Help!! How to retain new nurses

MikeyJ, RN · Nov 2, 2007

I am still a nursing student, however, I work at a hospital as a nurse apprentice that has an extremely low turn-over rate, and never has more than 10 - 20 RN positions open for the entire hospital. This is very rare for the area I live in, because most of the hospitals here have massive nursing shortages and most of the hospitals have experienced nursing strikes in the past few years.

The hospital I work at does numerous things to retain their nurses: they have a cap for nurse : patient ratios, they provide AWESOME benefits (to all staff, but it definitely helps with nurse retainment), administration is very open to nurses sharing their ideas to improve their work environment, put on many functions throughout the year to show appreciation to their nursing staff, are very pro-education and push their nurses to continue on with their education, really push their nurses to apply for promotions, have AMAZING management (very approachable and open-minded).... and that just names a few things!

rn to bsn student · Nov 2, 2007

Could you tell me what state you are in? Thanks!!

All_Smiles_RN · Nov 2, 2007

A good orientation with classroom style learning with time set aside for the new nurses to talk about different experiences they are having on the floors and where others can offer insight as to what they might do next time, etc. Having workshops, such as IV starts, documentation, time managements skills, and stress management. How about the unit manager or an appointed staff nurse takes 15 minutes with the new nurse once a week after their preceptorship to discuss any challenges they may be facing and offering ways for these new nurses to overcome these challenges? When you're a new nurse, you're insecure and having these little reminders that others are here to support you will go a long way, in my opinion.

Specialty: Cardiology

Location: FL

RosalindRN · Nov 4, 2007

I am not a new nurse but recently I started a new job in an area that I don't have a lot of previous experience in. I think what would help to retain new hire nurses is to not treat them like they are a staffing solution while on orientation. I am on orientation and just because I am an experienced nurse I often get left on my own with MY OWN ASSIGNMENT! I will have a "go to" person that has their own assignment. I'm finding this to be very stressful because While I am experienced, I dont always feel comfortable with my pt assignment because of new surroundings, new docs, new ways of getting the job done. I have had this problem before on another job that was just per diem. I was taken off orientation way too early even after expressing my concerns. I quit that job without notice. So my point is, let new nurses get the orientation they need to feel comfortable and maybe they will stay.

meandragonbrett · Nov 4, 2007

pay for certification exams, incentives for certifications, above average benefits ( I mean seriously, It seems as though RN's have some of the crappiest health insurance in the country), new grad programs, GOOD orientation with GOOD preceptors that are organized and have their stuff together. Don't give somebody 4-5 different preceptors in a 12 week period. Don't give horrible 3 patient assignments to your new staff (ICU here). And I think a major thing is just be friendly to the new person and help them out where we can.

PMFB-RN, RN · Nov 4, 2007

I live in Wisconsin and work in the ICU.

1. No tolerance for doctors abusing nurses.

2. Good pay and benefits.

3. Strong support and training for new grads.

4. Safe nurse to patient ratios.

5. Eliminate stupid and absurd rules that nurses must follow. Not a problem at my hospital but I have read here about hospitals who force nurses to lie to patients by making them say things like "Is there anything I can do for you? I have the time".

6. Open and honest communication between nurses and administration.

kukukajoo, LPN · Nov 4, 2007

How about retaining current nurses ?

Indy, LPN, LVN · Nov 4, 2007

One word: Staffing. Okay, make that two: adequate staffing.

Without it, even the experienced nurses will leave. Once there are enough nurses to actually do the job, teamwork will improve, attitudes will improve, patient outcomes will improve! Improved scores on crap like press-gainey and JCAHO surveys and such, makes the bean counters happy.

Managers need to look at the other stuff like stupid and redundant duties, and eliminate what isn't practical. Patients can smell horsesh!t so don't give it to them. Oh, and policy and procedure committees need to get input from real nurses, nightshift included. Ways to do this include asking the actual nurses what they think of ....whatever it is. One way is to do such on rotating basis: maybe once a month post a random policy have the managers ask the nurses (when it is feasible 'cause they're not running their butts off) what's wrong with the policy. Believe me there are enough stupid things in policy manuals that can hang the nurse if things go wrong. Remember that male nurse a couple years back who actually didn't know the hospital had a policy against rectal temps, and who was prosecuted for sexual harassment?

So yeah, involve the nurses in decision making, and do it in a way that doesn't screw up their sleep routine, mess with their days off, or piss them off entirely.

My current job has awesome managers. They come to me on night shift and hold staff meetings for me. I email them if a problem arises, they come explain the rest of the story and why it happened, on my shift when they would normally be home eating dinner. If a problem happens twice (and sometimes the first time) my manager fixes it. If she can't, I get an update. We have had emails fly back and forth on a single shift, middle of the night, with her trying to help me from her vacation.

So it's a two-edged question, really. One, how to retain new ones... and you must staff them right to have a snowball's chance in heck to keep them! Two, how to find and retain the managers that will actually do the job right. Nurses need advocates too, not just the patients. And I don't know where such good managers come from, so I can't answer that.

Ariesbsn · Nov 4, 2007

How about:

Longer orientation.
Preceptors who like to precept.
An on-going relationship with a mentor who likes to mentor.
Smaller assignments to start with.
A no tolerance stance on lateral violence.

tddowney · Nov 4, 2007

Hello, I am an RN that is currently going back to school for my BSN. One of my assignments is to collaborate with another nurse on a topic. Please help! What are some ideas that you have to encourage new nurses to stay at a facility? If you answer, please list your speciality and state. Thanks!!!

Start with the complaints commonly seen on these boards. Nurse/Pt ratios, inadequate and shortened orientations, unhelpful or worse response from those with experience on the unit.

The solution to these complaints is an organizational committment to nurses, not just new ones.

For a start, make new employee satisfaction a significant part of the performance reviews of charge nurses, unit managers, and up the line.

I'm a new grad, although with quite a few miles on me in other industries, and I work in transplant. For the record, I'm being given a very good orientation, despite changes in personnel in our unit. I very much enjoy my job. Sure, I feel stressed and dumb at times, but that comes with the territory of any new job. The thing is, I have people I can turn to.

One thing often missing from this type of discussion is the part the newbie can play in enlisting the staff as friends, rather than critics. Be friendly, be respectful, never carry tales, and jump in and help with the mundane tasks without being asked. As a newbie I know I can't carry a full load, but I can make sure I do carry the load I can.

Sassybottom · Nov 4, 2007

Strong leaders on the floor. Having a supportive, competent, and hard working charge nurse does so much for the morale of the nurses and support staff on the floor.

The difference between an excellent charge nurse and horrible charge is like night and day. One makes you actually look forward to working and the other truly makes you physically dread work.

Seeing a charge nurse sitting around doing nothing and eating while call bells are going off, admissions are coming in, and staff are running off their feet is frustrating and leaves a sour taste in your mouth. He never even offered to help - just sat around eating and surfing the net, reading. The only times he seems to offer help is when it looks like you have everything under control. I don't even trust him to come to him with questions - he is just not that knowledgeable - it would be like the blind leading the blind. I'd have better luck trying to figure it out myself or asking anyone and everyone but him.

Yeah, I am dreading working when he is charge vs. can't wait to work when a strong charge is leading the unit.

A good charge nurse has been the main reason I love my job ... managers should recognize this and grant salary bonuses to good charges.