Nurse Retention ideas

melsman1904 · Sep 17, 2015

Most others have mentioned it already... The #1 reason we all work: MONEY. I challenge anyone who disagrees with that to do any of our jobs for free while maintaining the (sometimes) unreasonably high standards required of us for 12 hours.

Don't hold us to "Professional" standards and then treat us like blue collar workers. And before anyone gets offended, let me make it clear that there is nothing wrong with being a blue collar worker. My state BON recognizes me as a professional and holds me to higher standards than those expected of blue collar workers. So, pick one and stick with it.

Don't expect us to martyr ourselves just because a patient has needs. News flash- every patient has needs. Allow proper staffing so that those needs can be met and we can take adequate breaks. And proper staffing should not be limited to just nursing. Other members of the team (Aides, Lab, Xray, etc) should be staffed adequately as well.

Quit telling us that YOU can't fill these open positions, give raises, replace equipment because money is tight and then break ground on some new building project. If you can't staff what you already have, why the hell would you build additional space?

mmc51264, BSN, MSN, RN · Sep 17, 2015

I just went to a retention retreat to discuss this very thing. We were grouped in to 15 years and had to answer key questions from out work culture survey that had not-so-good answers.

Many of the things we came up with have been mentioned here. Our biggest issue was losing new nurses after that first year (years 1-3 had highest turnover rate). Also, we desperately need a new acuity/productivity algorithm. I am on an intermediate unit, but we get some very high acuity pts. Out ratio is 4-5:1, but when it's 5, sometime it is 5 total care pts.

We are being asked to do more and more.

I will be interested to see what becomes of our suggestions.

ANnot4me · Sep 17, 2015

A job is like any relationship: we stay because it meets our needs. A job is a choice and we are not victims unless we choose to be...

imintrouble, BSN, RN · Sep 17, 2015

Most others have mentioned it already... The #1 reason we all work: MONEY. I challenge anyone who disagrees with that to do any of our jobs for free while maintaining the (sometimes) unreasonably high standards required of us for 12 hours.
Don't hold us to "Professional" standards and then treat us like blue collar workers. And before anyone gets offended, let me make it clear that there is nothing wrong with being a blue collar worker. My state BON recognizes me as a professional and holds me to higher standards than those expected of blue collar workers. So, pick one and stick with it.
Don't expect us to martyr ourselves just because a patient has needs. News flash- every patient has needs. Allow proper staffing so that those needs can be met and we can take adequate breaks. And proper staffing should not be limited to just nursing. Other members of the team (Aides, Lab, Xray, etc) should be staffed adequately as well.
Quit telling us that YOU can't fill these open positions, give raises, replace equipment because money is tight and then break ground on some new building project. If you can't staff what you already have, why the hell would you build additional space?

All the above.

We haven't had a raise in more years than I can remember. If a raise isn't possible give us equipment that works. Our COWs are worthless. Our computers are slow. We don't have adequate VS equipment.

Shared Governance is a joke. Management hand picked the newest, or the most docile nurses in the building. Then proceeded to spoon feed the group the responses they wanted.

Let me have a share in the decisions that impact my work day. Don't tell me what to do like a two year old when a two year would know what you're asking is impossible.

Don't tell me I'm insubordinate when I don't roll over and play dead. Don't threaten my job when I ask a question. Don't threaten my job when I refuse to do what you would never do, or just can't do.

LISTEN TO ME. Even if extra help is impossible, acknowledge that what you expect me to do is barely within my experience. A simple "I know" instead of a "You can do it". It's insulting.

Morale is at an all time low, and management without much finesse, comes to the unit and announces how many applications are sitting on their desk. That's a new low.

I could go on and on and on. Bad night. Rant done.

I can't imagine being a new nurse and walking into the work environment that exists today. I can at least remember what it was, and hope that it'll get better.

Gamecock73 · Sep 17, 2015

The best answer I can give you, OP, is in the first nursing job I worked. I worked at a for-profit hospital that was considered second-rate to the non-profit, larger hospital across town. I will never forget the CNO showing up to our senior day in nursing school. Some poor child had the balls to ask if that hospital offered a hiring bonus. This immaculately-dressed, perfectly coiffed lady chuckled to herself and stated that she liked to shop, but why buy a suit at full price when she could get it for sale? (Cue nurses hissing everywhere.)

