Specialties MICU


I need some input.. our Unit has experience a ton of turnover in the last year.. as all the hospitals in our area have.. well.. our director is now asking for input on RETENTION.. I have my ideas.. but would love to hear if any of your hospitals have retention programs in place.. and if they're effective.. also.. if you have a dream retention plan.. share it!!

thanks.. from OOOOOOKlahoma!!

Specializes in Dialysis.

Without knowing the particulars of why people are leaving, it's pretty difficult to give suggestions as to how to get them to stay. Are exit surveys being done to document reasons for leaving? What is important in one group may not be to another. Until this is determined, you won't make much progress. What this means is that administration has to be honest with itself and with its' staff--good luck on that one--and then work with hospital administration and even board of directors to fix the problems. If money and benefits are at issue, it gets harder, but if you can show that turnover is a really negative force in terms of costs, you have a leg to stand on. It sounds as though, since many institutions are losing nurses, this could be an issue. I myself think it would be much less stressful physically, emotionally, and mentally to do other jobs besides nursing for the money that is being paid to do it now.

As a suggestion, though, one thing that works wonders in my unit is self-scheduling (within limits, of course). We work on seniority and have a family-friendly approach to weekends--none of this every other weekend carved in stone baloney!! Nurses have a life, too. Good luck.

Specializes in ER, ICU, cardiology lab, nursing adm..

I am also interested in anything to do with new grad retention. We are in the process of trying to develop a new program at our facility that caters to the new nurse and extends a FUNCTIONAL orientation period for them that will focus on detailed assessment skills. I think that new nurses are so overwhelmed with processes and technology that often the actual care of the pt. and perfecting of assessment skills becomes a secondary goal in many instances. We really just have a concept at this point but would be interested in any ideas or comments. We are thinking of sending the nurses to shift after a basic 6 week orientation on days and assigning them to a group of pts with an experienced nurse as a preceptor to assist them for an extended period of 3-6 months to assist them with various job duties. These nurses would be assigned to one of the general nursing units that generally has high turnover and this group of staff would work that area with direct supervision to develop assessment skills prior to going to a more specialized area for their permanent assignment. The staff that will precept them are members of our float pool who have experience on several areas and also work in administration. We're hoping with the added attention that it will foster good relationships with administration from the beginning as well as boost confidence and strengthen skills before going to their assigned areas

Everywhere you look in the newspaper or whatever there are enormous nursing sign on bonuses( I have seen as high as $10,000 sign on bounus)

whereas if you have been a nurse at my hospital for any length of time you get nothing...we donot even get critical staffing bonuses any more. So we suggested to our CEO that instead of investing so much into new people that most of the time end up leaving that some of that bonus money should go toward retention bonuses i.e. $5,000.00 after each 5 years of service.

They seemed receptive to the idea but I have yet to see it happen.

Specializes in ER, ICU, cardiology lab, nursing adm..

Yes, that is a really good idea about retaining tenured staff....but as our staff here at this hospital grow older and retire we have to be able to attract new nurses as well. I certainly agree that we need to retain our valuable tenured staff....part of the issue with that has been the age old problem of increasing the starting salaries and not increasing it acrosss the board for all nurses. It's a vicious cycle. Thanks for your suggestion. I will forward to our adminstration

Specializes in ICU, Education.

burnout, I completely agree with you. So much is spent on recruitment and not near enough on retention. I've posted this before, but I think senioritiy should account for more as well. This last year, (at my now old job) all the new nurses were given the premo holidays of their chioce, and us older nurses were truly screwed. We were told we had to keep the new people happy or they would leave. Do ya believe that crap? Now the place has no core staff excpet new nurses. Think they'll get a clue?

Specializes in ER, ICU, cardiology lab, nursing adm..

I'm not sure if anyone will ever get the message....seems like we're always playing catch up and damage control. We seriously need more nurse educators to have the ablility to get the new nurses....a local program in our state has 400 potential students on a waiting list....that's just crazy. AND if hospitals would just take a leap of faith and add about $3 to everyone's salary...maybe we wouldn't have such issues with folks leaving the hospital to pursue less stressful environments not to mention we probably wouldn't have to work people to death with OT and pay out the nose for critical stafffing pay and agency. You'd think people in healthcare would realize that an ounce of prevention is worth of pound of cure....I mean that's what we preach as professionals every day.:uhoh3:

Specializes in Cardiac.

Every year at my hospital we have a Recruitment and Retention Plan. The nurses always end up getting another raise (and still get their annual raise) and they throw out a plan for overtime. One year it was double time for OT. The next year it was time and a half + $15/hr for all overtime shifts. Another year, we would get a Gift cert for each OT shift worked (in addition to OT). Also, they would give us bonuses based on how long we worked there. Some nurses got >$6000! I was a tech, so I got just over $1000. My best friend who is a nurse got ~$3000 and she had only been there 2.5 years.

It's nice knowing that something is always coming around next year.

Specializes in MICU, neuro, orthotrauma.

treat new nurses well. be patient with them. that is the single best way to retain new staff.

with experienced staff, give them monetary rewards as well as voice in nursing protocols.

i will eventually do SICU, but not if the nurses eat their young, or are even indifferent. i want to be surrounded by people who are excited about learning and want to help me know as much as i can.

I'm in a slightly different position to look at this--I'm a traveler, but before I traveled I worked for several hospitals, and turnover is/was a big problem everywhere. It seems that money is only a part of the reason. I think a lot of the new grad retention problems may have to do with a couple of things. One is finding your passion--lots of us start out in areas we *think* we might like and end up figuring out that isn't it. I know that was true of me; I thought it was peds and ended up in critical care. Another is the tradition of putting all new nurses on nights. Some people just aren't night people and will never be, and they'll grab a day position somewhere else the minute it's offered.

For us old hands, I think the problems are a little different. I know I and others have left units because of personality conflicts, not infrequently with nurses who are not management but think they are because they've been there forever and everyone kowtows to them for some reason; they are often very difficult to work with and will make it miserable for anyone who doesn't do things exactly their way. I've also left because of hospital politics and administrations that cut staff to the bone and still expect you to take care of 8 patients the way you would 4 (floor) or more than 2 critical care patients. Right now I'm getting ready to leave a position I would gladly have signed on another 13 weeks for. Why? Basically because the manager is so out of touch or overwhelmed that she doesn't see what's happening. There are 6 people leaving night shift, including a couple of travelers who have been there a long time. But she didn't ask me if I wanted to extend, either.

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