Nursing Retention help.....

Some suggestions:

• provide adequate orientation!!!
  
• assign a mentor to each new grad
  
• have individual weekly progress meetings (focus on strengths, areas to focus on)
  
• have meetings with all 6 new grad nurses (round-table discussion; allow the new grads to identify with one another)
  
• have a consistent preceptor who wants to precept (have it be someone other than the mentor)
  
• compensate staff who agree to precept; it takes extra energy and effort to provide patient care & precept at the same time.

Patients come to hospitals for nursing care, and hospitals therefore should invest time, energy, and money into new hires. New grad nurses need support and their orientation should be individualized. Just my $0.02.

The place where I worked had a policy that a preceptor should not have their own assignment when they were precepting. It was not always adhered to. The turn over rate amoung newbies that had a preceptor that concentrated on them alone for first few weeks was much lower than those who had a preceptor that was carrying their own assignment.

I agree with having a great preceptor program for new nurses. Also, employing a clinical ladder for nurses to move up through to get raises, take on more responsibility, and have short/long term goals to work towards.

Some suggestions:

• provide adequate orientation!!!
  
• assign a mentor to each new grad
  
• have individual weekly progress meetings (focus on strengths, areas to focus on)
  
• have meetings with all 6 new grad nurses (round-table discussion; allow the new grads to identify with one another)
  
• have a consistent preceptor who wants to precept (have it be someone other than the mentor)
  
• compensate staff who agree to precept; it takes extra energy and effort to provide patient care & precept at the same time.

Patients come to hospitals for nursing care, and hospitals therefore should invest time, energy, and money into new hires. New grad nurses need support and their orientation should be individualized. Just my $0.02.

You said everything I wanted to say! Once you get new staff, you must orient them properly. I am on orientee number three (just started with her last night) and I fight, each time, to make sure they get the time they need to do well. Also fight with the folks that think "oh you have an orientee" as the rationale for short-staffing the floor. The short-term outlay in money will be offset by not having to replace people every few months. The initial orientation is the most expensive part of a new hire - if we KEEP them and have to do it less, we end up saving money AND keeping up morale!

We just started "friend at work" campaign. Sounds a little cheesy, but it sounds like it might help. It involves a nurse and a new grad becoming "friends". The new grad will/can have lunch with this nurse. The nurse will check up on the new grad. Usually its someone else besides the preceptor. If u want more info. I will grab a flyer from work tomorrow night. Just PM.

If possible, give staff some control over scheduling and assignments where possible/practical.

The ICU manager would post a blank schedule and everyone would fill it in. We were responsible for filling in holes, but people who wanted their days all together got it, and the people who liked to space the days they worked could do that too. Having a little control over when you worked helped.

I totally agree with everything said on a good orientation program. You should contact one of the university hospitals - many (almost most) institute a nation-wide "Nurse Resident" program.

It lasts a year, and each month all the new grads in the hospital have classes together - each class covers a topic (pain control, emergency situations, etc.), and there is time for the new grads to bond with each other. This was very helpful for me, because I was the only new grad on my unit and I felt very isolated.

On each unit, the new grad is on orientation for 3 months in med/surg and 6 months for ICU. They are assigned a preceptor, and that preceptor NEVER has their own patient load on top of precepting - for the entire orientation period. The preceptor also is compensated $2 extra an hour.

And - this is very important - preceptors are required to take a precepting class, in which they learn about different learning styles, what new grads need (encouragement, etc.), how to deal with certain situations that might come up, etc.

It's very important to pick preceptors who want to do it, and not necessarily people who have the most experience on the floor. Just because they have an expansive skill set does not mean they're good teachers. I'd rather have someone with less experience but is a natural teacher. My first preceptor was such a nightmare, I almost quit nursing. She had been a nurse for 30 years and was totally out of touch with the mind of a new grad. She couldn't understand why it took me "so long" to accomplish certain tasks (maybe because new grads are not as efficient as those with 30 years experience?) Many other new grads were frightened and intimidated by her, but our educator kept putting her with new grads because she had the most experience on the floor.

Another suggestion: keep your unhappy, bitter, and just plain mean nurses from torturing the new grads. If this means that the nasty nurse has an assignment other than Charge Nurse, so be it.

We have lost at least 6 new grads because of one vitrolic charge nurse: all her unhappiness is unleased on the new nurses. And, management is more than aware of the problem.

The retention expert they hired quit!:kiss

If you want to retain staff, (old or new)...

1) Control over the schedule. Self scheduling is an excellent suggestion.

2) A reasonable, appropriate workload.

3) Management that ensures that the workload does not become overwhelming on a regular basis.

4) Management that supports staff against unreasonalby demanding visitors, families and physicians.

5) Zero tolerance for bullying, harassment, or any otherwise inappropriate behavior from visitors, families, staff and physicians.

That is my dream. If anyone finds it, let me know!!

Vac!

Perfect Perfect Perfect

I Copied Your Suggestions And Will Post It On Our Bulletin Board!!!

Some suggestions:

• provide adequate orientation!!!
  
• assign a mentor to each new grad
  
• have individual weekly progress meetings (focus on strengths, areas to focus on)
  
• have meetings with all 6 new grad nurses (round-table discussion; allow the new grads to identify with one another)
  
• have a consistent preceptor who wants to precept (have it be someone other than the mentor)
  
• compensate staff who agree to precept; it takes extra energy and effort to provide patient care & precept at the same time.

Patients come to hospitals for nursing care, and hospitals therefore should invest time, energy, and money into new hires. New grad nurses need support and their orientation should be individualized. Just my $0.02.

:yeahthat:

I just started back in ICU after 9 months away from it and a brief time and L & D. One of the many reasons I left L & D? A preceptor that systematically broke down my confidence in myself. She was bossy and a bully. I was told "that's just how she is." Not everyone is a natural born teacher. Being good at your job does not qualify you to teach it to someone else. Would they have retained me longer than 3 months if I had had an adequate orientation with an excellent preceptor? Possibly.

At this new unit I had 5 different preceptors in my first 6 shifts. My "preceptors" were generally surprised to be "stuck with" an orientee at the beginning of the shift and complained vocally about it. I was offered another job at the time and seriously considered taking it. I didn't feel welcomed on my unit and never met my primary preceptor until the 5th shift. I have since been changed to yet another one who, thank goodness, has 30 years experience and is fantastic. At one point, I was put with a new grad nurse who graduated 7 months ago who is proud his 20 week orientation was shortened to 9. Are you kidding me? I work in an ICU at a Level I Trauma Center. That's just scary.

I started at the same time as two other experienced nurses. One has already left due to these same issues. Yet everyone complains about staffing and retention.

If you want to retain staff, (old or new)...

1) Control over the schedule. Self scheduling is an excellent suggestion.

2) A reasonable, appropriate workload.

3) Management that ensures that the workload does not become overwhelming on a regular basis.

4) Management that supports staff against unreasonalby demanding visitors, families and physicians.

5) Zero tolerance for bullying, harassment, or any otherwise inappropriate behavior from visitors, families, staff and physicians.

That is my dream. If anyone finds it, let me know!!

What an excellent suggestions you made!