Staff Retention Policies

Nurses General Nursing

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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 no floating after 10 years, no holidays after 15 years, etc. Do any of you have units that do this or have some ideas to add to a policy like this?

Specializes in Pedi.

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.

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!

If a hospital looked at big picture financially instead of the quarterly bottom line they would find that adding A/one staff member could improve morale, efficiency, improve retention. Which would then decease turnover, education costs, call in time, overtime costs..... I mean just think if they added two! Mind blown!

This happened at a SNF I cover - the STNAs kept telling the DON that there would be fewer falls with one more staff member. The DON LISTENED and did a study, and found out that with one additional staff member there were fewer falls, so she gave them one additional STNA per shift and made them promise she would not hear call lights going off then. The entire staff was thrilled that she LISTENED and gave them one more STNA.

Specializes in NICU.

Our policy had no floating after 15 years ,worked well until it got screwed up by whining junior staff.

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.

This just not exist anymore.

This just not exist anymore.

I wish I were a Nursing Sister of Yore; i.e. a nun. Then I might be able to deliver this.

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This is such a pressing problem in nursing today and one that I (and many others) have commented on here in like threads. What makes me see red about this whole issue, is that hospital management is FULLY aware of the steps needed to retain quality employees-no administrator could be so obtuse as to NOT know what the real core issues at hand are here. Instead, they (management) would rather have their 'brainstorming' groups with staff and disingenuously talk around the elephant in the room, instead of effectively addressing the problem-that would hit them in their pocketbooks-ouch! Staff don't care so much about pizza parties or acknowledgment of Nurses' Week.... Instead implement and strictly adhere to safe and reasonable nurse/patient ratios, don't task nurses with additional BS, offer competitive pay and restore the benefits and pay that have steadily been whittled away for twenty-five years. Personally, I absolutely refuse to engage in these silly discussions that are inane and serve no purpose whatsoever!

Specializes in ICU, LTACH, Internal Medicine.
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 was disciplined more than once for catching things everyone else missed (like retroperitoneal bleed) and for performing physical exams the way they intended to be. I was told that it should be more senior nurse's responsibility to do so and that doing physical was "needless disturbance".

Thanks God that after year of this I found a unit with a blaring acute need of a SMART nurse.

Specializes in IMC, school nursing.
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..

The skull fracture? Still on the stretcher from ER, the MI, just admitted and 30 minutes into my shift. The real reason this ER went downhill so far? Throughput. More energy spent on low wait times than effective medicine. The end result of bringing customer service into medicine.

ETA: I got the sarcasm in the post. Well played.

Specializes in NICU.

Plus we have really awesome staffing and our bosses will put on scrubs and help out on the floor or work a little while to prevent us from being too short staffed.

I am speechless, our manager stated that helping out when understaffed or census surges "is not her role".

How you like them apples?

Specializes in orthopedic/trauma, Informatics, diabetes.

we have those in place. We need to work on the

Specializes in Dementia.

How long is a long time?

If it's great in your eyes, why don't people want to work there for a ‘long time'? Ask not yourself, but the nursing staff.

I refuse to stay working at a place with constant short staffing. The workplace can start there at least.

I also find it important that admin. have at least some nursing background so as to understand the importance of staffing & other nursing issues.

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