I have found that RN/LPN retention is one of the most important parts of my job as a nurse manager. I think a decent compensation package (salary and benefits) goes a long way to helping nurses stay in their job, but the single most important thing I have found has been whether a nurse feels like he/she is appreicate and valued. Over the years, I have involved nurses in the management of the unit, asking for their input on policies, scheduling and many more things, but I have found that the single most important thing for a nurse to stay is that pat on the back and a simple thanks for the hard work.
Over the last year, I have worked as a staff nurse and realized more than ever, that being appreicated is almost worth as much as getting the pay check. Hello .... please don't get me wrong, raises are very NICE (I am a single father remember), but aside from money, having the manager recoignize something that I did and provide me with a positive comment or feedback, made me feel appreciated and valued as a member of the team.
What do you do for your nurses in relationship to retention? Perhaps we can share some ideas of things that have worked for us. Also, nurses that are reading this forum might want to add a comment about what makes them want to stay at their current job. Like I said earlier .... sure money is great, but I am talking about things besides money.
I hope nurse managers are reading this thread. Some of the contributions are truly wonderful. I agree with treating professionals as professionals and also agree with not sweating the small stuff.
I have been a nurse manager for many years. Recently took a step to staff nurse and it has been a a truly refreshing change for me. However, I am now moving back into management and can take with me the lessons that I have learned as a staff nurse. I have always believed that nurses need to self manage their practice and for the most part, I think nurses appreciate this. In addition, I have always believed that a unit should function with the contribution of the whole .... the manager serves as a catalyst and coordinates the differing perspectives from the whole.
Nurse managers are often the middle person and take a lot of guff from administration and take a lot of guff from the nurses. There have been plenty of threads that have asked the question of whats happens to a nurse when they move into management - do they lose their understanding and compassion for the floor nurse? I submit that most nurses that enter into management are good leaders. They want what is best for the patient, the nurse and the unit. However, there are many challenges that nurse managers face. First and foremost is staffing .... this is a 24/7 responsibility and can be totally exhausting. And .... before anyone says ... "well you get the big bucks for being in that position," I have to say that a great many nurse managers do not make as much as you might think when you consider the 24 hour call, 50-60 hours a week and staffing other shifts when nurses call off and there is no replacement. Yet, I am thankful that there are nurses that want to handle this responsibility and make life for the staff nurse a little better. At least this is my goal.
I would love th hear from other nurse managers out there and what their perspective is. I think this thread has turned out to be a wonderful information source for nurse managers and what nurses actually want to be happy and stay in their current position. I have to admit that the nurse manager can only control so much ..... there are other influences that impact the operation of the unit. However, with that said ... nurse managers are responsible for creating a unit environment that can be nurturing, and focused on growth and development for the staff nurse.
Specializes in Gerontological, cardiac, med-surg, peds.
personally think that a lot of nurses are so stressed out because they're driven by fear--fear of losing a patient, fear of being sued, fear of being written up, fear of making a mistake, fear, fear, fear. Nurses have a real culture of fear ingrained into them from nursing school on.
Therefore, to have a great workplace culture, you don't want or need to threaten--the fear is already there so much that some nurses simply wake up one day and can't go to work, ever again. Fear. It ruins the joy that we take in our job.
You don't threaten--you encourage. You stop a negative behavior and show them the positive behavior. You stress that their success is important, that you--the entire team--wants them to succeed.
WOW! I really like what you say. You have summed up in a few sentences what I have been trying to do as a nurse educator. I really loathe the prevaling practice of intimidation and fear in nursing education.
OH God, I have just had the theatre managers day from hell!. Two resignations in one day, both from the same theatre team. There's something fishy going on here! yep, the surgeon has been dishing out crap for too long, to staff that aint takin it no more. I understand, but ... I have to find new staff... and I feel bad I didn't know, and didn't intervene to prevent this. I have only been in this position 9 weeks so I don't know all the issues, but I had a feeling this team and surgeon were brewing trouble. Anyway, he is on holidays now for 3 weeks, so I have a bit of a breather to find staff.
some of those measures are done in defense. The hospital has to take some action when lawsuits result from nurses not documenting correctly. We have trouble getting nurses to attend meetings to discuss just about anything. After 12 hrs everybody wants to go home (me too!) and there is no one to take their place if they leave the floor. Never ending cycle. We have tried suggestion boxes, paying them to come to meetings, just about everything. But people are apathetic. Really a shame, because nurses have so much to offer and their input is valuable.
I have found that RN/LPN retention is one of the most important parts of my job as a nurse manager. I think a decent compensation package (salary and benefits) goes a long way to helping nurses stay in their job, but the single most important thing I have found has been whether a nurse feels like he/she is appreicate and valued. y.[/quote
*Ding, Ding. Ding-We have a winner :)
You expressed it exactly. I'll take a lower paying job in a hospital or clinic, where the employees are appreciated over a high paying job, where you're just another employee number.
