I can't keep staff. Why do I try?

Janet Barclay · Jul 20, 2001

Don't let it get you down, Clarice!

I just get to thinking that our positions are filled and that everyone is happy, then I get three more wanting to travel, or go casual, because full time regular work interferes too much with life!

We are employing a well educated,skilled and MOBILE group of people. The same characteristics that make them great nurses make them rotten employees (only becuase they don't stay around).

All you can do is have fun while you have a team, and enjoy the next mix that comes around.

You can also take heart in the fact that they probably all love you ass because you sound like a great person to work for. Tuck those thank you/goodbye cards away and re read them when you'r having a bad day.

((clarice))

Janet

ClariceS · Jul 20, 2001

Thanks for the words of support. This is just really "ouching" right now and I just got another one this morning. If only I could figure out how to clone.....

ACNORN · Aug 4, 2001

ClariceS, I know how you feel. I spend all my time coaching crabby nursing staff to try to get along and implement an endless number of incentive programs to try to reward staff for positive performance. This week one of my staff nurses actually complained that we were allowing PRN nurses (our employees - not agency staff) to work before we allowed full-time nurses who were in overtime to work. What are they thinking?

Just wanted you to know your not alone. Keep you chin up. I'd be interested to know what recruiting & retention strategies you've tried that have worked.

PhantomRN · Aug 4, 2001

I feel nurses in general are a disgruntled group. I see some of the same things where I work. Ircrum---your comments blow me away and just comfirm my position.

I have Rns who one day will say "Dont cancel me ever. I am not willing to use up my earned time. " and then the NEXT DAY complain because someone else was given the day off for low census. There is no rhyme or reason.

I would not want to be a manager in this climate of sign bonuses that encourage nurse hopping for .50 or a buck more an hour.

wornoutnurse · Aug 11, 2001

I understand how difficult it is to keep nurses. I'm an interim DON at a Nursing Home and recently hired a LPN who practically begged for the job. She worked one day and then didn't come back. When I called her to find out what happened she simply stated she didn't like the way things were done and proceeded to give me a list of minor problems that she "simply couldn't stand for" and said she was sorry. I've had multiple interviews and with each have been asked what type of bonus did we have to bring them in and before I could even answer that question, how long they would have to stay before they received it. I've had a couple quit to take jobs at a local hospital who promised them a couple of dollars more an hour but won't guarantee how many hours they'll work. For some reason they don't understand $2 more an hour isn't going to pay the bills if they've went from 40 hours to 20. If anyone has any ideas on how to retain staff please let me in on the secret!

mikemw · Aug 16, 2001

Clarice you sound like a manger I'd like to work for You appear to care. That is a trait that manager often loose becuase of what you are talking about.

I have not been a manager as a nurse, but I was in the military for 20 years and have experience both as a first line supervisor and dept manager. As anyone with a military background can tell you, your "employees" are constantly being transfered.

What I found to cope with this was to establish the mindset that this was going to happen. My best people were going to be leaving usually after a significant investment of my time and effort in helping them mature in their professionalism and skills.

Take pride in the fact that you are helping that person develop as nurse while they are working for you and that the next employer will gain a better prepared nurse because of you.

I understand your frustration, but dont get caaught in the trap of hardening yourself against your current employees for something that past employees have done.

One thing that might give you a heads up is to ask what their goals are (both short term and long term). People who move voluntarily usually do it because it is helping them meet the goals they have set for themselves. For exmple my last manager knew I would be there for 1 year because I needed the expeirence from that floor to work in the emergency dept. She helped me develope the skills I needed but did not expect me to be there after I recieved the year's experience. I still keep in touch with her and have actually refrerred nurses to her because she was a good manger/mentor but I also know she put department funds and more of her time in to develping those who told her they would be there longer. I would have done the same and don't fault her for that.

Hope this helps. Keep up the good work. Those of us at the bottom of the totum pole appreciate efforts of good mangers unfortunately we just dont take the time to let them know.

Mike M

ClariceS · Aug 21, 2001

Thank you for your replies. I am a little less despairing than I was a couple days ago although things haven't gotten any better. I was just told by one of my main charge nurses that she was going to another unit for further development. I appreciate her honesty. She even told me that she struggled with the decision because she likes my management style. It's an everyday struggle.

