The BIG word - RETENTION!!!!!

Havin' A Party!, ASN, RN · Aug 5, 2004

Some ideas: improved bennies, preferred shifts, time off, etc.

gladtobeOB · Aug 5, 2004

With my new job working the weekend program, I think I should get some sort of compensation for it. I get paid just as much as the regular people, well that isn't true either being the newbie but I think I should get pd several more dollars for this position?????

danu3 · Aug 5, 2004

One of the hardest for a manager - hiring good people who can work together as a team. You may have very good people individually but they just don't "click" together, or worst, they just don't like each other.

Once you manage to put together such a team, do everything to encourage the team to stay together. And enjoy the team as it is always good to watch people work well together in a team.

In my previous career in computer engineering, I had the fortune of having a few very good managers. We tend to work long hours anyway withoug being told to do it. One manager kicked us home actually. Her reasoning, the current situation do not require us to work overtime, she don't want to burn us out. There will be time when we are needed for big overtime, when that time comes, she wants us to be "fresh", not all "burned out" when the crunch hits.

Another manager I had is older than all of us by at least 25+ years. He treated us like his own kids (extra kids, I guess). Small things, like he has this incredible network of somehow knowing where all the little celebration in the company are. He would go to them, gets the goodies (cakes and stuff) and bring them back to us to eat.

Who else? Oh yea I had a very good 2nd line manager once and one time I had to do lots of technical research for my 1st line manager for his presentation. That was when I just got out of school. I still remember my 2nd manager came to my office and said to me "Dan, you need protect your 1st line manager by getting real good, accurate information. He is representing you and everybody in the group. You need to protect him just as he protects you and the group." I never thought about me "protecting" my manager! Boy, you won't believe how hard I work and made sure everything is accurate.

A manager with some humor is always good. On a real bad project once, both my manager, my colleagues, and myself were working really late. Anyway, my manager's wife is suppose to pick him up around 7:30. We did not get out discussing some technical stuff around 9:00 and the poor wife is out in the parking lot, probably steaming her head off (why didn't she called? ). Anyway, our manager begged us to go out first to the parking lot and explain what happened. So we went to his wife and explained what happened. We told her how scare he is right now, how he is so sorry... etc. We did get her to smile finally. Anyway, he went home without any bodily harm with his wife.

A manager who stands up for his/her people. To this day I still remember one of the team leads my officemate had. It was actually a summer job. Toward the end of the summer, my officemate's project all of a sudden got into potential real trouble. One thing led to another, the manager thought it was because my officemate's carelessness (which is not true). He was extremely angry when he was in our office. And this is what I remember to this day - My officmate's team lead literally took a step and stood between my officemate and the manager and thus shielded my officemate. The teamlead stood up for my officemate while she has no idea at the moment whether it was my officemate's fault or not. They went to a room privately and talked over an hour. Came out and things are ok as it turned out there were some major misunderstanding. That little action of physically shielding my officemate had a huge impact on me. When I teamlead, I always protect my people. If they messed up, I work with them privatly but I take the blame publicly. If they do real good, I make sure higher ups knows about it.

What else, overtime or less desireable shifts are fine as long as they are not so much that it burns a person out.

Continue education opportunities. Do more than the minimum to get the require CE every year.

Safe working environment.

Always have all the resources necessary to do the required job. Resources could be anything from time to good equipments to whatever.

Only admit nice easy going friendly patients:rotfl:

Finally, spend a few billion dollars for some fancy robots to do all the documentations automatically:).

More on a serious note, for me, good manager and good colleagues to work with will probably determine more than anything else whether I would stay as long as benefits and pay are decent.

-Dan

barefootlady, ADN, RN · Aug 5, 2004

One thing I would appreciate from administration, when I agree to work overtime, how about a free meal ticket? If I cannot use it that evening, then I could use it another day. Sure I am making a few extra bucks, but I am doing the unit, the HN, and the facility a favor. SO give me a little something to show me you recognize my effort.

I would appreciate a note from my HN on my birthday, saying a little something to lift my spirits and letting me know my work and dedication are appreciated. Surprise the staff at holiday time with a list of "nice" things we do that you have noticed. Say good morning or good night to us. Notice new glasses.

These may sound like small, silly things, but I spend a lot of time with you. Do not treat me as a blob, a number, or a warm body. Treat me as a human being. If I have called in sick, ask me how I feel when I come back, and sound like you mean it.