By the way, Can I come work for you ?
It doesn't cost a lot of money or time for a supervisor, manager, or upper management to just say "Thank you" once in a while. As in, "Thank you "for working overtime, comeing in on your day off, taking care of that difficult patient, etc.
We have a quality assurance team that reviews our work and not once in 6 years, have I ever had even a post it note from them acknowledging my going the extra mile for a patient or what I know was excellent care for medically complex patient.
I have found that RN/LPN retention is one of the most important parts of my job as a nurse manager. I think a decent compensation package (salary and benefits) goes a long way to helping nurses stay in their job, but the single most important thing I have found has been whether a nurse feels like he/she is appreicate and valued. y.[/quote
*Ding, Ding. Ding-We have a winner :)
You expressed it exactly. I'll take a lower paying job in a hospital or clinic, where the employees are appreciated over a high paying job, where you're just another employee number.
By the way, Can I come work for you ?
It doesn't cost a lot of money or time for a supervisor, manager, or upper management to just say "Thank you" once in a while. As in, "Thank you "for working overtime, comeing in on your day off, taking care of that difficult patient, etc.
We have a quality assurance team that reviews our work and not once in 6 years, have I ever had even a post it note from them acknowledging my going the extra mile for a patient or what I know was excellent care for medically complex patient.
If you are ever in Western North Carolina - be sure to look me up for that job! :)
I agree with you. A simple thanks or some other form of appreciation goes a long way.
I have found that RN/LPN retention is one of the most important parts of my job as a nurse manager. I think a decent compensation package (salary and benefits) goes a long way to helping nurses stay in their job, but the single most important thing I have found has been whether a nurse feels like he/she is appreicate and valued. Over the years, I have involved nurses in the management of the unit, asking for their input on policies, scheduling and many more things, but I have found that the single most important thing for a nurse to stay is that pat on the back and a simple thanks for the hard work.
Over the last year, I have worked as a staff nurse and realized more than ever, that being appreicated is almost worth as much as getting the pay check. Hello .... please don't get me wrong, raises are very NICE (I am a single father remember), but aside from money, having the manager recoignize something that I did and provide me with a positive comment or feedback, made me feel appreciated and valued as a member of the team.
What do you do for your nurses in relationship to retention? Perhaps we can share some ideas of things that have worked for us. Also, nurses that are reading this forum might want to add a comment about what makes them want to stay at their current job. Like I said earlier .... sure money is great, but I am talking about things besides money.
I strongly believe that being receptive to ideas and suggestions nurses submit can make them feel like a very valued part of the organization. Flexibility in allowing nurses to participate in choosing their work schedules is an also an excellent method of retention.This really works well where I am employed. Nurses work with each other to make certain that shifts are covered, which provides them with a sense of satisfaction, and poor attendance is less of a problem.
I strongly believe that being receptive to ideas and suggestions nurses submit can make them feel like a very valued part of the organization. Flexibility in allowing nurses to participate in choosing their work schedules is an also an excellent method of retention.This really works well where I am employed. Nurses work with each other to make certain that shifts are covered, which provides them with a sense of satisfaction, and poor attendance is less of a problem.
Excellent points and I do agree. As nurses feel involved and are able to voice their opinions about the environment in which they work, it leads to a better level of satisfaction. The best part of this is the ownership factor. Nurses that feel connected to their unit and their team are more likely to work toward solutions to problems rather than being the problem.
I work as a staff nurse in a SNF and have seen an unbelievable turnover. I think a lot of it boils down to respect from administration. Last week I was written up for not taking a 20 minute break!!!! And that was 3 months ago!!! Many of us have had similar experiences. I am a professional and feel that these punitive measures are insulting. Listening to staff is important also...obvious favoritism...the bennies and pay are important too...but nothing brings down morale faster than pointing out trivial matters and not showing appreciation for what we do. Administration is so gung ho on filling openings and getting bonuses for not having agency that they dont listen to us when we tell them someone needs extra time with orientation...consequently someone almost died because the new nurse made an error. well, I could go on....but I wont Thanks for listening
I really like this thread. I'm probably one of those few that are looking to go into administration. The purpose being is that I hope to be a good advocate for nurses, realizing and appreciating all the hard work needed.
Always have all the resources necessary to do the required job.
Only admit nice easy going friendly patients
some fancy robots to do all the documentations automatically
-Dan
all good points...
I have worked w/ managers that supported their staff...and those that didn't.
Definately makes a big difference.
