Need Advice with Encouraging Staff to Precept New Hires!

[That Nurse86]

I am hoping some of you have insight/experience with difficult employees not being friendly with new staff and refusing to train as well.

I am an education coordinator at a large SNF/Rehab facility. For our new nurses and CNA's I do general orientation and basic training with them for a week then they get assigned to a floor staff member to precept them on their assigned hall. We are having trouble specifically with our night shift staff refusing to train new staff for nurses and CNAs. I think a main reason for this is the senior staff are set in their ways and get upset when they get "bumped" off their assigned unit to precept a new person. It's in their union contract that new staff stay on the same unit for so many days which is why the person precepting has to train the new hire on the floor the new hire will be assigned to. Then we have staff train that are not very friendly or welcoming to our new hires and those that do not get scared away don't receive a very thorough training. On top of all this many of the current staff do not get along, are constantly fighting with each other, and I fear teamwork/communion is just not what it should be. Like most LTC facilities we struggle to retain nursing staff and have many open positions. Since this is a facility that mandates nursing staff you would think they would welcome new hires with open arms but sadly this is not the case.

So the point to my long saga here is I am wondering if anyone has had similar experiences to this and did any interventions work? I want to improve the work environment and the way we train our new nursing staff. Also to help engage floor staff to wanting to train.

[JKL33]

I'm very curious when anyone looks at a situation like this and draws some of the conclusions you are drawing.

Here is what you have said:

1 hour ago, That Nurse86 said:

the person precepting has to train the new hire on the floor the new hire will be assigned to

1 hour ago, That Nurse86 said:

On top of all this many of the current staff do not get along, are constantly fighting with each other

1 hour ago, That Nurse86 said:

teamwork/communion is just not what it should be

1 hour ago, That Nurse86 said:

we struggle to retain nursing staff

1 hour ago, That Nurse86 said:

and have many open positions

1 hour ago, That Nurse86 said:

this is a facility that mandates nursing staff

1 hour ago, That Nurse86 said:

I think a main reason for this [behavior] is the senior staff are set in their ways

No that is not the main reason for the difficulty you are having. The main reason is that your facility treats people like crap and then tries to blame the fall-out on those same people.

Resorting to ever-more desperate means of staffing in lieu of treating employees well enough to have employees who want to work there is making this problem worse. It is not nurses' fault that when faced with difficulty over their own choices, employers choose to double-down.

Why doesn't the employer have any staff on the shift and on the same floor who can orient the new people they hire? That is not a problem with the nurses, it is a problem with the employer.

[LibraNurse27, BSN, RN]

I think when nurses are overwhelmed and feel taken advantage of morale goes down. I think better nurse to patient ratios and no more mandating would help hire and retain staff and increase the morale/teamwork of current staff. Being forced to work overtime when you are frustrated and exhausted from a difficult shift makes people feel angry, abused and taken advantage of. Bad for patient care, new staff, and current staff.

When I worked in a hospital with horrible ratios asking a coworker for help was not easy because no one really had time to help each other, so of course people were annoyed with each other and even more annoyed with management. Everyone felt like management scrimped on staff to put more money into their own pockets, although hospitals/nursing homes would likely attract more patients if they had enough staff to treat patients well.

[Guest219794]

First, develop excellent nurses.

• Pay enough to attract qualified applicants, then pay more than the competition- that is how any business finds and keeps good staff.
• Provide good safe working conditions and ratios.
• Invest in additional training, then pay more for qualifications earned.
• Give them an actual voice in decision making- not the typical approach with meetings and surveys that are ultimately ignored.
• Make sure lunch breaks as well as other periodic breaks are taken, and be sure to provide adequate vacation time.

Once you have a core staff of excellent, committed nurses, develop them into preceptors:

• Provide actual evidence based training in how to precept. As professional educator, you know that education is as much a science as nursing.
• Pay a significant differential for precepting.
• Ensure that the preceptor is adequately prepared to work in the unit in which they are precepting.
• Don't forget that when precepting, the preceptor needs a reduced load, as it takes much longer to provide the same level of care while teaching.

I guarantee that if you do all of the above, you will develop good staff. How much of this are you currently doing?

[hppygr8ful, ASN, RN, EMT-I]

Make being a preceptor more attractive. Like others have said give them a lighter case load and more money to do that. I am what my facility calls a "Master Preceptor" and I get a differential plus a lighter case load while I am training someone.

Hppy