Nursing Shortages: Strategies for Retention & Patient Care

Improving Nursing Retention

With the constant shortage of nurses acknowledged, the staffing and retention of nurses continue to be an area of concern. In many hospital settings, improving nursing retention is a challenge and leaves most facilities short-handed. The goal is to keep nurses in the organization. Most nurses work twelve-hour shifts or longer, and managers need to acknowledge their loyalty and investment in the organization. Recent reconstructions in organizations with strategic planning have made many nurses feel organizations lack poor management skills and are not loyal to permanent staff, and the unequal distribution of nursing staff has forced many nurses to leave positions within the first year of hire.

“The most commonly expressed reasons were: unsociable hours, dissatisfaction with salary, workload, poor image of the vocation, and lack of recognition in the workplace” (Nyssen et al., 2018, p. 239). Nurses devote themselves to staying within an organization related to benefits, and with many years of investment, they have seniority and they are in a comfort zone. “To this end, job satisfaction is comprised of various components, including; job conditions, communication, the nature of the work, organizational policies and procedures, remuneration and conditions, promotion /advancement opportunities, recognition/appreciation, security and supervision/relationships” (Halcomb et al., 2018, p. 1).

Strategies

Nurses no longer work hard for the money. I can validate that ten years ago, the unit I worked on was a hard-working, highly motivated group of team workers. This unit was my family away from home. During this period, the organization went through a reconstruction at the hospital, and the unit was closed until further notice. Nurses were moved to other units, and nurses lost their jobs. Nurses were devastated. Eventually, they no longer had weekend options, and this caused a Tsunami effect at the hospital. This forced nurses to seek employment in other surrounding hospitals.

The devastation caused mixed emotions, but the organization brought back only three positions for the weekend option. So many nurses left, and with few weekend option positions went to people who had been there the longest mostly. I was a misfit on another unit, and the staff resented me. I cried for months because I lost a family of co-workers. “Other factors identified to negatively impact job satisfaction included; a lack of recognition, poor role clarity, and poor organizational communication” (Halcomb et al., 2018, p. 11).

The organization began hiring travel nurses, but at what cost? Many nurses felt the organization was not dedicated to permanent staff. Travel nurses had more privileges than permanent staff, including no-call days, and travel nurses could make their own schedules. This resulted in low morale in units. On some days working during the week, only one nurse was the only permanent staff. “As hospitals move away from employing staffs composed of core RNs and toward employing higher shares of contract RNs, they have fewer patients who are highly satisfied” (Hockenberry & Becker, 2016, p. 908). Nurses function at many levels. However, the most important aspect of effective nursing and to decrease nurses leaving an organization is to build relations based on teamwork. “Good team functioning is associated with improved patient outcomes, heightened staff satisfaction, and reduced burnout (Miller et al., 2018, p. 1).

“With a historical background of nursing available to us, we can look back and learn from the past, those practices that did not help nurses to function effectively and improve upon them” (Samuel & Edward, 2016, p. 14). Nurses find it difficult to manage higher patient acuity, and nurses are burnout with the fast-paced demands of patient care along with short-staffing. Organizations should base patient care on acuity, not based on the number of patients, for strategic planning. “In order for optimal patient outcomes to be realized, nurses must be able to deliver the safe, quality care that patients deserve” (Chovanak, 2017, p. 6). This decreases nursing burnout and allows nurses to deliver high-quality patient care and gain independence and trust in their capabilities to stay committed to organizations.

In conclusion, the goal of every hospital is to develop and retain a nursing team dedicated to high-quality patient care. Currently, nurse retention and recruitment are priority issues in every health organization. The fundamental goal is to teach teamwork, so nurse leaders can work together efficiently to retain new nurses and provide excellent patient care as a team. Effective leadership in hospital units directly affects the satisfaction of nursing staff, and employees are interested in executives who can guide and manage the staff in a positive and encouraging way. (Krepia, Katsaragakis , Kaitelidou, & Prezerakos, 2018, p. 192). There are pros and cons to each side; however, nursing is a profession with many specialties of care, and it is the organization and nurses who help guide the recruitment of nurses.

References:

1. Chovanak, L. (2017). EDITOR’S NOTES. Why Reducing Nurse Fatigue Has an Economic Benefit to Hospitals. Ohio Nurses Review, 92(6), 4-7. Retrieved from Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=129053205&site=eds-live&scope=site
2. Halcomb, E., Smyth , E., & McInnes, S. (2018, August 1). Job satisfaction and career intentions of registered nurses in primary health care: an integrative review. BMC Family Practice, 19(1), pp. 1-14. doi:https://doi.org/10.1186/s12875-018-0819-1
3. Hockenberry , J. M., & Becker , E. R. (2016). How Do Hospital Nurse Staffing Strategies Affect Patient Satisfaction? ILR Review, 69(4), 890–910. doi:https://doi.org/10.1177/0019793916642760
4. Krepia, V., Katsaragakis , S., Kaitelidou, D., & Prezerakos, P. (2018). Transformational leadership and its evolution in nursing. Progress in Health Sciences, 8(1), 189-194. doi:https://doi.org/10.5604/01.3001.0012.1114
5. Miller, C. J., Bo, K., Silverman, A., & Bauer, M. S. (2018). A systematic review of team-building interventions in non-acute healthcare settings. BMC Health Services Research, 18(1), 1-21. doi:https://doi.org/10.1186/s12913-018-2961-9
6. Nyssen, A. S., Gillet, A., Sougné, J., Bidee, J., C. Gerimont, Pepermans, R., & Hansez, I. (2018, August 1). Do management and executive share the same perception on the critical issues facing the front-line nursing staff? International Journal of Healthcare Management, 11(3), 239–242. doi:https://doi.org/10.1080/20479700.2017.1353786
7. Samuel, A.-G., & Edward, B. (2016, January 1). Nursing in Ghana: A Search for Florence Nightingale in an African City. International Scholarly Research Notices, 1-14. doi:https://doi.org/10.1155/2016/9754845