It is difficult to find and keep nurses, especially good nurses. All of the administrators want agency usage eliminated. Nurses, as a whole, are usually unhappy with their current working conditions and salary. Usually nursing management is caught in the middle of this and that can be a miserable place to be. What do we do about all of this?
It is my opinion that addressing the current issues that are leading to a nursing shortage and directly contributing to the dissatisfaction of nurses starts with the nursing leadership. Unit and department managers have a primary responsibility to engage in leadership activities that will promote job satisfaction. Directors of Nursing or Chief Nursing Officers should support and expect their unit managers to work to improve morale of the staff nurses. If we are going to advance our profession and retain and recruit people into the profession we must start improvements ourselves. There is far too much fighting among ourselves and petty competition and bickering over patient assignments and a general lack of teamwork and so on. This is not to mention staffing issues and workload issues. American nurses are shouldering a heavy burden compared to nurses in other places so maybe we should start recognizing the skill, knowledge, and dedication our nurses possess and stop criticizing so much.
If your staff nurses are not successful and satisfied then you will not be successful or satisfied. Satisfied employees = satisfied customers = satisfied managers. Unit managers need to actively find ways to support, recognize, reward, and generally make the staff nurses' life easier. If the manager's success depends on the success of their staff then some of the major functions of their job become quite clear--support your staff!! There are many ways to do this and much literature has been written on the subject. Just a few of my ideas:
-stay out of your office, be visible, be available
-pitch in and help when you see staff struggling with something
-go all out to honor requests for time off
-come in early and take report with your staff
-work the desk and ensure good communication and flow of info
-stand up for and defend your staff when appropriate
-actively and aggressively look for things that are done right
-seek out, recognize, and actively celebrate high quality care
-leave your "power trip" at home, view yourself as a servant of your staff, not a "master"
-allow your staff to have the professional autonomy they need
-encourage educated risk-taking in trying new things
-create an open, relaxed, positive, professional atmosphere
-communicate, communicate, communicate
-do not criticize openly and be slow to reprimand
-do not engage in gossip
-do not criticize the administration of the hospital
-do not create an "us versus them" culture and feeling on the unit
-look for ways to make your hospital the best
-look for ways to build business in your hospital
-view your unit as your own small business
-be passionate about your work, your unit, your staff
I would encourage Directors of Nursing to have the same attitudes and to aggressively learn how to link nursing interventions to positive patient outcomes to positive financial performance for the organization. One view we must overcome is that administration often sees nursing as "a nurse is a nurse is a nurse." They also sometimes don't understand why a nurse is better and required versus an unlicensed person or an RN versus an LPN. Our staff nurses depend on you to communicate the value of nursing to administration. DONs must be able to identify and explain the interventions that are unique to nursing and that no one else can do so the value of nursing is promoted. We must be able to link these unique nursing interventions to positive patient outcomes to positive financial performance so that nursing can begin to be seen as a revenue generator and not a mere consumer of resources and a very high salary expense that must be contained and decreased in some way. You should know that making a profit and/or maintaining an operating margin is a top priority for the administration of all hospitals. Develop new and creative ways to show how nursing adds to the financial performance of a hospital and not merely chips away at their bottom line.
Educators--please consider incorporating some basic healthcare finance into the curriculum. Also some leadership training and training on professionalism. We have to present ourselves and communicate that we are professionals and I believe the socialization process for new nurses begins in nursing school.
Just a suggestion: When you would like us to work extra, on our days off, etc. ASK us-- don't say "I need you to work Wednesday...." "You have to work Wednesday"-- We do have LIVES, and families, so please have the common courtesy ASK us "Is it possible you could work?" or "Are you available to work?" & then if we ARE available to work, if you agree to use us part of a shift, PLEASE have the decency to make SURE we don't get stuck there 3 hrs after we had to leave !!! It shows a lack of respect to us as humans to just TELL us rather than ASK-- you might get a little more cooperation that way & effect better MORALE as well!! Another suggestion: if there are issues that need to be addressed, PLEASE keep us informed as they come up, so we can work on problems & have input, NOT bombard us w/vague unsubstantiated complaints (or GOSSIP!) at our yearly eval. THAT's poor management!! (talk about a reason for poor morale & nurses leaving!!)
Please don't ignore the night shift. Meetings are never convenient, classes are not convenient, etc. But nursing is a 24/7 job and if you're not visible and/or available for the night shift, but are perfectly available for dayshift, this will not help you... see below.
When people from differing shifts get into conflict, don't automatically side with your favorites from ... dayshift... please. It shows an inability to think critically. It also shows that you know nothing about what goes on when you aren't here, due to lack of effort to see what your other shift does.
Oh. By the way. If you want your lackeys to do things your way, and this involves suddenly intentionally understaffing the unit, TELLING us would help avoid shift conflict. We remember all the silly crap you spit out at meetings about communication being the key to solving and/or preventing conflict, and we wish you would remember it too.
Why, OH why, do you have lackeys in the first place? Just do the staffing yourself and maybe the shifts will have one less thing to gripe about. Better yet, just make sure we're staffed decently to begin with and that will eliminate 80 percent of your problems.
Just a suggestion: When you would like us to work extra, on our days off, etc. ASK us-- don't say "I need you to work Wednesday...." "You have to work Wednesday"-- We do have LIVES, and families, so please have the common courtesy ASK us "Is it possible you could work?" or "Are you available to work?" & then if we ARE available to work, if you agree to use us part of a shift, PLEASE have the decency to make SURE we don't get stuck there 3 hrs after we had to leave !!! It shows a lack of respect to us as humans to just TELL us rather than ASK-- you might get a little more cooperation that way & effect better MORALE as well!! Another suggestion: if there are issues that need to be addressed, PLEASE keep us informed as they come up, so we can work on problems & have input, NOT bombard us w/vague unsubstantiated complaints (or GOSSIP!) at our yearly eval. THAT's poor management!! (talk about a reason for poor morale & nurses leaving!!)
These are good points. I would also like to add: Please don't listen to whiners & complainers who call you at home & then get their way!! Stand up for policy & respect SENIORITY. If you have faithful hardworking reliable employees that have proven they can be relied upon, show THEM your appreciation by including them in decisions that effect the unit-- not coddling newbies that only want to work certain days and still get their preferred shifts & days off, while the old faithfuls just keep working w/out complaint b/c they understand the needs of the unit & being FLEXIBLE, & that complaining or calling you on your time off is manipulative. You will eventually lose your longterm reliable employees and be left w/the whiners/manipulators you have supported. If you're losing good experienced longterm employees, LOOK at WHY & LISTEN to the ones you have left in the trenches!!!!!!!!!! RECOGNIZE & support your longterm employees! Lastly: WAKE UP & reward GOOD behavior NOT childish behavior!
penguin2
148 Posts
Just a suggestion: When you would like us to work extra, on our days off, etc. ASK us-- don't say "I need you to work Wednesday...." "You have to work Wednesday"-- We do have LIVES, and families, so please have the common courtesy ASK us "Is it possible you could work?" or "Are you available to work?" & then if we ARE available to work, if you agree to use us part of a shift, PLEASE have the decency to make SURE we don't get stuck there 3 hrs after we had to leave !!! It shows a lack of respect to us as humans to just TELL us rather than ASK-- you might get a little more cooperation that way & effect better MORALE as well!! Another suggestion: if there are issues that need to be addressed, PLEASE keep us informed as they come up, so we can work on problems & have input, NOT bombard us w/vague unsubstantiated complaints (or GOSSIP!) at our yearly eval. THAT's poor management!! (talk about a reason for poor morale & nurses leaving!!)