be known that you will welcome back nurses who have been away from the bedside for a while.

In regards to creative scheduling: does everyone need to work 12 hour shifts? how about 8's? 10's? 6's? 4's? Some of us, as we get older, have a hard time working 12 hours straight; some of us just don't want to and won't if we don't have to.

So, look at the patterns on the floor. Is it very busy in the very early AM, getting blood sugars and insulins? Are there lots of folks going down early for surgeries or procedures, and night shift running like mad for an hour or so getting everything done? If so, what law says that one or two day shift folks can't start an hour or so earlier in the day? You might have someone on staff that would love to come in at 5 am! Or, maybe someone who would like to come in from 5A-9A and then leave to go to school, another job, or whatever. (Of course, offer any innovative shifts to your current folks first!!). If the floor gets busy late AM with patients coming back from surgery, then maybe there's a nurse who would like to get her kids off to school first; let her come in a little later.

I think, with a little creativity, thought, and structure, some innovative scheduling could work well. I think it would be a huge incentive to getting nurses who are currently not at the bedside back into those roles, and in preventing many more from leaving.

Roesseba, I'm sorry if I hijacked your thread! Retention, and ways of addressing the shortage of working nurses, is something that does get me fired up, mostly because I think there are some pretty simple solutions out there that no one is even looking at!! I think part of the solution is in people like you: finding out what our nurses are thinking, what they want, what will keep them in their jobs, and acting on those things. I think the solutions are there, they just aren't being explored and used.

roesseba · Jul 16, 2008

you have great split shift scheduling ideas. I've wondered why they don't do more of that. I'm not in management, I've just wondered why they don't reward the nurses that have been there forever?????? They deserve it.

Ruby Vee, BSN · Jul 16, 2008

the retreat idea doesn't appeal to me at all. as a "senior nurse", what would impress me is scheduling priveleges -- allow nurses who have been at the bedside for a long time to have perqs that the newer nurses don't necessarily get. first dibs on vacation time, or fewer holidays or weekends required would be a start. some hospitals give additional vacation time with seniority but make it so difficult to use that those of us at the top of the pay scale frequently lose our vacation time because we cannot use it.

i like the idea about split shifts and know that would appeal to many.

keep giving us raises if we've earned them. so many pay scales "max out" when you've been in a position for 20 years. with over 30 years of experience, i'm one pay step away from being maxed out even though i've only been at my present position for 4 years. i'll be maxed out this time next year.

in short, money and time off. don't mess with either, and you're one step closer to retaining senior nurses. and an institutional culture that values retention above recruitment would be a novel way to retain senior staff!