Has anyone noticed that the "onboarding" process today has changed drastically from yester-year? I seem to remember the big "welcome aboard" parade of papers, events, appointments , all with a cheer, a smile, and sometimes even a mug full of lifesavers. Because that is what we are. A process by which a new nurse is welcomed to the employ of the hospital, in a "we're happy to have you" schedule of events, days of classroom orientation, videos, catered lunch, and then off to our units to be what we are, spectacular nurses.
Fast forward to 2018, when I accepted the job from (you know where) . The hurdles I had to jump through for this job were higher and larger in number than any other place I had ever worked. It was a Behavioral Health facility. One thing I learned (I should have read the employee reviews PRIOR to taking the job) is that when the Onboarding process is toxic, so is the job. The job lasted a week, and here's why:
The big warm "welcome" from this facility was done by an "Onboarding" department, separate and distinct from Human Resources. I later realized that the "onboarders" who worked in the "Onboarding" department have a vested interest in constant employee turnover, to cement their cushy M-F office jobs. So it is not hard to see why continual employee turnover was in fact, caused by the "onboarders."
After a week of having it drilled through my head of 20 ways to Sunday employees will get fired here, and just dying to hear 6 ways to Monday , how we will be successful, me and four other colleagues decided to dump the job, mid-show. There were 25 of us this month. Last month there was 28. All in, they were the most negative bunch of sour puss employees I have ever seen on a "welcome wagon". One was repeatedly cursing as she gave her segment on day 1 and day 3. Another was dressed in a tie-die T-shirt, and a nose ring. A couple of others could not be bothered troubleshooting the computers we had to use for 3 days to complete the online drills. Oh, yours doesn't work? That's not my job.
So my point in all of this is, when we see Negative Nellies at the front door, sometimes we become them. They tend to have a trickle down effect. I have no regrets that I left before I actually started. I don't think the other 3 did either.
Specializes in Nurse Leader specializing in Labor & Delivery.
8 minutes ago, nate411 said:
They don't have to "train" anyone. In fact, training is rare.
“Orient,” then. And orientation can be anywhere from 4 weeks (experiences nurse) to 4 months (new grad) everywhere I’ve worked. And yes, it is a drain on resources, and leadership certainly doesn’t like the idea of continuing to hire and fire people constantly, as implied by the OP.
They don't have to "train" anyone. In fact, training is rare.
Yes true. They "audition" new people. Training is something different. If training actually took place, nurses would not be leaving the bedside in droves. It costs nothing to "audition" new hires. Training is where the $$ is. And training is rare. Onboarding deaprtments, on the other hand, have a vested interest in seeing people fail . That was the point of the article , that Klone missed.
“Orient,” then. And orientation can be anywhere from 4 weeks (experiences nurse) to 4 months (new grad) everywhere I’ve worked. And yes, it is a drain on resources, and leadership certainly doesn’t like the idea of continuing to hire and fire people constantly, as implied by the OP.
Definitely. At the very least, those first couple of days getting paid to go through general corporate information and orientation costs the company money. I'm not a big fan of a lot of companies, but I think it's a big stretch to say that they have a vested interest in getting rid of staff as quickly as possible. Wouldn't you think retention is used as a performance metric to evaluate "onboarding" staff?
Definitely. At the very least, those first couple of days getting paid to go through general corporate information and orientation costs the company money. I'm not a big fan of a lot of companies, but I think it's a big stretch to say that they have a vested interest in getting rid of staff as quickly as possible. Wouldn't you think retention is used as a performance metric to evaluate "onboarding" staff?
Normally, I would agree, but because corporations are neither bears or bulls, but rather big pigs, it has become one fast race to the bottom. The saturation of the job market in healthcare allows them to keep offloading their staff to hire cheaper workers. The process of onboarding and offloading in a non stop cycle actual keeps their costs down, because they are constantly in a state of no benefits for all. At less money per hour. Each time they offload. Think of it like burger king and mcDonalds. Coming and going at minimum wage and no benes for anyone , because everyone leaves. No raises, no medical, no PTO, no FMLA. No workers comp.
Specializes in Nurse Leader specializing in Labor & Delivery.
2 hours ago, panurse9999 said:
Onboarding deaprtments, on the other hand, have a vested interest in seeing people fail . That was the point of the article , that Klone missed.
I didn’t miss your point, just don’t agree with it. It’s not a financially viable business model to not retain staff. Businesses, even hospital businesses, do not want to constantly hire and fire staff, because it’s a huge drain on resources and it kills productivity.
I didn’t miss your point, just don’t agree with it. It’s not a financially viable business model to not retain staff. Businesses, even hospital businesses, do not want to constantly hire and fire staff, because it’s a huge drain on resources and it kills productivity.
You mean businesses don't love to waste money on background checks, physicals and training just so they can arbitrarily and capriciously fire unsuspecting nurses as management maniacally laughs while they schedule yet another job fair to lure in fresh victims?
I didn’t miss your point, just don’t agree with it. It’s not a financially viable business model to not retain staff. Businesses, even hospital businesses, do not want to constantly hire and fire staff, because it’s a huge drain on resources and it kills productivity.
It has been my experience in numerous hospital systems, that although this practice is counterintuitive, and may not be a viable business model, it is still commonplace in many areas. Judging by administrations' inaction in not actively addressing some of the core issues relating to nurse dissatisfaction; N/P ratios, stagnant salaries, reduced benefits, increasing demands... I'm led to believe they (administrators), just really don't care. When there is a ready supply of replacements (often cheaper) for those leaving, the impetus for change dries up and the status quo of the 'revolving door' staffing continues.
