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Effectively Engaging Your Nursing Staff

High nurse retention rates enjoyed by employers during the Great Recession may quickly evaporate as the economy recovers.

As the economy begins to show subtle signs of improvement, organizations - including, and perhaps especially healthcare organizations - are at risk of losing valued staff who choose to either move to another organization or retire.

In fact, in healthcare particularly, staffing issues loom as the country prepares to address changes precipitated by healthcare reform.

Are you doing what you need to do right now to fend off impending transitions among your staff?

A Perfect Storm

David Delong, PhD,  is the author of "Lost Knowledge: Confronting the Threat of an Aging Workforce (Oxford University Press, 2004), and works frequently with nurse leaders.

"The aging nursing workforce has kind of been put on the back burner since the Great Recession," acknowledges Delong. But, he says, "that could all come to an end very fast, as veteran nurses who have delayed retirement suddenly start calling it quits."

The issue is probably more prevalent in nursing than in other professions given that more than 50%of the RN workforce is age 50 or older, according to a 2013 survey conducted by the National Council of State Boards of Nursing and The Forum of State Nursing Workforce Centers.


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Many organizations may have been lulled into a false sense of security as their seasoned nursing staff stayed on board, hesitant to retire in a tight economy. But that sense of security is likely to fade rapidly in the not-too-distant future.

In addition, notes Delong, "as the nursing workforce ages, veteran high performers are much more likely to be asked to mentor younger staff. They're also more likely to be called on to participate in performance improvement initiatives." This, he says, can lead to burnout and result in "unwanted turnover or premature retirement of your most valued managers and clinical staff."

Consequently, the goal for all healthcare organizations is to ensure that they are engaging all members of their nursing staff effectively.

"The loss of some experienced nurses is inevitable," says Delong. "But, smart leaders don't wait to create a pipeline of younger staff to step in."

A Role for Leaders

Donna Nickitas, PhD, RN, CNAA, BC, is editor of "Nursing Economic$," and reports regularly on issues affected nursing and healthcare. The recent IOM report, "The Future of Nursing" provided the evidence needed to engage stakeholders, policymakers and business leaders in doing everything they can to advance the healthcare around the nation, says Nickitas. There is much that they can do, she says:

"On the education side, we have to make sure that we have funding for school and grants available so we can prepare the workforce and support them in their academic endeavors.

"On the clinical side we have to make sure that nurse leaders and healthcare administrators provide a healthy work environment-that means that we staff appropriately and have the resources available so staff can practice to the full extent of their scope and training.

"And, then, of course, we have to ensure that we have government support. As the Affordable Care Act comes to full fruition under the law, more and more Americans are going to be using healthcare and they need the providers to do that."

This means, she says, that "we will look to our advanced practice nurses, our nurse practitioners, our clinical nurse specialists our nurse midwives and our nurse anesthetists to take up the care that's going to be needed."

Engaging nurses in the workplace, she notes, is predicated to a large degree on ensuring that staffing levels are appropriate. That is, she says, one of the biggest drivers of satisfaction - and dissatisfaction.

Following are some things that you should be doing now to build a culture of engagement at your facility.

Building an Engaged Nursing Staff

It is, or should be a given that staffing levels should be established so as not to tax nurses and, by association, not put patients' safety at risk. Beyond that, there are other things that organizations and their leaders can do to boost engagement.

 "Obviously you want to make sure that you have a workforce that feels supported and engaged," notes Nickitas.

Delong agrees and points out that "immediate supervisors make or break the experiences of their nursing staffs," says Delong. "Progressive nurse executives continually strive to keep the workplace positive." Certainly that can be difficult to do in an environment of continuous change and uncertainty, but it is an imperative.

Magnet hospitals provide a good example of organizations that have made this commitment, says Nickitas. "Many institutions have not committed themselves to the Magnet journey, or already have Magnet status and we know that Magnet institutions engage their nurses through self-governance or shared governance where nurses are involved in decision-making on a daily basis right at the bedside."

That autonomy and involvement are crucial and go a long way toward ensuring that nurses recognize the value they provide and have a sense of personal contribution and accomplishment.

Being part of a safe and supportive institution is also important, says Nickitas. Nurses will be engaged when they are part of an environment where they are not bullied and threatened - where there is a sense of respect, she says.

These are organizations where "nurses are listened to and feel they are contributing not only to themselves, but to the patient's welfare and the families as well," Nickitas says.

Still, despite the best efforts of many healthcare organizations to retain their nursing staff, it is possible to avoid what will be the eventual, and inevitable retirement, of large numbers of nurses.

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Looking Ahead

Organizations can prepare for this inevitability, says Nickitas, by planning now and taking steps to ensure that new nurses receive the support, coaching and mentoring they need and by considering some creative ways they might maintain the value of the talent and experience that retiring nurses can provide.

"As the economy gets better I think organizations are going to be smarter and they're going to say 'is there a way to engage this aging Baby Boomer generation in new and different ways so we can continue to reap the benefits of their talents and expertise?'"

That might mean, she says, offering part-time opportunities, engaging with retiring nurses in consultative arrangements or asking nurses to serve on advisory boards. Nurses have much to contribute and can provide value in a variety of ways.

"Not all care is acute," she notes. "Nurses can be patient advocates, navigators, they can serve their communities on local governmental boards, PTAs, local churches, local synagogues - there is so much nursing value to be added to this society and we have to make sure we don't lose that."

For nurses, for now, the best thing that their leaders can do to ensure that they remain engaged is to open up conversations around what they need, what they are receiving, and where the gaps may be in terms of their current and potential future contributions to the organization, the community - and society as a whole.

Lin Grensing-Pophal is a freelance writer.

At Work Archives
  Last Post: February 20, 2014 | View Comments(3)

This article was forwarded to me by one of the outstanding nursing professionals with whom I've had the pleasure of working for almost two years. Well written, informative and right on target! Thank you for highlighting issues, approaches and evidence to support what so many of us (RNs over 50 years of age) have been trying to explain to 'the powers that be'. Many in my age group have returned to school, as have I, to earn doctoral degrees (I graduated with my DNP in May 2012). We are rich in experience and have much to offer. Your focus on this is greatly appreciated!

Nancy ,  Director of Care ManagementFebruary 20, 2014

good article

Connie February 19, 2014

Nurses contribution to health care evolution stems from their ability to be effective and efficient in holistic care continuity. Their ability to address patient-family physical, mental, economical, spiritual, cultural, etc needs: especially for low income, rural communities with high risk chronic conditions requiring multiple hospitalizations due to lack of various barriers. As nurses advance in education and practice through evidence-based initiatives provide care outcomes that exemplify reduce hospitalizations, improved community-based outreach education, eliminate inappropriate resource utilization/cost effectiveness, enhance patient/family adherence while improving treatment outcomes which improves quality of life.
Nurses employ the Healthy People 2020 and other conceptual frameworks as standards for measuring evidence-based health outcomes in addition to patient satisfaction. This is not a new phenomena. Nurses are abreast that certifications, competencies, CEUs, research, etc provides the basis for their ability to maintain or change clinical practice especially when collaborating with other disciplines. In addition, this demonstrates an environment of Magnet readiness or sustainability.

Mary Mites Campbell,  Adjunct Professor,  University of PhoenixFebruary 19, 2014
Plantation, FL


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