Introduction
The shortage of qualified nurses is a truth in the global situation: the US, the UK, Australia and other nations. In the US alone, the shortage is expected to be 400000 over the coming twenty years (Perrine, 2009). Retention of registered nurses has become a dire necessity. A challenge has evolved for nursing leaders to retain RNs with special skills as there exists a competition for experienced RNs in the nursing market. Inability to retain these qualified personnel may cause catastrophic consequences in the health care facilities in the form of financial deficits, dismal quality care and malpractices (Perrine, 2009). The discussion here intends to elicit the various causative factors which contribute to the issue and hopefully find means to correct the situation as far as is possible. Though the topic is a highly debated crisis, this team will sincerely participate to share their thoughts and discuss practical points on how to remain in the profession and what factors could be changed to do so. Most points are expected to come out into the open for discussion. All members of the team will be given roles of questioners; the questions are being prepared earlier so that each member of the team asks questions which I, as the mentor, will be replying. The matter for discussion will be incorporating the information gathered from literature and is given below.
Main Body
Every professional RN has her own perception of a satisfying job. The majority are caring and competent members who work within a similar environment cheerfully (Challis, 2009). Pofessional practice involves the administration of quality care to patients.
Job dissatisfaction has been described as a major factor for RNs leaving the profession (Perrine, 2009). Studies have found that burnout, low salaries, and little time with patients due to other responsibilities and other incidental events in their lives have worked towards their leaving. Effective strategies have to be evolved to overcome the tendency to move out at the slightest hint of dissatisfaction.
Baggot et al have suggested a strategy which stabilizes a relationship between the preceptors and nurses (2005). Improving the teaching skills of the preceptors should help the transition of new nurses into their practice and the hiring of new nurses. Retaining the older experienced nurses and training them to become good teachers would help in producing a new generation of RNs who have had an effective training at the hands of nurse leaders who have the backing of their vast experiences in the field (Baggot et al, 2005). Shortage of the nurse educators directly affects the nursing shortage (Halcomb et al, 2007). Qualified nurse educators must be retained at all costs. Retirement age must be modified for this. Academia would do well to retain them and not allow them to join the private sector. Their many stressors must be noted and support strategies be made in the policies to accommodate these aging but capable educators (Halcomb et al, 2007).
Providing the nurses a chance to participate in the decision-making and the governance provides them greater autonomy. This participative environment ensures a greater job satisfaction than in an autocratic one (Tang, 2003). The shared governance model can be practiced at the unit level too. Empowerment in a collaborative surrounding where respect is obtained and decision-making is permitted is what nurses desire (Vaughan, Healthleaders). The staff members would then have significant influence on the professional issues, practice and working conditions (Perrine, 2009). “Self-scheduling”, speaking practice before the unit council members to present issues, taking the advice of the performance improvement teams and assisting in the policy matters all help to raise the autonomy of the nurse (Perrine, 2009). Flexible scheduling allows the nurse to maintain an equilibrium between her professional and personal lives (Vaughan, HealthLeaders). Participation in planning committees is another move to strengthen the autonomy of the nurse. Mentoring programmes could help her fit into her new workplace. Assisting her to improve her career and providing opportunities to progress through continuing education opportunities is another strategy to retain the graduate nurse (Vaughan, HealthLeaders).
The efforts of the leaders of the smallest unit, like the acute care unit, to implement strategies would enhance the nurses’ perceptions of respect in that unit or organization. The leaders can ensure that the opinions of the subordinate nurses are given due recognition which conveys the information that she is being valued with dignity and worth (Tang, 2003).
Recognition of their achievements in private and public and paying individualized attention to their shared thoughts would score highly amongst them. Their confidence remains boosted. The leaders can send emails and letters to all the staff of the hospital or publish this commendation in a newsletter (Perrine, 2009). Encouraging them to set professional goals, the leaders can assist in competencies of clinical work and leadership by stimulating their assertiveness, public speaking and research.