Rapheal · Aug 5, 2004

What inspires loyalty in me is a truly flexible schedule or agreed upon hours, not being nitpicked to death over whatever is the new charting policy of the week, and having enough NA's.

Being expected to do almost all the NA work while being responsible for meds, labs, treatments, and documentation has burnt me out. We all hear about prioritizing in nursing, but no matter what is going on a patient who needs the bedpan or BSC will expect you immediately. I am also tired of being yelled at for not having grandma bathed by 3 pm or complaints about not getting fresh ice water. Seems nobody cares that I am busy with a patient with SOB.

An employer who employs enough aides to help me accomplish my nursing tasks will find me a very loyal employee.

RNPATL, DNP, RN · Aug 6, 2004

One thing I would appreciate from administration, when I agree to work overtime, how about a free meal ticket? If I cannot use it that evening, then I could use it another day. Sure I am making a few extra bucks, but I am doing the unit, the HN, and the facility a favor. SO give me a little something to show me you recognize my effort.
I would appreciate a note from my HN on my birthday, saying a little something to lift my spirits and letting me know my work and dedication are appreciated. Surprise the staff at holiday time with a list of "nice" things we do that you have noticed. Say good morning or good night to us. Notice new glasses.
These may sound like small, silly things, but I spend a lot of time with you. Do not treat me as a blob, a number, or a warm body. Treat me as a human being. If I have called in sick, ask me how I feel when I come back, and sound like you mean it.

When I read your post, I have to say that I am shocked that there is not at least a little thanks or recognition for working the overtime and helping out the unit. For my nurses that work OT, I generally provide them not only with a meal ticket, to use whenever they want, but also two movie passes and my sincere thanks ... of course, the nurses that go above and beyond for me, I remember when I am scheduling and they have requested time off.

The other thing that we do is send a note home to the employee's spouse or kids and tell them that we think their mom or dad is wonderful and how we appreicate having them work for us. This has been one of the most inspiring things that we have done and it really is simple and means ALOT to the nurses. I love the reaction we get when the nurse comes into work the next day .... it's pretty cool!

Small things make a big difference!

RNPATL, DNP, RN · Aug 6, 2004

What inspires loyalty in me is a truly flexible schedule or agreed upon hours, not being nitpicked to death over whatever is the new charting policy of the week, and having enough NA's.
Being expected to do almost all the NA work while being responsible for meds, labs, treatments, and documentation has burnt me out. We all hear about prioritizing in nursing, but no matter what is going on a patient who needs the bedpan or BSC will expect you immediately. I am also tired of being yelled at for not having grandma bathed by 3 pm or complaints about not getting fresh ice water. Seems nobody cares that I am busy with a patient with SOB.
An employer who employs enough aides to help me accomplish my nursing tasks will find me a very loyal employee.

I really try not to nag my staff. However, I have charting and clinical expectations that must be achieved. As a professional nurse, you are truly accountable for making sure the care you provide meets JACHO standards and that you have charted it. I don't nag ....just expect it done. Of course, on the otherhand ..... it is imperative to make sure that the nurses have the tools and equipment necessary to be able to accomplish the mirad of things they need to in a shift.

Nothing is more frustrating that dealing with clinical issues on a patient that is having trouble and then being expected to do NA work on top of it. As the nurse, you have to prioritize and putting a patient on the BSC does not take priority over a patient with chest pain and having shortness of breath. I certainly understand this and hopefully other managers do too.

chimama · Aug 6, 2004

I have been an RN for many many years, the last few as a travel nurse and many as a agency nurse. I have seen ,repeatedly, nursing management and hospital administration make stupid decision after stupid decision the make their staff feel unvalued and leave.It is a source of constant amazement to me. One particular...I have seen charting system after charting system be decided on with no discussion with the staff who will be using it.It seems that now the management is focused on "accountability" (as if civil and possible criminal charges and the loss of your ability to lose your income and earning ability is not "accountability " enough

