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Hospitals Explore Innovative Nurse Retention Strategies


Reprinted with permission from

Hospitals know that it’s less expensive to retain the nurses they have than to recruit, train and place new ones. So as the nursing shortage drags on, hospitals and other facilities continue to look for new ways to keep their nurses right where they are. And some are learning that, sometimes, it pays to be creative.

Last year, the Florida Center for Nursing instituted a recruitment and retention program to encourage medical facilities to apply for small grants to launch their own unique programs. In 2008, the first year of the program, nine projects received funding.

One of them was Shands Jacksonville Medical Center in Jacksonville, Florida. Officials from Shands consulted with their staff for ideas for programs and studied research by Rose Sherman, RN, EdD, the director of the Nursing Leadership Institute at Florida Atlantic University. Finally, they decided to apply for funding so they could develop a new program to support the development of their charge nurses.

“Those are the folks that set the whole tone for the shift,” explained Tracee Holzendorf, RN, MSN, director of clinical services.

The medical center formed focus groups to get feedback on what would help charge nurses do their jobs better. They identified a few key areas, such as conflict resolution, multi-tasking and dealing with compliance issues. Then they set up two off-site sessions and invited 150 charge nurses to participate.

Almost 130 nurses attended the events, which included lunch, recreation at a local Dave & Buster’s restaurant and a keynote address by Sherman herself. The nurses also received a detailed manual of resources to aid them in doing their jobs. After the events were over, the hospital analyzed the program and crunched some numbers. One year later, the hospital has retained at least 95 percent of those charge nurses.

Holzendorf said the events were such a rousing success that the hospital plans to do it again, even without new grant funding. They want to continue to demonstrate to their charge nurses that they are committed to them.

“We’ve actually had folks from other places contact us about it,” she added.

Across the country in Scottsdale, Arizona, the Mayo Clinic instituted its own retention program for nurses who might get burned out from the daily stresses of their job. Recent studies have shown that nurses who get burned out tend to leave their jobs and their profession, which is regularly cited as a problem associated with the nursing shortage. So the Mayo Clinic settled on a target: stress.

“Stress keeps us from communicating effectively and it contributes to patient care errors,” said Debra Pendergast, RN, MSN, chair of the division of nursing services for the Mayo Clinic. “The stakes are high in a nurse’s job, with patient safety on the line.”

To tackle this issue, the hospital decided to institute a stress management program for its staff, starting with middle management leaders.

“The program educates staff on stress and it teaches them tools to recognize stress and decrease it in the moment,’ she said. “It teaches them breathing techniques and the power of positive emotion to change their thoughts and their reactions.”

“And it shows them that we care about them and their health,” Pendergast added.

The results were very encouraging. The participants filled out post-workshop questionnaires and reported a significant improvement in decreased fatigue and anger, as well as fewer aches and pains from learning to use the stress management techniques. The hospital plans to continue the program.

What are other interesting options that hospitals could investigate in order to maximize their efforts to recruit and retain their nurses?

Barb Averyt, program director for the Arizona Hospital and Healthcare Association’s Patient Safety and Workforce division, ticked off a list of other recruitment and retention efforts that have been successful for certain Arizona hospitals. Many focus on improving the working situation for nurses.

She noted that magnet status, a designation awarded by the American Nurses Credentialing Center for facilities that exhibit excellence in nursing, is always a draw for nurses. Growing their own nursing students is another initiative undertaken by some Arizona hospitals; they sponsored students to attend nursing school, with the students promising to work there when they graduate. And more hospitals are dedicating valuable resources to establishing comprehensive orientation and training programs for new employees.

“When those nurses go out onto the unit, they are very comfortable with the hospital processes,” Averyt said. “The turnover rate for those hospitals have dramatically dropped. Overall, it’s just a win-win.”

Bernadette Melnyk, RN, Ph.D., dean of Arizona State University’s College of Nursing and Healthcare Innovation, agreed that hospitals need to make sure they are creating a work environment that is supportive of nurses—and of evidence-based practice.

“Nurses need to feel supported,” she said. “They need to feel they have people to turn to, perhaps mentors who can help them learn how to deliver the best possible care and be satisfied by their jobs.”

“Nursing schools produce the nurse and hospitals make it a workplace that will make them want to stay in the profession,” she noted.

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