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 was a manager until about a month or so ago. I came back from vacation to find my job was given to a corporate person. I was told by email. I attempted to find out what my new job title was.........ugh no one knew. I ended up taKing a job description out of the policy manual and signing another one for other duties I did there.
I would have to say respect is the most important..........
I started this thread in an effort to get some feedback and I can see that many nurses have been treated very poorly. For me, this thread has been a good barameter to ensureing that I do treat my staff well. I work hard each day to acknowledge and recognize the contribution of my staff members. Listening is probably the single most important aspect of what I do. As far as supporting the nurses .... my sense is that the nurses are correct until they are proven wrong when there is a dispute with a physician or family member/patient. Regardless of who is right or wrong, I expect physicians and other health care professionals to treat my nurses with respect. They are awesome people and really do a great job! Thanks for all the great responses.
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.
Gosh, sounds just like my current director/manager. I mean, to a T. I've never seen our unit morale as low as it is now. I've been there so long that I'm determined to outlast this person. But what a piece of work.
Don't forget:
1)blatant lying when challenged on inappropriate comments, as in "No I didn't say that", when you heard it with your own ears;
2)a cruel sense of humor, rather than a good one
3)announcing during a staff meeting "I will never help with patient care, that's not my role, so don't expect that";
4)telling charge nurse after she has spent hours trying to find staff for the upcoming shift which is 5 people down "what do you want me to do about it".
These are true instances, with no exageration(sp?). I've had some decent managers, none so good as some of the people on this forum sound, but pretty good ones. This one we have right now I have no respect for. Gives a very bad name to all things corporate. Doesn't even talk or act like a nurse, just like a company business person.
I applaud those who have written here about their own management styles, and commend you. I would love to have any one of you as a manager. I'm actually a staff nurse who can be a manager's dream employee: I don't "gripe", but do make comments and suggestions, and try to maintain a mostly positive attitude; I work hard while I'm there, and help out others who have a heavier load; I'm a pretty happy person by nature, but I can't abide not being treated in a respectful and professional manner.
RNPTAL I am glad your listening. Thanks for caring enough to do that.
renerian
I have been a manager for most of my career - both in and out of nursing. I fundementally believe that people want to do a good job! They are generally motivated by appreciation from their boss. Listening is the single most important trait that a manager can possess. I have found that if I listen more than speak, I learn much more and I can also recognize the issue that the employee might be frustrated with. Sometimes, as managers, we are rushed from one priority to another and listening can be much more of a challenge than we might think.
I have also found that if an employee comes to me with an issue, I close the door, turn off the phone and pay close attention to the details. From the information I receive, I can make a decent and well informed decision or provide practical advice to the employee. So far, it works.
I am blessed! Where I work I have great co-workers (95% of time) . And administration does do little things for nurses. But sometimes I get totally befuddled over NM's. I do believe that JACHO requirements are a big part of some problems. Every year it is something else, so we have constant changes in the charting,etc. Plus where I work, we are headed toward total computerization, the latest I heard was by 2006, even the docs will do orders in computer. That will be nice (and med school will be able to eliminate that secret course for illegiable hand writing that was always required.) I too feel that the charting is too standardized-click here, click there, oh! Nothing fits the click I need. So then I type in the notes, but must remember that the first 5 words must be the eye-catcher, cause when reviewing the notes it is essential for those looking to be able to find that note fast, and only about 5 words show up on that screen. Plus the docs never review them I am told. At least there are committees that nurses can join to review charting and change the fromat and screens to improve them...but that also takes extra time and extra staff to cover the nurse that was assigned to floor that day and needs to do committee. Thankful that there are some computer savy nurses among us. It has been a real challange for me and if it were not for helping co-workers I don't think I could do my job any more. I think too that having a good team,and having the thank yous, and the decent pay and benefits are key to retention. Very few nurses where I work leave cause they are disgruntled.
Just found out this AM that my new manager lied to me and my coworker. We were told we had been mandated to work this weekend d/t short staff. Now we found out "pets" just had last minute plans and needed coverage. Guess Tim MacGraw is more important than their jobs. Guess I will be looking in paper in am. I might not be so angry if I was asked to work, not told a lie about it. I guess this manager needs to learn that it is better to be fair with all staff than have "pets" who get all of the breaks. :angryfire
Just found out this AM that my new manager lied to me and my coworker. We were told we had been mandated to work this weekend d/t short staff. Now we found out "pets" just had last minute plans and needed coverage. Guess Tim MacGraw is more important than their jobs. Guess I will be looking in paper in am. I might not be so angry if I was asked to work, not told a lie about it. I guess this manager needs to learn that it is better to be fair with all staff than have "pets" who get all of the breaks. :angryfire
barefoot - I am sorry that happened to you. How terrible that is for a manager to lie about coverage! Good luck with your search!
RNPATL....I would love to come work for you. Nursing needs managers like you. So far in my nursing years, I've only come across three nurse managers that impressed me. The rest suck big time!
Thanks Pat for the words of encouragement. Funny thing is I really don't mind working most weekends, like to be home with hubby during the week since he is having some major post cardiac memory problems. But, to lie about something so small leads me to wonder what will happen when there is a real emergency or a real need with this team. I have only been at this job for 3 months, already 6 people have quit. Some did not even show up for the second day of orientation. I have also been pushed into taking most of the patients who have more than one problem, medical along with psych, pain vs terminally ill, little things that I really think every nurse with few years experience under their belts should be able to manage. I have all of the vas cath care, all of the difficult labs sticks, all of the don't know where this one fits type of patients. The director said to me on Friday, "you have been a gold mine to us", Funny thing since I had to get a corrected pay check the same day. Hubby feels I am working too many hours and not getting the money or time off tocompensate for the hours. I guess I will just start thinking of going to visit my daughter again. I see lots of adds for RN's there. He would be with people who understand his current problems and I guess this group will lose another nurse who will not take the time to give them the straight answers they need to get this place running correctly.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
OH boy you have hit a nerve in me w/this thread. I have ideas and thoughts, but will hold back for now. I feel quite HOT about this issue, having felt a bit unappreciated lately by our management and administration. More on this later. Meantime, I am enjoying the replies I see here so far. You guys are right on target!
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
OH boy you have hit a nerve in me w/this thread. I have ideas and thoughts, but will hold back for now. I feel quite HOT about this issue, having felt a bit unappreciated lately by our management and administration. More on this later. Meantime, I am enjoying the replies I see here so far. You guys are right on target!
renerian, BSN, RN
5,693 Posts
I was a manager until about a month or so ago. I came back from vacation to find my job was given to a corporate person. I was told by email. I attempted to find out what my new job title was.........ugh no one knew. I ended up taKing a job description out of the policy manual and signing another one for other duties I did there.
I would have to say respect is the most important..........
renerian