Continuing Ed would be nice...I am 23 years in my field, so the little "in-house" attempts at CEUs are boring...an annual stipend for quality higher ed would be nice
I want to know how to limit the patients to only nice, friendly patients!
In L&D, we get visibly excited when we have married, educated parents! LOL!
How about microphones on a lapel clip so we can just dictate our notes as we go? Woouldn't this be a big help?!?
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
What do you do for your nurses in relationship to retention? Perhaps we can share some ideas of things that have worked for us. Also, nurses that are reading this forum might want to add a comment about what makes them want to stay at their current job. Like I said earlier .... sure money is great, but I am talking about things besides money.
Here's what NOT to do:
Announce at the staff meeting that you know turnover has been horrendous, but it's because you're hiring the best and the brightest, and they go on to bigger and better things. After all, anyone who would stay in a staff nurse position in this unit for a decade has to be mediocre. (This is why I left my last job -- the final straw anyway!)
Announce that you have self-scheduling in a computerized system and that once the staff member has inputted their schedule, it's written in stone. Then change around everyone's scedule before posting the final draft.
Take the MD's side every single time there's a dispute between a nurse and a physician. After all, the MD has more education and makes more money -- that makes him right all the time, doesn't it? No need to listen to the nurse's side of the story.
Take the patient/family's side every time there's a complaint. No need to hear what the nurse has to say. The customer is always right.
In fact, no need to support your staff at all!
Be quick with criticism, slow with praise. After all, they're supposed to be doing things right, so why should you have to recognize it?
Take overtime for granted. After all, work is more important than families, hobbies, church, etc.
Float incessently. Overstaff your unit on the holidays because you know other units are going to need help.
Fail to reward seniority in any way. That might piss off the new people.
Do not engage in small talk. The staff might begin to see you as human or, worse, begin to think that you see them as human!
Do not aknowlege a staff member you see outside of the work environment. See above.
Fail to learn the names of your staff. After all, they're interchangable anyway. (Actually had a manager tell me this is why she couldn't remember my name.)
Don't get to know the strengths and weaknesses of your staff. That's what you have assistant managers and charges nurses for after all.
"Forget" to pay overtime, charge pay, preceptor pay, etc. After all, aren't nurses working to help people?
Circulate a memo outlining the criteria for selection as charge nurse. Have everyone write an essay explaining how they meet the criteria. Give the position to the people you like the best even though they clearly do not meet the criteria. Explain that as manager, that's your perogative. Don't apologize when the folks who DID meet the criteria express disbelief or anger.
Counsel your assistant managers for rating everyone too highly in their evaluations. After all, if you have to promote someone up the clinical ladder, they get a pay raise and that will increase the staffing budget.
Have a list of criteria for being promoted up the clinical ladder. When someone meets all of the criteria, explain to them that now they have to jump through an additional hoop before they can be promoted. Keep this up until they quit.
I've experienced ALL of this. There are precious few good managers out there! I've been fortunate enough to have a couple of good managers, but not recently.
RNPATL, DNP, RN
1,146 Posts
I hope nurse managers are reading this thread. Some of the contributions are truly wonderful. I agree with treating professionals as professionals and also agree with not sweating the small stuff.
I have been a nurse manager for many years. Recently took a step to staff nurse and it has been a a truly refreshing change for me. However, I am now moving back into management and can take with me the lessons that I have learned as a staff nurse. I have always believed that nurses need to self manage their practice and for the most part, I think nurses appreciate this. In addition, I have always believed that a unit should function with the contribution of the whole .... the manager serves as a catalyst and coordinates the differing perspectives from the whole.
Nurse managers are often the middle person and take a lot of guff from administration and take a lot of guff from the nurses. There have been plenty of threads that have asked the question of whats happens to a nurse when they move into management - do they lose their understanding and compassion for the floor nurse? I submit that most nurses that enter into management are good leaders. They want what is best for the patient, the nurse and the unit. However, there are many challenges that nurse managers face. First and foremost is staffing .... this is a 24/7 responsibility and can be totally exhausting. And .... before anyone says ... "well you get the big bucks for being in that position," I have to say that a great many nurse managers do not make as much as you might think when you consider the 24 hour call, 50-60 hours a week and staffing other shifts when nurses call off and there is no replacement. Yet, I am thankful that there are nurses that want to handle this responsibility and make life for the staff nurse a little better. At least this is my goal.
I would love th hear from other nurse managers out there and what their perspective is. I think this thread has turned out to be a wonderful information source for nurse managers and what nurses actually want to be happy and stay in their current position. I have to admit that the nurse manager can only control so much ..... there are other influences that impact the operation of the unit. However, with that said ... nurse managers are responsible for creating a unit environment that can be nurturing, and focused on growth and development for the staff nurse.