Addressing the Shortage: Recruitment Efforts are Key
By Jennifer Larson, NurseZone feature writer
While many hospitals in the nation are looking at ways to retain their nurses in the midst of a growing nursing shortage, others are realizing that recruitment of new nurses is crucial, according to many experts.
Nursing schools around the U.S. have started up programs to teach young people about the potential of a nursing career, and now hospitals are starting to follow suit.
Scripps Memorial Hospital Encinitas in the San Diego, California, area, decided to start its recruitment efforts with students at nearby schools. Elementary, middle, and high schools, to be exact.
Natalie Germuska, RN, MSN, director of the hospital’s inpatient services, and several of her nursing colleagues created a program called Nursing Ambassadors, patterned after a national program designed by the Coalition for Nursing Careers in California.
So far, the team of nurses has participated in a career fair at a local high school and talked to a classroom of students at an elementary school. They answer questions about the differences between doctors and nurses and explain how they use technology in their work, too.
"We just want to make sure that people understand what nursing is really all about," Germuska said, adding that the group wants to clear up misconceptions about nursing and pique the students’ interest in nursing as a future career.
"Why not have them say, ‘I want to be a nurse,’" she said.
Others say that recruitment and retention are and should be intertwined. Liz Jacobs, RN, spokeswoman for the California Nurses Association, approves of ambassador programs designed to educate youth about nursing, but she emphasizes that the hospital workplace issues must also be addressed to retain those future nurses once they become part of the workforce.
"Ultimately, if a nurse gets out of nursing school and finds the whole reality a shock...you’re not going to retain those nurses for very long," she said.
To achieve recruitment goals, the nurses who are already working in hospitals must feel good enough about their working conditions to convey this to potential colleagues, said Brenda Nivodjon, RN, MSN, an associate clinical professor at the Duke University School of Nursing. That also goes back to creating a good working environment.
"If your own staff aren’t recruiting for you and talking positively about your organization, you will have trouble getting people to come," she said.
Tallahassee Memorial Hospital’s senior vice president for nursing, Ann Evans, RN, agrees that creating a satisfactory work environment should be a priority. Meanwhile, her hospital will continue with its new strategies and see what works.
"We have to work very hard on recruitment, and we have to work equally hard of retention," she said. "We’re trying to be as proactive as we can."
Jennifer Larson, NurseZone feature
in Macon, Georgia is offering free sodas to nurses who have done particularly
good work or gone beyond the call of duty. Meanwhile, a hospital in Buffalo, New
York is partnering with an international corporation with local headquarters to
pay for people to attend nursing school if they promise to work at the hospital
unusual solutions to the shortage of nurses, but creative solutions seem to be
growing in popularity as hospitals realize that they must find new ways to
recruit and retain nurses.
national nursing vacancy rate is hovering around 13 percent. Hospitals around
the United States are so desperate for nurses that they’re promising sign-on
bonuses of $1,500, $2,000, or even as much as $5,000.
that’s just not enough to make a significant long-term difference in the
nursing shortage, many nurses say. It’s not about the bonus check; it’s
about respect, better working conditions and job satisfaction.
that desperate promises and sign-on bonuses aren’t working to keep nurses in
the acute care setting, some hospital administrators have decided to fall back
and punt. They’ve put their energy into creative solutions to the nursing
shortage in the hopes that their new strategies will be more effective.
have typically responded to past nursing shortages by offering bonuses to nurses
who sign up to work there. Some hospitals, like Regions Hospital in St. Paul,
Minnesota, are still offering them, including “sky-high” bonuses of $8,000
and $10,000 for some nurses with critical care experience.
strategy has helped that particular hospital, said Jan Rabbens, spokeswoman for
the Minnesota Nurses Association, but it’s just succeeded in moving nurses
around, not creating or recruiting new ones.
just robbing Peter to pay Paul,” Rabbens said.
aren’t the sign-on bonuses effective at recruiting and retaining nurses in
U.S. hospitals? According to the National Council of State Boards of Nursing,
the current shortage is different from past shortages. This one is worse, and
the traditional solutions aren’t likely to work when it gets worse as the
nursing workforce continues to age over the next decade.
time, it’s not working really well,” said Brenda Nevidjon, RN, MSN, an
associate clinical professor at the Duke University School of Nursing and a
member of the international nursing honor society Sigma Theta Tau. “They’re
finding that they’re not getting the same responsiveness that they got 10
years ago. Nurses are not necessarily getting lured back into the workplace with
a sign-on bonus when…they know it’s a very stressful workplace.”
today’s nurses know they have other options, like home care or ambulatory
surgery centers, and a sign-on bonus won’t compensate for what many feel is a
better job situation, she added. “I’m not going to compromise my quality of
life for $5,000 or $10,000” is what many nurses feel, she said.
