Staff Retention Policies

[Positive_Outlook]

I work on a great unit that's trying to come up with incentives to make staff want to stay on our floor for a long time. We have decided to make a retention policy and are brainstorming ideas such as no floating after 10 years, no holidays after 15 years, etc. Do any of you have units that do this or have some ideas to add to a policy like this?

[RockinNurse2018]

No, we do not, but with our high turnover rate, it would seem like they would want to do something. Right now, there is little incentive to stay, so we are constantly losing nurses and working short staffed.

[QuietIsntAWord]

We get a raise every year if you score a certain amount on your eval (which isn't hard unless you are downright lazy) and our retirement plan you can take with you if you stay at least 5 years. Why don't have a high turnover rate, but I also work at a great facility :)

Oh and your Christmas bonus gets bigger based on how long you've been there

[bugya90, ASN, BSN, LVN, RN]

Our policy is ervyone floats on rotation. Everyone's name goes on a list in the break room and floating goes down the list. The list is nice because you can see exactly how many people are ahead of you before it's your turn to float again. Since everyone takes their turn, you only get floated maybe 2-3 times a year. We also have a float pool which really cuts down on floating across the hospital.

For holidays it is first come first serve and seniority. So me as the newest person on the floor will get the last pick at holiday time, by everyone has to work at least 2 major holidays per year and one of those days has to Christmas/Thanksgiving time. Seniority gets first option to go on call that day if we have low census.

Our unit has the lowest turnover in the hospital. We have a great teamwork atmosphere and our manager will come work the floor with us, especially around lunch when we get slammed.

Retention is about more than just holidays. Also keep in mind you still have to attract new employees too, so don't completely screw them over either.

[KatieMI, BSN, MSN, RN]

So, some management genius is thinking that the prospective of not working holidays after 15 years would surely and right today emplore people to join, stay and bear all the following holidays for 15 years?

:roflmao:

Please let that dude know that in developed world there is one proven way to keep employees put : $$$. And, maybe, what is named "great atmosphere" for EVERYONE. Not only for long-time favorites.

[RNperdiem, RN]

Those ideas are OK to start with, but 10 to 15 years are way out there for most nurses.

Most nurses will be looking for satisfaction along the way.

What is your scheduling like? Do your staff have any measure of control over the days they work? I have worked with both self-scheduling and the kind of scheduling where the manager does all the scheduling except for the vacation days you request off. Are reasonable vacation requests honored?

Are the same few nurses doing all the precepting of new nurses, or always put in charge? Giving you senior staff a break from these responsibilities sometimes gives them a chance to recharge. That, and making sure they get their vacation.

Does your department use CNAs? Are they high-performing? When I was a nurse in med-surg, the CNA could make or break your day. I worked with the full spectrum of aide- from the stellar to the absentee.

Is the workload reasonable enough to let the nurses eat lunch most shifts? This was the final straw in why I left my first job. The nurse gets blamed for poor time management where the truth, for me was, that even getting to work early, staying late every shift and rarely eating lunch, yet not feeling I provided the bare minimum of care caused such a feeling of discouragement, that I left after one year.

[Crush]

Holidays off are determined by seniority here. But all employees must work at least 2 holidays annually. But those who have been here longest can pick which 2 . Christmas is double pay so alot of us want to work it and our boss brings a small gift and dinner for those who work it. We get to pick a gift (from a catalog they give us) for every 5 years we work here and get a pin.

Our boss goes out of her way to pay genuine compliments for service excellence. We all get recognition for a job well done and even the "little things" are noticed. I seen one on the kudos board (only the boss posts on it) for a person coming to work with a "smile that lit up the unit" on a certain day.

Plus we have really awesome staffing and our bosses will put on scrubs and help out on the floor or work a little while to prevent us from being too short staffed.

[guest769224]

They will stay if they get significant raises and adequate staffing.

[Eris Discordia BSN, RN]

Competitive starting pay, annual standard of living pay raise plus merit based pay raises, balanced self scheduling and adequate staffing, quarterly rounding individually with staff to listen to what is working and what isn't, a solid, fair floating policy, reliable prn staff who are required to work some hard to fill shifts as part of their contract (Fridays, Monday's, weekends, evenings and nights, etc.), flexiblity with granting PTO days and vacation requests, and early, vested retirement savings (vested after 5 years for example).

