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How to Attract and Retain Great Nurses

It's a well-known fact that the nursing profession currently suffers from a significant and growing worldwide shortage. According to a report released by the Joint Commission on Accreditation of Healthcare Organizations, there are 126,000 nursing positions unfilled in U.S. hospitals nationwide. With the aging of the nation's baby boomers and the nurses themselves, the report estimates the nursing shortage will reach 400,000 by 2020.

Various approaches are being taken to address this serious situation in the United States, including hiring bonuses, increased wages and benefits, increased contract/agency nurse staffing, lower selection standards, new or increased foreign recruiting efforts, financial support for completing education... the list goes on and on. But while most of these initiatives address the symptoms of the shortage, only a few address the fundamental causes.

Many healthcare organizations point to the shortage as the key reason they cannot attract nurses to their organization ("There just aren't enough"). But imagine if the nurses in a hospital felt so positive about their workplace that they told other nurses, "Come work at my hospital"? Or even "You should consider nursing as a profession, and then come work at my hospital"?

While it's been well documented that one of the best sources of new employees is referrals from current employees, the majority of nurses that Gallup surveys say they would not recommend their organization to other nurses -- in fact, only 29% say they would do so. However, for the hospitals in which workplace engagement and satisfaction are a priority, the number of recommendations is dramatically higher.

The net results are higher retention, engagement/satisfaction, and productivity of the current nursing staff, as well as a continuous flow of referrals from the engaged staff members within the hospital. In these organizations, workplace culture becomes a competitive advantage.

In my years as a healthcare consultant, I have discovered that many of the most successful healthcare organizations do several things to set themselves apart in the areas of recruiting and retention of quality nurses. They include the following:

1) They hire first and foremost on the basis of talent. They select their nursing staff based on an empirical study of the best nurses. They realize that education and experience are not enough if an applicant lacks empathy, a strong sense of responsibility or motivation. They hire people who have the "unteachable" qualities vital to successful nurses, and worry about helping them to acquire the teachable skills later.

These hospitals reject the idea that they simply need "warm bodies" to fill open positions -- even in times of shortage. In its most recent research efforts to develop the latest generation of selection tools for nursing, Gallup discovered that the second most common reason that top-performing nurses say they have or would leave their organization is, "working with ineffective colleagues."

2) These organizations extend the theory of "recruiting for talent first" to selecting and promoting nurse managers. They don't hire or promote people to management positions based on skills and knowledge, but rather they look for those with the "right wiring" or talent for management. Gallup research has shown that the best managers (regardless of industry) are "hard-wired" with special traits such as responsibility, discipline, courage, team-building and problem-solving. Organizations that select managers with these qualities have more talented, effective, engaging and productive management teams, which in turn encourage higher retention levels and referrals from other talented employees.

3) The best hospitals continually focus on the development of their staffs, with an emphasis on the maximizing the strengths of each individual. They help staff members to identify their talents and skills, and focus on how to make best use of those talents and skills. They continually ask themselves how they can maximize the response to the question, "Do our people have the opportunity to do what they do best every day?"

Key Points

The best solution to the nursing shortage is not to focus on short-term quick fixes. The key to retaining excellent nurses and nurse managers is to hire the right people in the first place -- to select for talent first and then skills or experience, and continue to nurture and develop the talents of each individual. If talented people are hired into jobs that complement their strengths, they will be happy and productive and recommend their organizations to others.

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