Retention ideas

lever5 · Feb 7, 2002

I worked in a hosp. in upstate NY where there were a lot of nurses that were there for 15-20 years. The draw.... they did not have to float or be called off after 12 years with the organization. This means a lot to a nurse.

Goodlaura6 · Feb 7, 2002

Interesting ... My unit (L&D) is looking into granting "perks" starting with 20 years. Like maybe, no "on call" or getting a straight "Day" shift (no rotation). AT 25 years, maybe not working any "Holidays" any more ... at 30 years, no weekends etc ... Just an idea right now. Anyone have such things in place where they work?

VickyRN, MSN, DNP, RN · Feb 7, 2002

My hospital has not done a very good job at retention. Because of the severe nursing shortage, our hospital offers generous sign-on bonuses to attract new nurses. This, in turn has led to a "contract-mentality" among the nurses (especially in our intensive care unit). The nurses all say "when my contract runs out, I'm going to travel, I'm doing agency, I'm going to anesthesia school, etc, etc..." VERY FEW IF ANY say, "I like working here and plan to stay!" The new nurses are hired at a salary not too different from nurses who have been in the unit 3, 5, 10 years (IF there are any of these left). So what is the impetus to stay? Actually, in order for retention to work, the whole atmosphere, the whole culture of the hospital needs to change. A generous retirement package would be a BIGGIE. Monetary incentives to keep on working in the unit would help, too (especially since one big hospital in the area is sending unsolicited offers through the mail to all CV nurses in our region--$10,000 sign-on bonus to go work with them!!!). Fair raises would sure send a signal "I want you to stay!!!" Oftentimes (and I kid you not), if you want a good raise, you have to quit and work elsewhere for a year or two---then come back. It is guaranteed they will offer you a GREAT salary increase to come back plus a BIG SIGN-ON bonus to boot!!! :chuckle

Years ago I was one of the few OB nurses at a small community hospital in our region. The OB department was floundering, so the "bright" administration was offering experienced L&D nurses from neighboring hospitals $5/hour to take OB call for our hospital and BIG BUCKS per hour when they were called in to take care of one of our laboring patients. Well, how do you think this made me feel when I found out??? (We're not idiots--the other employees always do find out about these things.) I had been taking call for years with LITTLE TO NO REMUNERATION. When I got called in to take care of a laboring mom, did not receive time and a half, only my regular salary. (Had to drive one-half hour one way over dangerous country roads just to get to the facility.) Well, I tell you what, it made me feel VERY UNAPPRECIATED and TAKEN FOR GRANTED. Wasn't too long afterwards, I left this facility for the "big city" hospital and am making $10 to $12K more a year. Would have stayed, however, if they had just treated me fairly and shown some appreciation.

VickyRN, MSN, DNP, RN · Feb 7, 2002

Oh, another thought. It is always the LITTLE things that will make a BIG difference either positively or negatively. Once morale plummets in a place, it is very difficult to get it back (like fighting water bursting over a dam). Bad morale will result in nurses constantly leaving. Good morale, great teamwork, and feeling appreciated will result in nurses wanting to stay. It all stems from the "top." The management sets the tone, the atmosphere. Bad morale often results over management nittpicking--very stupid, amazingly insignificant matters. For instance, in our level III cardiac intensive care unit, ALL the nurses recently received a "love letter" from management. Management is VERY upset about "unapproved" overtime and wants us all out by 7:15 (any exceptions--get the charge nurse to approve). Well, obviously, NOBODY wants to stay beyond their shift. As any bedside nurse can tell you, Murphy's Law of Nursing states that if anything bad is going to happen, it will happen at change of shift!!! So, we are to leave, regardless, even in the middle of a code, GI bleed, dangerous dysrhythmia, etc. You wouldn't believe the level of anger this has created among the nurses in our unit!!! I also see nurses clocking out at 7:15 just to appease management and then returning to work (unpaid) to finish tying up those "loose ends" at the end of the shift. One nurse lamented, "They only point out negative things to us, never compliment us for the positive things, all our hard work, dedication. It would be nice to receive some POSITIVE reinforcement once in a while." Another nurse angrily commented, "So, they want us out by 7:15! Well then, I'm not going to answer the phone anymore--just let it wring off the hook! And no more entering orders in the computer! I'm just going to concetrate on doing my job and getting out of here."

LTC-LPN · Feb 7, 2002

The LTC facility I work at has gone from 20 nurses who were regularly scheduled (in the year 2000) to 13 nurses now. Several nurses with almost 20 years of experience in this facility left for a number of reasons. I can attest to the negative reinforcement versus positive - we seldom are complimented or told we are doing a good job. Just "you're doing this wrong" and "why are you staying past your scheduled time?" The emphasis is on recruiting with no emphasis on retention. This surprises me because I see the problem as being equal - you need to recruit AS WELL AS RETAIN.

I'm glad that we at least get positive feedback from our residents. It is great to hear, "oh you're my nurse tonight, I'm so glad." And I know in my heart that I am doing a good job.

I agree that it is the positive reinforcers that make a difference in how you feel about the facility. A little positive recognition is a good tool, but seldom used here.

Jane Ann

Goodlaura6 · Feb 7, 2002

I read a paper floating around work about Nurse retention and what Nurses want. It was written from some frustrated nurses soul, I think. She listed 4 main problems: Salary cap, Work Schedule, retirement plans, and respect. It is long..1 1/2 pages of typed print or else I'd rewrite it here. What a shame, I fear newer nurses see us older nurses and definately don't want to end up like us! Unless hospitals change, they'll leave.

sleepyhead · Feb 7, 2002

I work in a fairly large teaching hospital associated with a private university. If you work at the university (including the medical center) for five years they will pay a large percentage (or sometimes all, depending on the cost) of your children's tuition when they go to college. They also match up to five percent of your wages after a year which goes toward retirement. They also have recently implemented a career ladder which gives fairly large pay increases the further "up" the ladder you are. Also, the nurse-to-patient ratio even on the "floors" is getting better (I think about 5:1 with nursing assistants for all patients). I really feel lucky to work where I do considering all I have heard about other facilities.:roll

sharann, BSN, RN · Feb 7, 2002

I've heard a lot of financial suggestions for nurse retention, but have yet to hear of the one major item that would have "retained" me at my last position as a bedside CVU RN: Safe staffing and no regular floating and call-offs when the unit is "staffed to acuity". Acuities were plain BS! We had to fill them out once a shift only to have managment say we we overstaffed when we in fact were staffed appropriately. Of course, they floated someone which led to the normal dangerous staff ratios again! More money and great benefits would be marvelous, but with current staff ratios I'd have to say no amount of $$ is worth my patients lives or my rn license.