Staff Retention Policies - page 2

I work on a great unit that's trying to come up with incentives to make staff want to stay on our floor for a long time. We have decided to make a retention policy and are brainstorming ideas such as... Read More

  1. by   adventure_rn
    In my experience, the flight risks aren't the nurses with 10+ years on the unit, it's the younger new grads and new hires who aren't married, don't have kids, and can leave to find something better at the drop of a hat. In order to retain the nurses at highest risk for attrition, you have to appeal to your entire staff base including the newer nurses (rather than simply rewarding the highest seniority nurses).

    The promise of a bonus or incentive at the 10 or 15 year mark isn't sufficient incentive for a new hire to stick around that long; you have to make it a desirable place to work at this moment (reasonable ratios, reasonable salary, reasonable management).
  2. by   Lisacar130
    Promising no floating or no holidays after X number of years will never work because a new manager can come around and change it like nothing, leaving the nurses who were counting on it happening with nothing. The nurses won't believe it will be guaranteed so it won't really work. Plus, what about the nurses who are already there for that long... suddenly they won't have to float anymore or won't have to work holidays anymore and the newer nurses will have to do it even more often to balance that out and that won't be fair and they will quit.

    I can't think of anything that won't cost money, like increased salary/retirement benefits/ or increased staffing.
  3. by   llg
    Quote from JKL33
    This problem won't be solved the way you are coming at it.
    I wish I could "like" that post multiple times. Very well said!
  4. by   MrNurse(x2)
    I left my management after three decades. Why? I had it with the condescending seniority remarks. Had a patient admitted with GI bleed that turned out to be a basilar skull fracture, that I caught, not the docs. I was told that was expected because of my experience. Two docs dismissed this man's chest pains, I stuck on it until he made it to the cath lab, once again, expected. Meanwhile a new nurse gets recognized hospital wide for dealing with a screaming patient who was heard throughout the whole unit when he occluded his fem-pop. I was not the only multi decade nurse to leave, half of our experienced nurses left. I now work a facility that listens to what I have to say and treats me as an adult.
  5. by   Crush
    Quote from MrNurse(x2)
    I now work a facility that listens to what I have to say and treats me as an adult.
    Key here is mangement that is respectful and listens. That is why I like and will stay where I am.
  6. by   OldDude
    Quote from not.done.yet
    People do not leave jobs. They leave managers. Your retention policy needs to include training for excellence in management, making sure that nurses who have experience are the highest paid employees on the floor and that your staffing ratios are reasonable. Period.
    OMG!! No truer words have been spoken! But who wants to listen to common sense?
  7. by   kbrn2002
    Quote from QuietIsntAWord
    We get a raise every year if you score a certain amount on your eval (which isn't hard unless you are downright lazy) and our retirement plan you can take with you if you stay at least 5 years. Why don't have a high turnover rate, but I also work at a great facility

    Oh and your Christmas bonus gets bigger based on how long you've been there
    You still get a Christmas bonus?? Since our Christmas bonus has been holding at precisely zero for more years than I can count there's nowhere to go but up!
  8. by   Ruby Vee
    The jobs I've stayed at were the ones where I was treated as a respected professional by my manager, by her boss and by her boss's boss. I could step on an elevator with the Director of Surgical Nursing for a 1000 bed hospital and she not only recognized me as one of "her" nurses, but she remembered my name and used it when she greeted me and asked if the rain/snow/sunshine/whatever had messed up my commute/weekend/whatever. On Christmas, Thanksgiving and Easter the hospital staff were all treated to a free meal served by hospital management -- from the Chairman of the Board to the CEO to the various department heads. They each signed up for a holiday meal on a rotating basis. The medical director of our unit stopped in every major holiday with a basket of home-made goodies he had made with his own two hands (sometimes with the assistance of the newest crop of interns on service). When you went to any of the physicians with a concern, they listened and if they disagreed with you, they did so respectfully. (And if they DIDN'T, they were promptly straightened out and delivered an appropriate apology. Meaning the intern who chewed me out in front of the entire unit apologized in front of the entire unit, and if the apology was inadequate -- which was rare -- he had to repeat it until he got it right. Or they weren't back the following year.)

    The manager -- who wasn't an ICU nurse -- listened to those of us who WERE ICU nurses and took our advice. If, for some reason, she couldn't follow our recommendations (recalcitrant upper management for example) she met with us to explain the situation and we all worked together to find a different solution. If there was no different solution to be had -- for instance staffing sucked because everyone wanted to go to the funeral of a colleague, she talked to her peers in the other 8 ICUs and paid overtime to anyone who would volunteer to come in and relieve one of our nurses for part of a shift. Everyone who wanted to got to go to either the funeral or the visitation. The day shots were fired on our campus, our manager was right there on the unit with the rest of us, disseminating information as she got it, listening to everyones fears/concerns/ideas. When the blizzards hit, she camped out in her office for the duration and during the hurricane, she was unavailable so her boss was on the unit. Neither our manager or her boss was able to take a patient, but they answered the phones, ran specimens to the lab, fetched icewater for visitors and kept the coffee pot going. In short, they were there, helping, getting their hands dirty and no doubt ignoring some of their own work to do so. If I hadn't had to relocate, I'd still be there.
  9. by   Been there,done that
    Management / administration knows what is needed to retain experienced nurses.. it is money and respect. Any policy formation is a moot point.
    "no floating after 10 years, no holidays after 15 years"..is a carrot dangling before their nose, that smart nurses can see through.
  10. by   cyc0sys
    Quote from MrNurse(x2)
    I left my management after three decades. Why? I had it with the condescending seniority remarks. Had a patient admitted with GI bleed that turned out to be a basilar skull fracture, that I caught, not the docs. I was told that was expected because of my experience. Two docs dismissed this man's chest pains, I stuck on it until he made it to the cath lab, once again, expected. Meanwhile a new nurse gets recognized hospital wide for dealing with a screaming patient who was heard throughout the whole unit when he occluded his fem-pop. I was not the only multi decade nurse to leave, half of our experienced nurses left. I now work a facility that listens to what I have to say and treats me as an adult.
    I completely agree with the statement above.

