How to retain nurses?

[old&improved]

"How can we retain nurses?" This question was queried at my last staff meeting by the director. We currently are using 17 or more travel nurses in our approximately 150 bed hospital with at least 20 or more openings for full time, part time and seasonal nurses posted. I heard that one nurse said something to the effect that no one in admin listens to us so why ask? Hospital positions were always the "sought after" positions for new grads. Now they leave after 1 year to find something more tolerable.

When things go right, when we get complimentary letters and "good" patient satisfaction scores we are told, "good job", "keep up the good work", but when one patient or family member complains, when there is one fall, one problem there is a verbal or written (or God forbid a final written) warning that stays on your record for a year and a required essay as to how you're going to fix the problem.

And yet here we are day in and day out dealing with abuse, criticism and complaints from patients and family members, and a workload that is frequently impossible to complete in a safe or sane manner. The other day admin bought everyone pizza because the day was so bad. Really!? Is that what you think will fix the problem?

I've had it. We are NOT appreciated. If we were, YOU would back us up instead of pandering to the ones who complain. YOU would hire enough staff so we weren't completely fried.

Sorry for this rant. I just had to vent. And, yes, I am looking for another job after many years of bedside nursing.

[RNperdiem, RN]

Yes, I think the real question another poster wisely pointed out is : how can we retain nurses without spending any additional money.

I don't know where you are located, but a 150 bed hospital sounds like the rural county hospitals you hear about on the news about how they are closing after years of decline in poor depopulated areas.

[brandy1017, ASN, RN]

4 hours ago, River&MountainRN said:

Recognize and reward hard work...and I don't mean with a keychain or thank you note. When you get the same pay and the same evaluation score (because "we don't believe in giving 5's-the best or 1's-the worst to anyone") as your fellow employee who sits around and does nothing, and you're doing your work AND theirs because it would be unethical to let the patient be the one to pay the consequences of your coworker's laziness, then the harder working nurse is the one who is going to get burned out faster. This leads to the hard working nurse getting sick/injured more often and/or deciding to move on.

You misunderstand the rationale behind performance evals. They are not really meant to reward workers, rather they are a cost cutting measure whereby management creates a budget say 2% across the board for everyone so that for someone to get exceptional say a 4% another person has to get 0% to even out the budget. Everyone jumps on the performance eval thinking they are exceptional and are going to make more money, but the reality is unless you are a favorite you will probably just get the average, mediocre 2%.

As to doing others work, that should stop. You should speak to your manager and then it is their job to discipline the problem coworker. Truthfully if a person was doing so poorly that they shouldn't get a raise, then in truth they shouldn't have a job!

[Hoosier_RN, MSN]

21 hours ago, TriciaJ said:

I would burn that bridge and enjoy the blaze.

you must be my sister from a different mister!

[Daisy4RN]

Agree with others that have stated that management/admin knows exactly how to retain nurses but refuses to do what is needed and instead just dumps it on the staff to come up with "ideas". My favorite is the coffee mug, shirt (fill in the blank unwanted item) with the company/hospital name on it. I would rather have the pizza.

[River&MountainRN, ADN, RN]

I once got a corporate-logo stress ball...oh, the irony!

[Katillac, RN]

Attribution: I'm quoting myself from another post. Feel free to copy and paste every time you get asked the same stupid retention question.

"Comedienne Brett Butler says of her devotion to her second husband, "You let one dog get away, you're gonna build a taller fence and put better food out." Translated to nursing, that means employers need to provide attractive opportunities, including some combination of compensation, benefits, scheduling, training, and workplace environment and culture. Then, equally importantly they need to prioritize retaining the staff they hire by actively showing they respect and value the commitment, knowledge, caring and experience of their staff, both seasoned and newer.

It's kind of that simple.

When my daughter was born, I took my maternity leave and then tried to go back to the small company I worked for. I couldn't make myself get out of the car at the sitter's house. I tearfully called my boss, told him what was going on, and attempted to resign. He asked me how long I thought I needed. I said six weeks. He said, "Take it, we'll see you when you're ready." Six weeks later, back at work, I was the most loyal employee you could have imagined. I would have walked through fire to do what needed to be done for them. They showed me what meant everything to me was important to them. I felt VALUED.

When I talk with nursing colleagues, NOT feeling valued is what will break the camel's back, so to speak. And $5 Starbucks cards don't do it. A rote closing at the bottom of every poorly written memo, "And thank you for all you do every day," doesn't do it. For me, having the time, support, policies and equipment to do what I need to do every day would do it. But it doesn't happen because it isn't a leadership priority. And it costs money. "

["nursy", RN]

On ‎2‎/‎17‎/‎2019 at 12:50 PM, morelostthanfound said:

^^^Love it-truth!!!^^^ Or, "um, how can we retain nurses and keep our year-end bonuses as well as all of the perks and bennies for our top heavy senior management team?

Yeah, that's the thing.....the last hospital I worked at had the LOWEST employee satisfaction scores for that organization in the country. And coincidentally it also had the highest profits, and of course the CFO kept making his big bonuses every year. COINCIDENCE????? I think not!!!!!!! I don't see anything improving in the near future, I'm out of bedside nursing and I couldn't be happier.