Incentives that require someone to stay there for 15 years are a joke. My kids will be in their late 20's by the time I would reap the benefits of having holiday time off with them in that scenario. If I like where I work, I will work the holiday requirements peacefully, as long as they are reasonable. If a place stinks to work at, no way am I hanging out long enough to reap the benefits of no holidays after 15 years. As for no floating after 10 years? If you make the floating policy fair and staff other units well so that they don't always rely on floats, floating every once in a blue moon on a set float rotation isn't an issue. Waiting 10 to 15 years for a reward? That's not an incentive, that's almost an insult.

And finally, find a way to celebrate each individual employee's strengths. Don't make it so that the only time they see management or administration is if something is going wrong. Commend them for picking up extra, celebrate them for positive peer relationships and mentorship, applaud their ability to handle difficult assignments. More rewards for good performance, less focus on punishment and reprimand.

[Nurse SMS, MSN, RN]

People do not leave jobs. They leave managers. Your retention policy needs to include training for excellence in management, making sure that nurses who have experience are the highest paid employees on the floor and that your staffing ratios are reasonable. Period.

[KatieMI, BSN, MSN, RN]

People do not leave jobs. They leave managers. Your retention policy needs to include training for excellence in management, making sure that nurses who have experience are the highest paid employees on the floor and that your staffing ratios are reasonable. Period.

There should not be "training for excellence". Management gets enough and more of them, with results most of us know too well on our own skins. What should be in place is the same criteria applied to management as to staff RNs. What is punishment for a staff RN for more than one serious "incident" such as med mistake with sequela for patient, missing serious clinical sign/symptom, missed/screwed order, etc.? Yep, termination and call to Board? Then same it should be for management. More than one episode of unsafe staffing, lateral violence in unit, favoritism, nepotism, etc. - welcome to job market and, yes, to nice talk with someone in your state's capital.

[JKL33]

This problem won't be solved the way you are coming at it.

In what other every-day relationship in life can we successfully treat people as a means to an end or a subject to be controlled? None. We wouldn't succeed by treating a spouse/partner that way, nor raising a child, nor maintaining a friendship. Human beings do not work that way. We either care about the people we want to have an ongoing relationship with, or we don't. If we don't care, we won't have an ongoing relationship. Some may say this is different because it's business. Well, I think it holds true, I think I'm right, and the proof is right there for anyone who wants to look at it.

The thing that some people don't understand is that nurses have always worked in situations where we didn't have endless resources to perform our duties. Nothing new there. The thing that has changed is the idea that all of this is somehow our fault. There have been endless times in my career where patients keep coming in the doors, multiple things are needed at once, patient conditions change rapidly, and we are ROAO the entire shift - but it used to be that someone eventually said, "well done," and "take the best care of the patient that you can and we'll worry about the rest later." There was such an incredible sense of teamwork, belonging, and accomplishment in successfully handling these situations! But I think I would fall over dead if I heard either one of these two things in our current environment. In other words, there was moral support for our efforts. Moral support has currently left the building and been thoroughtly replaced with shame and blame.

No professional is going to put up with that for very long. Nor should we. Working one less Christmas or floating two less times per year (after 15 years of service???) is not going to endear people to the idea of being repeatedly scapegoated and treated like a thorn in everyone's side.

If a business can't afford to speak with, treat, and consider adult human beings in a manner consistent with the idea of maintaining an ongoing, mutually-beneficial relationship, then one won't be had. It's that simple.

As a matter of fact, I believe they very well know this already, which is why they have plans in place knowing they will churn through employees. I personally could not be happier that their careful calculations and accommodations for treating people like sh*t aren't panning out.

Over time, you cannot pay (most) people enough or throw enough half-hearted "rewards" their way to have them agree to be treated poorly every day, day in, day out. That only works for a time and then you'll simply again be faced with your refusal to have a real relationship.

ETA: This is the same reason why the "patient satisfaction" game won't be won. There is a difference between treating people well because you care about them and doing things to try to make them feel like you care as a means to an end.