    But as a previous poster mentioned, that's what's expected of you. After all, you're with the patient 8-12 hours per day. Surly even the most lowly skilled and lowly paid professional could recognize those medical s/sxs because the Docs are too busy solving the riddle of the Sphinx. Then navigate the health care gauntlet, against all odds, uphill from a subservient position.

    However, there's no reward for a positive out come. Only punishment for negative ones, even if it's the result of protocol and policy driven from management and administration. How dare you think outside the box and advocate for the patient. 'Father' or 'Mother" knows best.

    Alas, the real dilemma is patient care above profits. Patients are not my customers and we are not flight stewardess serving narcotics.
  11. by   Nurse Beth
    People who are appreciated go the extra mile
  12. by   KelRN215
    Most people don't stick around 10-15 years, in my experience, and, as someone else said, those that do aren't the ones who are the biggest flight risk. My last job, I was the most senior nurse in the department 10 months in and, before I left the job last week, was the most senior person in the entire department at just over 2 1/2 years. I feel like there is little to be done in each floor if hospital-wide policies do not encourage or incentivize longevity. You can't expect people to stay somewhere where benefits are cut and wages are frozen when they can get a better deal somewhere else. Not saying that's an issue at your hospital but the benefits are the biggest reason I left my last job.

    Also research shows that you shouldn't just stay at the same job. Raises staying at one employer do not come close to matching what you get by moving around. In under 3 years, I've raised my annual salary by $20K by moving around. If I had stayed at the job I was at 3 years ago, I'd have maybe gotten 3% raises annually. Or none. And would be making $15K/year less than I am now.
    You Should Plan On Switching Jobs Every Three Years For The Rest Of Yo

    Most places don't offer pensions anymore and 401Ks/403Bs are easily rolled over between employers.
  13. by   LadysSolo
    Quote from JKL33
    This problem won't be solved the way you are coming at it.

    In what other every-day relationship in life can we successfully treat people as a means to an end or a subject to be controlled? None. We wouldn't succeed by treating a spouse/partner that way, nor raising a child, nor maintaining a friendship. Human beings do not work that way. We either care about the people we want to have an ongoing relationship with, or we don't. If we don't care, we won't have an ongoing relationship. Some may say this is different because it's business. Well, I think it holds true, I think I'm right, and the proof is right there for anyone who wants to look at it.

    The thing that some people don't understand is that nurses have always worked in situations where we didn't have endless resources to perform our duties. Nothing new there. The thing that has changed is the idea that all of this is somehow our fault. There have been endless times in my career where patients keep coming in the doors, multiple things are needed at once, patient conditions change rapidly, and we are ROAO the entire shift - but it used to be that someone eventually said, "well done," and "take the best care of the patient that you can and we'll worry about the rest later." There was such an incredible sense of teamwork, belonging, and accomplishment in successfully handling these situations! But I think I would fall over dead if I heard either one of these two things in our current environment. In other words, there was moral support for our efforts. Moral support has currently left the building and been thoroughtly replaced with shame and blame.

    No professional is going to put up with that for very long. Nor should we. Working one less Christmas or floating two less times per year (after 15 years of service???) is not going to endear people to the idea of being repeatedly scapegoated and treated like a thorn in everyone's side.

    If a business can't afford to speak with, treat, and consider adult human beings in a manner consistent with the idea of maintaining an ongoing, mutually-beneficial relationship, then one won't be had. It's that simple.

    As a matter of fact, I believe they very well know this already, which is why they have plans in place knowing they will churn through employees. I personally could not be happier that their careful calculations and accommodations for treating people like sh*t aren't panning out.

    Over time, you cannot pay (most) people enough or throw enough half-hearted "rewards" their way to have them agree to be treated poorly every day, day in, day out. That only works for a time and then you'll simply again be faced with your refusal to have a real relationship.

    ETA: This is the same reason why the "patient satisfaction" game won't be won. There is a difference between treating people well because you care about them and doing things to try to make them feel like you care as a means to an end.
    Can I please like this a thousand times? This says it all - treat me like a human being trying to do a good job with what little resources I have, and have my back when (if) something goes wrong due to circumstances beyond my control (dietary screws up a tray, PT is late, etc.) DON"T make it MY fault when it isn't!

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