Jacobs, RN, spokeswoman for the California Nurses Association agreed. She said
that nurses need the profession to “return to a place where we can do the
things that give us job satisfaction, like patient education and basically
feeling like you’re not jeopardizing patient care and your license every
Ives Erickson, RN, MS, also agreed that hiring bonuses aren’t effective
because they are a symptomatic solution that does not address the fundamental
nursing shortage. Erickson is senior vice president for patient care and chief
nurse at Massachusetts General Hospital and a faculty member of the Institute
for Nursing Healthcare Leadership.
many theories as to the best strategies to address the shortage, but the
strategies that focus on truly improving the workplace have the best potential,
according to Jacobs and Rabbens.
hospitals are already struggling to provide enough nurses to cope with the
numbers of patients. Nursing needs money, social commitment, and efforts to
improve working conditions, Rabbens said, or patients will suffer the
consequences. And nurses do not want to feel that they are compromising patient
safety, she added.
to be a concerted effort,” Rabbens continued. “I think we have to wake up
and go to public debate about the patient flow problem we have right now. We do
not have enough resources to meet the demand, and we have to do something about
Healthcare Complex’s “Cokes for Caring” program is a nice bonus for
nurses, but such strategies are not enough to make a long-term difference, she
are few quick fixes to the problem and attracting more women and men into
nursing and the other health care professions will take years, if not
decades,” Erickson said. “We need to employ new approaches to attracting
more interest in health care careers.”
nursing shortage is so critical in Florida that the Florida Hospital Association
has predicted the state will need 34,000 additional nurses by 2006. One hospital
in Tallahassee, Florida, has decided to put some money towards improving the
work environment, retention and recruitment efforts in the hopes that it can
staunch the flow of nurses away from the critical care setting.
nurses want to be paid adequately and recognized for their performance,” said
Ann Evans, RN, senior vice president for nursing for Tallahassee Memorial
Hospital. “I think they want to work in a place with good outcomes. People
want to work where they’re respected.”
in mind, Tallahassee Memorial Hospital officials decided to earmark part of a
$1.9 million Robert Woods Johnson Foundation grant toward this goal. The
hospital is creating a workforce development program and working to apply for
magnet hospital status.
hospital status is a relatively new designation, but many hospitals hope that
becoming a magnet hospital, which is designed to be nurse-friendly, will help
them keep and recruit nurses. Nevidjon said she hopes that magnet hospital
status does not become a purely symbolic designation and that hospitals that
apply for it truly change the workplace to make it better for nurses.
the jury’s out on this,” she said. “I think that if people say, ‘This is
really important to our organization’…and truly transform their
organization, it’s going to be great.”
Memorial Hospital also is adjusting its pay strategies to better suit its
employees’ needs and has instituted a tuition reimbursement program as an
incentive for its nurses to continue their education. The hospital is now using
a market-based pay strategy to remain competitive and will regularly
re-evaluate. It’s also using a new 15-step compensation program, where
employees can get a pay raise for each new level to recognize their gains in
other nurses, Evans hopes these programs will be more effective than sign-on
bonuses. “It’s sort of a bad cycle,” she said of bonuses. “If you
don’t, and your competitor does, it makes you look bad.”
California Nurses Association’s Jacobs suggests that mandatory
nurse-to-patient ratios, which California recently announced, may also improve
the work environment for nurses enough to draw more nurses back into hospitals.
Jacobs said the association also has high hopes for California Governor Gray
Davis’ $60 million, three-year Nurse Workforce Initiative plan, which funds
the training and eventual hiring of 5,000 additional nurses in the state.
said she tries to use the following principles to guide her when working with
the nurses at her hospital: Nurses want to feel the importance of their work,
nurses want to feel valued for their work, and nurses must feel they have a
voice in decision-making that impacts their practice and work life.
hospital has implemented strategies like a clinical recognition program and
nurse participation in collaborative governance committees. These initiatives
are two major factors in making nurses feel they are receiving recognition and
making their voices heard, she said.
are the glue—the backbone of the health care system,” she said.
28, 2002. © 2002. NurseZone.com. All Rights Reserved.