ACNORN · Aug 24, 2001

Clarice,

Sorry to hear about your charge nurse's decision. My situation has gotten somewhat better - I've been able to recruit 5 additional FT RNs. It took some convincing, but I have decided to handle recruiting myself. I wrote my own newspaper ads and specifically bullet pointed about 7-8 reasons nurses should work at our facility versus somewhere else. I also made sure that any newspaper responses would come directly to me so I could promptly set up interviews and get things going. It took several weeks, but it has worked. I've even had some PRN RNs switch from PRN to FT. Is there any way that you can get the authority to fix your own recruiting and retention problems? You seem like a smart, caring manager and I'm sure you have ideas about what could be changed to make your unit the favored unit for nurses. I' ve also focused on some supply issues. My nurses were getting frustrated because they didn't always have ready access to some supplies and was a source of frustration to them during their shifts. I've been paying attention to what kind of things happen during their shifts that frustrate my nurses - things like misplaced supplies or equipment, co-worker conflicts, inappropriate physician behavior, etc. Of course, fixing staffing is always an important challenge too. A few facilities in our area have had to limit the census on some units until nurses could be recruited. In our area, it costs on average 18-20K every time we have a RN turnover. A well thought-out action plan and some cost data about how much it costs your facility every time one of your nurses leaves should encourage your superiors to give you more control over your situation. I feel for you. If you can take charge of the situation, I'm sure you'll start to see progress

bbnurse · Aug 25, 2001

As a manager, I feel the same panic and dispair when nurses talk of the sign on bonuses or the new gizmo another place has or when they resign. One thing which helps to get past the fear that we can't manage without them, is knowing that it isn't personal, it's one professional person taking care of herself. I tell them, I understand. If you don't take care of yourself, no one will.

I have listened to the frustrations and needs voiced by the staff who are my hands and eyes. I can not do both their jobs and mine every day. So I depend on their expertise to tell me the issues with the care I ask of them. I truly believe no one goes to work every day to do a bad job or to make my day awful. I can help them and in return they help me.

One success to make us the "favorite unit" was setting up some committees or groups to work on HOT topics. We avoided the use of empowerment or self governance since the CNO is not able to let that go. Groups set up our Closed Unit Staffing, Pt. education, QI, Improving "report", rearranging supplies and par levels, re-writing performance checklists, set a unit vision, and are currently working on our computerized charting development.

No one leader has all the answers to all the issues in the unit. The one who does the job, knows the solution.

When education was cut (again) the staffs' idea was to have each person chose a topic they could teach or demonstrate. We have had some GREAT posters and education which is effective.

Each person is responsible to provide the education to every person on the unit in 4 weeks timeframe. Works great. Cheap.

Present plans in the unit include making the "party" usually given with the departure of a nurse, a "WELCOME" party when new nurses arrive. We are planning a "Tea Party" for each of the rotations of the newest students to recruit for next year. We ask for people who wish to work with the students to arrange to work consistently on "student" days. Everyone is expected to recruit the students by their example and friendliness. We will eat cookies but Never our Young.

I need to learn to follow my gut during interviews more. My hiring people who just don't interview well should stop. They rarely work out and leave quickly OR I have a poor performer that is dead wood for much too long. I think we need to not accept a warm body in desperate times, but look for good fits and abilities.

Staff tell me, they would rather work short or do OT than to have someone who performs poorly or who hates their job.

I have rambled way too much. My synopsis is this: Listen to staff. Give them feedback. Over communicate. The person at the bedside knows the best way to do the job and if I provide their needs, IT WILL BE DONE.

And---I just like and respect them. I expect them to do well and they usually do. If they don't, it's probably the system that failed them. Correct it. If they still perform poorly, another story.

For what it's worth, I love to manage but mostly I set the vision, provide the tools and then just get out of the way.

DebiD · Aug 26, 2001

Hi ,I am a DON in a LTC Center in Kansas. I have been in this position since April 2001. When I took over it was under an hostile enviroment. The previous DON and Adm. could not work out a working relationship so the DON left . When she left, over 50% of the staff went too. That month of April I cannot ever remember feeling as paniced as I did then. Two things got me though it,#1 I repeated to myself, I just needed to get thru the moment,that this was just one moment in a whole space of time. Then the other was to give it up to the Lord. I figured if he put me in this perdicament then he would and BETTER get me out of it.

As it turned out the month of April was building my character for the Month July, when I lost 6 nurses in the first two weeks. Four of them were on the second shift.But now I know I can make it and have faith that I will get the staff back up to par. I am not saying its easily but you can though it.

I believe eventually I will have a stable staff. I have found that being positive and giving them the support not to panic and telling them we will get though the moment,has been successful in building that team and laying the ground work for a stable enviroment. Similar to the Field of Dreams .

I also have tried the sign on bonus. I have found that I get more response in promting good benefits like ins and 401K and a desire for a strong professional team. Just hang in there, you'll get though the moment! DebiD :)

Bjo · Aug 29, 2001

The same thing has happened to me. I hate to sound like a parrot but it's true. What I'm seeing at our facility is that nurses are in general looking for more money with less responsibility and we all know the opposite is the norm. I believe a lot of nurses went in to the profession because of the hype of the nursing shortage and being guaranteed a job when they graduate. If you don't have the compassion in your heart to be a nurse and willing to sacrifice for others, you aren't going to be happy in any nursing job. Of course this is my opinion, but as a nurse manager, I've seen this demonstrated through my nurses who have quit. If they don't quit they complain continually and the patients suffer because of it.

Bobbi Jo