Magnet hospitals in the US are able to attract nurses and retain them to provide quality care. It has been found that these hospitals have a retention rate twice as much as the other hospitals (Trossman, 2002). The work environment is cordial and instigates job satisfaction. Better patient outcomes are also seen.
A nurse manager who is bossy, unfriendly and abusive will be the single cause for the nurses to leave the job in a huff, however many benefits or perks or growth potential is possible (Vaughan, HealthLeaders). Providing training in conflict resolution, leadership styles and the methods of creating a positive environment could produce transitions in the managers which would keep nurses from leaving. Managers who simply cannot change even with all the training are the ones who are preventing nurses from staying back because they do not possess the emotional intelligence or personality traits to be effective leaders; they should be given other jobs or their workload must be reduced or shared out (Vaughan, HealthLeaders).
An important retention factor is the access of communication between the RNs and the leadership in the organization (Tang, 2003). Nurse leaders can manage this by facilitating the communication process by implementing various committees within the unit and placing the nurses on them. Interdisciplinary team meetings, participation of the unit level nurse in hospital rounds and facilitating meetings between the nurse officer and the unit level nurse help the process (Tang, 2003).
Healthcare organizations have become diverse in generations so that even four generations of nurses still work together (McNamara, 2005). The diversity is seen in the changes of social, economic, public policy and society attitudes (Kupperschmidt, 2000). Values towards work, leisure activities and even thoughts on authority could be different. Since the different generations could exist even in the smallest unit, the nurses must increase their awareness of the needs of the different generations; only then is greater job satisfaction and productivity possible. Lectures and seminars on the differences and occasions to appreciate one another could bring the different individuals together. The contributions of each must be highlighted whenever possible (McNamara, 2005).
Conclusion
The global crisis of the shortage of nurses is an enormous problem for the heath care services. Efforts to retain registered nurses within the health care services have become the need of the hour. Research has elicited many strategies which can increase the retention rate of RNs.
Good salaries or compensation may not be the only factor that attract and retain nurses: job satisfaction is a major criterion. Retaining capable senior nurses as nurse educators and managers affect the retention of nurses directly. The senior educators play a significant role in the transition of new nurses into their practice. Leadership qualities of the managers and other senior nurses assist in soliciting the cooperation of the nurses in sharpening their skills through shared governance, improving their perceptions of respect, training them to speak and communicating with the other members of the organization. The achievements of the nurses are recognized publicly and their morale and confidence are boosted. As bad nurse managers can put off new RNs, training them in helping to retain the nurses is equally necessary. Valuing the generational diversity is important and the different generations need to view each other with respect and dignity.
References
Baggot, D.M. (2005). “The New Hire/Preceptor Experience: Cost-Benefit Analysis of One Retention Strategy” Journal of Nursing Administration, Vol. 35, No.3 , p. 138-145.
Challis, A. (2009). “RECRUITMENT & RETENTION REPORT: An appreciative inquiry approach to RN retention”. Nursing Management, Vol. 40, No. 7. Convera Inc.
Halcomb, K. et al. (2007). “Implementing supportive strategies to retain nurse educators” Teaching and Learning in Nursing, Volume 2, Issue 4, Pages 133-137.
Kupperschmidt, B.R. (2000). “Multigenerational employees: Strategies for effective management”. The Health Care Manager, Vol. 19 (1). P. 65-75.
McNamara, S.A. (2005). “ Incorporating generational diversity”. AORN J, Vol. 81 (6), p. 1149-1152.
Perrine, J.L. (2009). “Strategies to boost RN retention” Nursing Management, Vol. 40, No. 4, p. 20-22, Wolters Kluwer Health.
Tang, J.H. (2003). “Evidence based protocol: nurse retention”. Journal of Gerontological Nursing, Vol. 29 (3), p. 5-14.
Trossman, S. (2002). “Nursing magnets: Attracting talent and making it stick”. AJN, Vol. 102, No. 2, p. 87-89.
Vaughan, C. “Why nurses quit”. Web.