[Ruby Vee, BSN]

On 2/17/2019 at 9:15 AM, morelostthanfound said:

From now on, whenever I hear this question asked by academia or nursing management, I am going to just walk away. It is painfully obvious what would remedy the situation; manageable N/P ratios, tolerable workloads, less focus on 'customer service', unfreezing stagnant pay....duh!!! They (academia and management) would rather be disingenuous, play their little games and talk around the problems instead of effectively addressing these concerns head on. In the future, I chose to NOT insult my intelligence by indulging in these little charades and exercises in futility.

They don't really want to know how to retain nurses -- what they want to know is how they can retain nurses without it costing them something.

[Ruby Vee, BSN]

I once read an article about retention of older nurses -- which surprised the absolute HECK out of me, because it seems that older (more experienced) nurses really are not valued. Basically, there were three ideas set forth: don't mess with their money, don't mess with their time off, and reward seniority. Those three things don't really cost all that much -- assuming, of course, that you're not systematically driving experienced nurses away to reduce your salary costs.

Don't freeze the pay of experienced nurses until their orientees catch up to them and surpass them. Don't mess around with their differentials. I worked in an ICU that had a really stable night shift of experienced nurses . . . it was a great place to train newbies because they had so many experienced nurses on nights. And then some executive thought to "save money" by cutting the night, weekend and holiday differentials. And within three months, all of those senior nurses had left or gone to days. Suddenly, night shift was all newbies and instead of the excellent care patients had been getting, there were mistakes made, subtle signs missed, poor outcomes. Management absolutely could not figure out how this happened.

Don't mess with time off. If someone has earned six weeks of vacation time, let them take it -- not around the holidays, but let them take it. If someone has a Friday-Saturday-Sunday schedule that works for them, why mess with it by forcing them to work Mondays because "everyone has to."

Seniority ought to have some perks. Maybe you get first choice of which holidays you want to work, or which you'll have off. Maybe you bid on vacation time by seniority. Maybe the bids for day shift are settled by seniority. Maybe all three. Maybe none of them, but seniority gets you out of floating. Or first dibs on attending that seminar.

[Katillac, RN]

20 minutes ago, Ruby Vee said:

I once read an article about retention of older nurses -- which surprised the absolute HECK out of me, because it seems that older (more experienced) nurses really are not valued. Basically, there were three ideas set forth: don't mess with their money, don't mess with their time off, and reward seniority. Those three things don't really cost all that much -- assuming, of course, that you're not systematically driving experienced nurses away to reduce your salary costs.

Don't freeze the pay of experienced nurses until their orientees catch up to them and surpass them. Don't mess around with their differentials. I worked in an ICU that had a really stable night shift of experienced nurses . . . it was a great place to train newbies because they had so many experienced nurses on nights. And then some executive thought to "save money" by cutting the night, weekend and holiday differentials. And within three months, all of those senior nurses had left or gone to days. Suddenly, night shift was all newbies and instead of the excellent care patients had been getting, there were mistakes made, subtle signs missed, poor outcomes. Management absolutely could not figure out how this happened.

Don't mess with time off. If someone has earned six weeks of vacation time, let them take it -- not around the holidays, but let them take it. If someone has a Friday-Saturday-Sunday schedule that works for them, why mess with it by forcing them to work Mondays because "everyone has to."

Seniority ought to have some perks. Maybe you get first choice of which holidays you want to work, or which you'll have off. Maybe you bid on vacation time by seniority. Maybe the bids for day shift are settled by seniority. Maybe all three. Maybe none of them, but seniority gets you out of floating. Or first dibs on attending that seminar.

These are some great ideas, Ruby Vee, and a good example of policies of meaningful retention efforts that don't need to cost a fortune.

[Leader25, ASN, BSN, RN]

On 2/16/2019 at 8:54 PM, old&improved said:

When things go right, when we get complimentary letters and "good" patient satisfaction scores we are told, "good job", "keep up the good work", but when one patient or family member complains, when there is one fall, one problem there is a verbal or written (or God forbid a final written) warning that stays on your record for a year and a required essay as to how you're going to fix the problem.

Here is your answer ,this situation should be tattooed on the butts of the lazy *** administrators that practice this modern day witch hunt inquisition.

No one ever left because they were so HAPPY!!

This press ganey,H caps system has got to go,hospitals are not Hotels with free perks,plenty of nurses to abuse at a whim ,the fearful "what is your name" phrase by abusive patients,families even directors ,managers who are pt/temps.

Enough already.

[MedicRU, RN]

No need to re-state the above said but, because healthcare has morphed into corporate money making machine, is it any wonder? Hospitals are run like publicly traded corporations and their main focus is revenue and profit, not lives.

In this grand scheme of profiteering, nurses are viewed as miserable grunts that are entirely expendable. And as long as there is a steady supply from nursing schools, which continue to feed nonsense and fantasy to naive and unadulterated students, this cycle of downward spiral will continue.