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?

[3peas]

10-15 years is way to long of a goal. Start with shorter incentives. Someone already mentioned it, staffing ratios..a charge nurse who has a decreased load...Things that matter. If a hospital looked at big picture financially instead of the quarterly bottom line they would find that adding A/one staff member could improve morale, efficiency, improve retention. Which would then decease turnover, education costs, call in time, overtime costs..... I mean just think if they added two! Mind blown!

[adventure_rn, MSN, NP]

In my experience, the flight risks aren't the nurses with 10+ years on the unit, it's the younger new grads and new hires who aren't married, don't have kids, and can leave to find something better at the drop of a hat. In order to retain the nurses at highest risk for attrition, you have to appeal to your entire staff base including the newer nurses (rather than simply rewarding the highest seniority nurses).

The promise of a bonus or incentive at the 10 or 15 year mark isn't sufficient incentive for a new hire to stick around that long; you have to make it a desirable place to work at this moment (reasonable ratios, reasonable salary, reasonable management).

[Lisacar130]

Promising no floating or no holidays after X number of years will never work because a new manager can come around and change it like nothing, leaving the nurses who were counting on it happening with nothing. The nurses won't believe it will be guaranteed so it won't really work. Plus, what about the nurses who are already there for that long... suddenly they won't have to float anymore or won't have to work holidays anymore and the newer nurses will have to do it even more often to balance that out and that won't be fair and they will quit.

I can't think of anything that won't cost money, like increased salary/retirement benefits/ or increased staffing.

[llg, PhD, RN]

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

I wish I could "like" that post multiple times. Very well said!

[MrNurse(x2), ADN]

I left my management after three decades. Why? I had it with the condescending seniority remarks. Had a patient admitted with GI bleed that turned out to be a basilar skull fracture, that I caught, not the docs. I was told that was expected because of my experience. Two docs dismissed this man's chest pains, I stuck on it until he made it to the cath lab, once again, expected. Meanwhile a new nurse gets recognized hospital wide for dealing with a screaming patient who was heard throughout the whole unit when he occluded his fem-pop. I was not the only multi decade nurse to leave, half of our experienced nurses left. I now work a facility that listens to what I have to say and treats me as an adult.

[Crush]

I now work a facility that listens to what I have to say and treats me as an adult.

Key here is mangement that is respectful and listens. That is why I like and will stay where I am.

[OldDude]

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.

OMG!! No truer words have been spoken! But who wants to listen to common sense?

[kbrn2002, ADN, RN]

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

You still get a Christmas bonus?? Since our Christmas bonus has been holding at precisely zero for more years than I can count there's nowhere to go but up!

[Ruby Vee, BSN]

The jobs I've stayed at were the ones where I was treated as a respected professional by my manager, by her boss and by her boss's boss. I could step on an elevator with the Director of Surgical Nursing for a 1000 bed hospital and she not only recognized me as one of "her" nurses, but she remembered my name and used it when she greeted me and asked if the rain/snow/sunshine/whatever had messed up my commute/weekend/whatever. On Christmas, Thanksgiving and Easter the hospital staff were all treated to a free meal served by hospital management -- from the Chairman of the Board to the CEO to the various department heads. They each signed up for a holiday meal on a rotating basis. The medical director of our unit stopped in every major holiday with a basket of home-made goodies he had made with his own two hands (sometimes with the assistance of the newest crop of interns on service). When you went to any of the physicians with a concern, they listened and if they disagreed with you, they did so respectfully. (And if they DIDN'T, they were promptly straightened out and delivered an appropriate apology. Meaning the intern who chewed me out in front of the entire unit apologized in front of the entire unit, and if the apology was inadequate -- which was rare -- he had to repeat it until he got it right. Or they weren't back the following year.)

The manager -- who wasn't an ICU nurse -- listened to those of us who WERE ICU nurses and took our advice. If, for some reason, she couldn't follow our recommendations (recalcitrant upper management for example) she met with us to explain the situation and we all worked together to find a different solution. If there was no different solution to be had -- for instance staffing sucked because everyone wanted to go to the funeral of a colleague, she talked to her peers in the other 8 ICUs and paid overtime to anyone who would volunteer to come in and relieve one of our nurses for part of a shift. Everyone who wanted to got to go to either the funeral or the visitation. The day shots were fired on our campus, our manager was right there on the unit with the rest of us, disseminating information as she got it, listening to everyones fears/concerns/ideas. When the blizzards hit, she camped out in her office for the duration and during the hurricane, she was unavailable so her boss was on the unit. Neither our manager or her boss was able to take a patient, but they answered the phones, ran specimens to the lab, fetched icewater for visitors and kept the coffee pot going. In short, they were there, helping, getting their hands dirty and no doubt ignoring some of their own work to do so. If I hadn't had to relocate, I'd still be there.

[Been there,done that, ASN, RN]

Management / administration knows what is needed to retain experienced nurses.. it is money and respect. Any policy formation is a moot point.

"no floating after 10 years, no holidays after 15 years"..is a carrot dangling before their nose, that smart nurses can see through.

[cyc0sys]

I left my management after three decades. Why? I had it with the condescending seniority remarks. Had a patient admitted with GI bleed that turned out to be a basilar skull fracture, that I caught, not the docs. I was told that was expected because of my experience. Two docs dismissed this man's chest pains, I stuck on it until he made it to the cath lab, once again, expected. Meanwhile a new nurse gets recognized hospital wide for dealing with a screaming patient who was heard throughout the whole unit when he occluded his fem-pop. I was not the only multi decade nurse to leave, half of our experienced nurses left. I now work a facility that listens to what I have to say and treats me as an adult.

I completely agree with the statement above.

But as a previous poster mentioned, that's what's expected of you. After all, you're with the patient 8-12 hours per day. Surly even the most lowly skilled and lowly paid professional could recognize those medical s/sxs because the Docs are too busy solving the riddle of the Sphinx. Then navigate the health care gauntlet, against all odds, uphill from a subservient position.

However, there's no reward for a positive out come. Only punishment for negative ones, even if it's the result of protocol and policy driven from management and administration. How dare you think outside the box and advocate for the patient. 'Father' or 'Mother" knows best.

Alas, the real dilemma is patient care above profits. Patients are not my customers and we are not flight stewardess serving narcotics.

[Nurse Beth, MSN]

People who are appreciated go the extra mile