I did start nursing at that facility, at the bare minimum wage for a nurse. (Weirdly enough, I had a fellow nurse tell me she started lower than I did.) We had a lot of new nurses on our floor.

As time went on, the older nurses (the ones from ICU who could start an IV in the dark) dried up. "So-and-so left, he's at the hospital across town." Wages were stagnant, and we were all compelled to accept turns at being charge nurse, at the princely sum of an extra $.50 an hour.

They've had a talent bleed for some years so it was with a devilish glee I recently noted that they held a job fair with a hiring bonus. I guess somebody figured out you can't always get an expensive suit for half-price?

theradiantforce · Sep 17, 2015

Of course upper management says money isn't everything! Meanwhile, take a risk and ask how much THEIR salary is....ugh.

At the end of the day, money helps. Hospitals have to stay competitive. Aside from that, the work environment is really important. The hospital reputation matters. Some hospitals are viewed as "stepping stones" for some nurses so, they may have a high turn over simply because of this reason. It might help to offer a new grad program. A lot of new grads cant find employment and your hospital can require that new grads give so many years in return for training.

nurseactivist · Sep 17, 2015

When you are in a union, worksite issues are taken to the bargaining table and agreed upon (wages and working conditions).

NurseFifty · Sep 18, 2015

My entire work life has been with a nursing union. In my opinion , nursing unions are not as aggressive in securing the best contract deals compared to other unions, especially considering nursing is a hard-to-find skill compared to the other non-healthcare skills. What we get as nurses should be influenced by the law-of-supply and demand of nurses. A BA liberal arts is a diem a dozen for example. The very idea of requiring a license to practice, in itself introdcues scaricity of supply. The recent move to hire BSNs insteads of ADNs further restricts the nmumber of qualified applicants. Dont ever believe that there is an oversupply I told her. My nursing manager for one is so out-of-date she just believes everything the hospital feeds her. I pointed it out to her - in my state, they are offering sign on bonuses. When that hiring practice occurs, it means there are not enough applicants! I really don't know why my unions (2 odf them) seem not as effective at contract negiotiations. When I contract my nursing rep for some questions or issues, she takes forever to respond. She almost always does not want to respond in print(email), she wants to talk over the phone. She has no clue about legal stuff. And so my hospital always wronly and malicioulsy points to my union as the party who wants certain restrictions in the employment. After a while I gave up on talkinmg to her.

mmc51264, BSN, MSN, RN · Sep 18, 2015

NC is a non union state so that is not an option here.

I think we have fair wages in this area because there are lots of options for jobs. We deal mostly with staffing as it relates to pt load and having to close beds because of lack of staff.

We just got an email offering a 1.0 FT position where we would work 3 days one week and 4 days the second, so we get 8 hours of overtime each pay period. Will not affect on-call or being sent home early for low census positions. I would LOVE to do it because I am already a weekend option person. Childcare is an issue (need someone for 1 hour to get my 11 year old on the bus).

NurseFifty · Sep 18, 2015

We don't have fair wages in my state even if there is lots of jobs in my area - in all fields - not just Nursing. So makes me wonder why. Many union workers (not just nursing) complain about unions being in bed with the employer. Could it be?????

kbrn2002, ADN, RN · Sep 18, 2015

Not just in hospital nursing but all areas of nursing...money! Our local school district doesn't differentiate between LPN and RN, all school nurses are paid the same pathetic wage. Add to that the benefits are not nearly as good as they were a few years ago. A couple of friends are school nurses and I never complain about my pathetic wage because I know theirs is even worse.

I also second decent, reasonably up to date equipment and supplies.

It would also be nice to know that I am appreciated every now and then. We only hear about when we screw something up, never a word when we do something right!

LadysSolo · Sep 19, 2015

1) Decent pay

2) Adequate staffing

3) Treat staff WITH RESPECT

4) Do NOT encourage back-stabbing among the staff (petty and very grade-school)