Retention

don't mess with my schedule -- allow me the opportunity to take the vacation time i've earned when i'd like to take it. don't mess with my weekends off -- as long as i follow the rules for scheduling myself x many weekend shifts, my assigned holidays and off shifts, don't mess with my schedule.

don't mess with my money. if i'm doing a good job, give me a raise. don't just decide that after i've hit a certain pay level i don't need, want or deserve raises anymore.

a real career ladder would be a plus. not just something you can proudly point at as a career ladder but really only use to reward the manager's favorites.

a fair manager would be another good thing.

1.Create a career ladder that allows RNs to promote without leaving the bedside.

2.STOP the insanity of sign-on bonuses. Give retention bonuses instead.

3.Persuade your CNO to see the advantage of "staffing to the grid" PLUS a float RN to give lunch and break relief to the RNs with a patient load.

Those are just a few off the top of my head.......

And I agree so much with you. I think you have great points and I will definitely bring those up. We do have a Career Ladder as well, but I would like to see more Career Opportunity...moving up a real ladder so to speak. Promote inhouse versus recruiting from outside. We do have a few employees that are taking the "real" ladder, but I'd like to see more encouragement.

How would such a Career Ladder look like to you?

I think our CNO is moving in the right direction, at this time we are offering only one sign-on bonus for OR Circulator, but we have Retention boni. Hmmm...love the input!

I am one mostly driven by internal rewards. However, I find that when good practice is not rewarded and poor practice is not punished, this encourages poor practice by those driven by external rewards. It promotes a culture where the minimum is the standard. These have been the places I left.

So, I guess what I'm saying is recognize and reward excellent practice, higher education, and certification in one's specialty. Recognize and discipline lousy nursing care and dangerous practice.

Hire enough staff that nurses can be taken off the schedule to attend educational classes and seminars and participate in unit based councils. Hire enough staff to have low patient to nurse ratios in order to provide for better patient safety and for nurses to get their meal breaks. Hire enough CNAs that nurses have enough help with basic patient care that they are able to focus on higher level nursing practice. Have someone besides the nurses supervising the CNAs to make sure they are doing their work and not surfing the internet or hiding in patient bathrooms texting on their cellphones.

I love the kind of nursing I'm doing, but if I leave my unit, it will be because the CNAs (to put it bluntly) suck, and there is no accountability. The nurses are constantly picking up their slack and missing meal breaks and having to stay late to finish charting, because the CNAs are not doing their job. Management is aware of it, and nothing is being done; in fact, the hospital is cutting back CNA hours to save money.

I foresee an exodus in the future if things do not change.

I commend you for starting this thread and actually asking the questions. I would suggest that if you're able to respect your staff, you'll retain them. Years ago we exellent nurse managers who respected their staff and overtime was nearly un heard of. Now we have the worse management team I've ever seen and overtime is through the roof. Two years ago we had one employee who made over $20,000.00 in overtime alone. That same employee last year made nearly $40,000.00 in overtime alone. We heard that overtime last year was over $100,000.00. Yet these Nurse Managers are unwilling to look at themselves in the mirror to ask why or take any responsibility. The reason for the overtime is various job possitions difficult to fill because no one wants to apply for them and many not thinking twice about booking off of work because they are so fed up with being treated like garbage.

Then there's this thread that I started:

https://allnurses.com/general-nursing-discussion/nurses-educated-professionals-363884.html

I think my original post in that thread would give you some added insight.

Best of luck.

Acknowledgment hat I am doing right rather than everything I am doing wrong. I'm trying to find a new job because my confidence cannot take too much more pounding =(.

Provide the environment, supplies and culture I need in order to give my pts the best care I can.

This means respect and listen to nurses, and make it a goal to improve working conditions.

Reduce duplicate charting, streamline paperwork, documentation, the processes of getting supplies meds, and so on.

Get rid of problem CNAs and nurses.

The above are more important to me than money, schedules, career ladders or anything else.

I am very grateful for all your answers. I believe Retention is the key to almost anything. Besides from the business standpoint of becoming a magnet employer for high qualified personnel, I also believe that caring is a two-way street. Healtcare staff is using a lot of emotions and caring for patients and that can be draining too. A caring environment helps the staff to recharge batteries and to keep going and giving. In Germany, I worked mainly in healthcare also as a Manager, but I did a little de-tour into other industries and I learned that a healthcare employee is a completely different type of person and needs a different type of treatment. Plus, not to forget the career stimulation and financial ones as well.

I think, and this is just me, I would take the same money.........not extra vacation time, no big bonuses, but I'd like a better work environment.

Better staffing. Not just for RNs, but for CNAs, housekeeping, pharmacy......everyone. I want support staff to "support" the process instead of slow me down all the time.

I sooo agree with retention bonuses instead of sign on bonuses.