)and tries to ultra standardize everything untill the medical record is bascially useless to communicate information about the care given. I have seen these systems implemented time after time with the staff screaming NO! to deaf ears.Nurses are given 1/8th of an inch do do this critical charting that "isn't done if it isn't charted"Or a "wonderful computer system" providing only Y/N input to record crucial observations. No one ever talks to the staff. On one assignment a hospital spent who knows how much on a beeper call system that everyone hated. No one asked the staff how they liked it and after a few weeks the beepers were in the drawers. One place implemented a "Clinical Ladder" that involved hours of extra-unpaid-work on the nurses part .All the nurses with husbands with benefits just went pool status, and many nurses quit when the MANDATORY note went up. Why don't nurse managers and hospital administrators talk to their staff and listen to their staff instead of deciding like Mama and Daddy what is best for all.One thread I recently read was about "scripting". How insulting can you get? Self-direction is an excellent idea but I have only seen it implemented in scheduling, and that is alwzys with mind-bending regulations about weekends and holidays.I am at the end of my career and I thank God even tho I love being a nurse.Maybe if self-direction is truly implemented and nurses were really empowered instead of pretend-empowered nursing will become a more attractive job and nurses can experience some of the contentment in their jobs that IS possible.

RNPATL, DNP, RN · Aug 6, 2004

Your post certainly talks to the way things are going in nursing. Standardized charting is crazy. It leaves little room to communicate what needs to be communicated, I totally agree. Hospital systems are moving away from nurses using independent judgement and moving more toward protocols and systems that leave little room for critical thinking. Over the years, this changed has left many nurses wondering why it is being done. Perhaps some of it is related to all the law suites the health care industry is facing. I am not sure what the answer is, but I agree that nurse managers and administrators need to listen to their nurses ALOT more than they do now.

gwenith, BSN, RN · Aug 6, 2004

If you are interested I will give a couple of ideas from over this side of the ocean. TOIL is GREAT MATE:D Toil = Time Off In Leiu. Originally an invention of goverment beurocrats it crept into nursing. What it means is that I can "bank" overtime or times when I have to come in for a meeting or a lecture and use that to take time off when we are not busy.

One of the biggest retention carrots is not only in nursing but Aust wide and that is Long Service Leave. You have to put in 10 years service and then you are given an extra weeks PAID holiday leave for every year that you work - and that is cumulative. So if I work 30 years for a facility and never claim LSL I can get a payout at the end of 20 weeks holiday. Incentive - you bet:D

Everyone who asks about coming over here is amazed that we don't have recruitment bonuses - what they don't see is our retention bonuses.

barefootlady, ADN, RN · Aug 6, 2004

Dear Pat,

How wonderful that you do these little extra's for the nurse's who help the unit in a pinch. What I would not have given, more than once, to just hear a thank you. You sound like a manager than will certainly have no trouble filling empty slots.

I agree that charting is a big issue today. I loved flow sheets, and they could be utilized in computer charting today. The program just needs to be set up right and the system needs to flow from one area to the other easily. The best flow sheets I every used were the ones that had additional information areas attached to the bottom of each section. This was used to chart those exceptions to the rule notes. Like a BS of 300 at 11:00. Nurse could make a note of steps taken and care given to address problem. Short and sweet. Computers have brains, why when a problem has been addressed in exception area could not a prompt of some kind pop up to remind the nurse to address the issue. If it is an ongoing problem she could address it. If it was an issue that was resolved, then resolve it. I hope I am making myself clear, but I really do think computer charting could be made easier.

I guess you can tell I come from the era of the "nurse is responsible for everything." I have eased up on that particular theory, but I do think we need to be aware of what is happening to our patients on our watch. I hate it when a CNA does not tell me about elevated BP's or temp's. I no longer take it for granted that they know what should be reported. I take the time to look over the VS sheet. I try to do all of my own BS's because some of the CNA's here really think that is a task only the RN should do and they are not viligant in getting them done on time. Yes, there are usually enough machines to do them, but CNA's here hate to do them. The best compliment I have gotten in the last 2 years did not come from my boss, my patient, or my coworkers. It came from an intake nurse at a speciality facility I was transferring my patient to, she thanked me for the "excellent report and tips I gave her regarding this patient, his condition, special ways of handling him and his family." She wrote a letter to the DON and HN, they did not acknowledge it to me, they just posted it on the bulletin board for some of the staff to read. If anything, the HN seemed rather put out that I spent the extra time talking to this nurse about this patients special needs. Don't mean to rant but please keep in mind that some of your nurses really need a pat on the back sometimes.

Anyway, I wish you continued success with your unit and staff.