You mean businesses don't love to waste money on background checks, physicals and training just so they can arbitrarily and capriciously fire unsuspecting nurses as management maniacally laughs while they schedule yet another job fair to lure in fresh victims?
/sarcasm
yes. At the $25,000 conference room table. Don't forget, the deck is stacked against the nurse. The new nurse will be $2.00 less per hour. At 2,080 annual hours, they made back the $25.00 background check fee, and the $100 physical. With $$$ in the bank. I mean their pockets. SO yes...do the math, and see for yourself how much they love it. Trust me on this. It is happening, especially here in PA.
I think (suspect) that if you can get to a point where enough of the job is protocolized and rule-bound and things like knowledge, wisdom and experience are less important, it seems plausible that you can probably indeed get to a point where it is more financially savvy to churn workers, for a variety of (hard and soft) reasons [Namely: Maintaining control over a group that can be considered an authority with regard to the ethics of caring for patients - which is at odds with the business of caring for patients].
I don't think either argument here is rock-solid/black and white.
I do think that direct managers and supervisors hate to have to replace employees (and I think it is genuinely hard on them), because theyare more involved in the relationships and also are tasked with the nuts and bolts of making it happen. I'm just not sure that the C's see things the same way, even if they might occasionally say they do.
- If you (corporate-level "you") want a "dynamic" workplace where everyone is supposed to enthusiastically acclimate to being constantly off-kilter in order to meet business objectives while serving in high-risk/high-responsibility/low-autonomy roles that demand ethics, while also being constantly subject to the kind of critique technology has enabled - - then it can't be said that you hate nurse turnover, because this type of milieu is a major dissatisfier in this profession. We are now seeing that it is a dissatisfier of younger generations of nurses, too - not just (maligned) old-fogies who (supposedly) "can't do change/can't adapt."
People are fed up with it. And yet it continues full speed ahead. To keep up with the turnover, no problem - - just keep shouting 'nursing shortage' and work harder at streamlining the on-boarding process. At some point that isn't trying to keep up - - rather, it is called doubling down.
- If a hospital corporation is able to post nursing positions as "rotating locations/facilities, days, hours, shifts, weekends, holidays," etc....and post nursing positions that are no longer unit specific but are 'float here and there and everywhere' or 'X Cluster' float....and post positions where the job description has been copied and pasted from some all-encompassing master list of RN functions (plus the employer's own fantasies) such that a job seeker isn't even exactly sure what the role is.....well, you (corporate "you") simply can't say with a straight face that turnover is bad for business. Even the job postings themselves are the perfect picture of disregard.
The hand-wringing about nurse turnover continues to be mind-boggling, because this much is black and white: When you are in control of others' livelihoods, you get what you ask for. What you incentivize. What you say you want. If nurses are leaving to the point that retaining nurses is a constant struggle proportionally out of line with a company's size, it is because the company said they wanted that. Per.i.od. That's really all there is to this. ??♀️
I didn’t miss your point, just don’t agree with it. It’s not a financially viable business model to not retain staff. Businesses, even hospital businesses, do not want to constantly hire and fire staff, because it’s a huge drain on resources and it kills productivity.
Well why don't they do things right and prevent it?, it makes me wonder. I don't think staff want to quit due to the bad conditions of the place, improper training etc.
I think (suspect) that if you can get to a point where enough of the job is protocolized and rule-bound and things like knowledge, wisdom and experience are less important, it seems plausible that you can probably indeed get to a point where it is more financially savvy to churn workers, for a variety of (hard and soft) reasons [Namely: Maintaining control over a group that can be considered an authority with regard to the ethics of caring for patients - which is at odds with the business of caring for patients].
I don't think either argument here is rock-solid/black and white.
I do think that direct managers and supervisors hate to have to replace employees (and I think it is genuinely hard on them), because theyare more involved in the relationships and also are tasked with the nuts and bolts of making it happen. I'm just not sure that the C's see things the same way, even if they might occasionally say they do.
- If you (corporate-level "you") want a "dynamic" workplace where everyone is supposed to enthusiastically acclimate to being constantly off-kilter in order to meet business objectives while serving in high-risk/high-responsibility/low-autonomy roles that demand ethics, while also being constantly subject to the kind of critique technology has enabled - - then it can't be said that you hate nurse turnover, because this type of milieu is a major dissatisfier in this profession. We are now seeing that it is a dissatisfier of younger generations of nurses, too - not just (maligned) old-fogies who (supposedly) "can't do change/can't adapt."
People are fed up with it. And yet it continues full speed ahead. To keep up with the turnover, no problem - - just keep shouting 'nursing shortage' and work harder at streamlining the on-boarding process. At some point that isn't trying to keep up - - rather, it is called doubling down.
- If a hospital corporation is able to post nursing positions as "rotating locations/facilities, days, hours, shifts, weekends, holidays," etc....and post nursing positions that are no longer unit specific but are 'float here and there and everywhere' or 'X Cluster' float....and post positions where the job description has been copied and pasted from some all-encompassing master list of RN functions (plus the employer's own fantasies) such that a job seeker isn't even exactly sure what the role is.....well, you (corporate "you") simply can't say with a straight face that turnover is bad for business. Even the job postings themselves are the perfect picture of disregard.
The hand-wringing about nurse turnover continues to be mind-boggling, because this much is black and white: When you are in control of others' livelihoods, you get what you ask for. What you incentivize. What you say you want. If nurses are leaving to the point that retaining nurses is a constant struggle proportionally out of line with a company's size, it is because the company said they wanted that. Per.i.od. That's really all there is to this. ??♀️
nate411
19 Posts
They don't have to "train" anyone. In fact, training is rare.