retention

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Retention & Recruitment

Retention & RecruitmentA growing trend

Christopher La Rue OwensKeller Graduate School of Management

February 7, 2012

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Abstract

Imagine the future of healthcare. Imagine a now twenty one year old person aging and is now considered to being a “geriatric patient”; Imaging this patient being in need of care and having little to no person interaction. Instead of a well mannered, professional nurse, and or other allied staff members there’s a newly generated technological device in which robots can monitor your every breath, pulse and current condition and send continuous, accurate reports to one personnel members to whom will make visits on an as needed bases. Now think for a minute of two. Is this the kind of service you want? Do you feel that this is the answer to addressing your population? If you’d say that this is quite in personnel and inappropriate then you’d be correct. But please not that while this is only a thing of imagination it’s also very possible to happen in the near future if the retention and recruitment of key healthcare personnel are not addressed in a efficient and effective manner.

Problem Statement

For the past few years we have all been aware of the posed nursing shortage. We’ve all heard the rants and raves of legislative change via the Presidential administration and most of us look forward to embarking on a country to where both convenient and moderate access of healthcare is available. But what does this mean exactly? How if we are facing a personnel shortage, can we remedy an issue thru adding more consumers to a system with limited and shrinking crucial staff members?

The fact of the matter is this; according to a recent study the average age of nurses are roughly forty six; which is only sixteen years from the national retirement age of sixty two. In addition more than fifty percent of the nursing workforce is close to retirement. As a nation we are seeing rather large increase in patents over sixty five. This demographic has many needs, and will surly put a strain on the health system. Not to mention the recent reforms in healthcare will give millions of people access to the healthcare system. With all this in-mind it’s no wonder that more nurses as well as health professionals are needed in response, (BLS, 2010).

Problem Analysts

We are all concerned with the Healthcare reform and some of the key changes in which its geared to bring to the nations healthcare system. One most important feature will be its high increased consumer count that shall grow with every waking day. Looking at the reform on a more business side I’d like to high light some business features that few of you may be aware of. Changes such as Small business tax credits, which was implemented back in January of 2010. This feature provides a tax credit towards employers with no more than twenty five employees and annual wages of less than 50,000 that provide health insurance for its employees. This credit

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covers of up to thirty five percent for for-profit organizations and twenty five percent for the non-profit organizations. Also, could qualify for up to fifty/thirty five percent of employers cost only if purchased through a two year insurance exchange. Another feature is the pre-existing condition insurance plan. This is a state and federal program that temporarily provides low premium coverage for eligible candidates. Theirs also a tax for indoor training services, as well as Medicare premiums for higher income beneficiaries. This feature freezes the income threshold for income related Medicare part B premiums for the years 2011 thru 2019. This supportively is suppose to have more people paying income related premiums all while reducing Medicare part D; this is for those with income of over eighty five thousand individual annual income and one hundred seventy couple. There are more regulations in effect and on the way in the future.

http://healthreform.kff.org/Timeline.aspx

All in all any business want to make profit, all while sustaining and or providing high quality care and establish a good business reputation. Given the current trends in the industry, this it self is becoming rather challenging. With age come a number of both good and bad things. From a business perspective a geriatric nurse can be a double edge sword. While on one hand they are wise and highly seasoned in their profession, their quality of work can very well dwindle and or slowly diminish through poor eye sight, memory lapse, lack of physical strength, at risk sickness and fragility. All these things and more give way to quality care and service.

The following is an illustration of what slowly but surly led us into this inevitable situation. If you’d view figure 3B, notice the significant age difference in employees. Notice how back in years 2002-2003 the majority of nursing staff where between the ages of thirty five and forty nine at a whopping forty eight point three percentage. These once middle aged workers have now transitioned into the retiring ages currently; mind you this is an illustration of results of nearly

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ten years ago.

("Graphic on nurses," 2009)

Also note, through H.R. 876/S.58 also known as the registered nurse safe staffing act hospitals and or facilities are held to a higher standard in regards to accountability and procedural overlay. This would include whistle blower protection and providing public reporting of staffing information. All in all, this act insures compliance. “ANA and its Constituent & State Nurses Associations (C/SNAs) in the states are promoting legislation to hold hospitals accountable for the development and implementation of valid, reliable, unit-by-unit nurse staffing plans. These staffing plans, based upon ANA's Principles for

Nurse Staffing, are not mandated ratios. They are created in coordination with direct care registered nurses (RNs) themselves, and based on each unit’s unique circumstances and changing needs.” ("Safe staffing," )

The nursing industry has had the chronic illness of high retention need for quite some time now. Visual illustration below shows a significant trend in nursing education from years past:

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As a potential nursing student myself, I’ve gained some much needed insight on higher education and the various paths and or barriers in potential students’ educational endeavors. I’ve researched various accredited Universities and trade schools. What I‘ve discovered is a strong demand for highly grade point averages and firm background in science. For me, myself, I found it quite challenging to enter an attractive BSN program. Even though I recently obtained a BS in business management, my overall grade point average hinders me from being a desired candidate. I believe that my situation as well as many others are the same in that there are many people to whom want to enter the licensed profession, but are faced with scholastic, financial and some what’s bias barriers in doing so.

There are a number of various ways in which people can enter the nursing field. The most typical levels RN, (registered nursing) are bachelors level, Associates, and Diploma. Even though these are options many facilities are cutting back on the retention of candidates to whom has less than a BSN degree. This can be interrupted as higher education equals higher quality personnel. Because of the cost and difficulty of admittance into some RN programs a lot of people are taking even lower roles in the allied force as Certified Nursing Assistance, and Licensed Practical Nursing. This will only cause a future incentive for these people to return school and further their education.

Not only is the difficulty of entering a good program challenging, but dealing with and having access to passionate and helpful instructors are also becoming of a great concern. Prime example; in my quest to admittance into a universities nursing program I just so happen to meet a former nursing school student from that very same school. She informed me of her experiences with the department and stated that she decided to switch her major because of the nursing facility and

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staff. She was reassuring that It would be in my best interest to consider another school. She also stated how it was rumored that the school may even be loosing their nursing accreditation. This is all because of the nursing instructors disconnect with the new generation. There’s a barrier among the two and not only that many instructors feel under compensated for their roles as instructors and there for only perform to the level of which they receive… little to nothing. It was stated that instructors did not fulfill office hours, and hand a very condescending attitude towards students. This is the sad truth of our state and nation and should be addressed A.S.A.P.

Proposed Solution

It is within the best interest for an employer to focus on appropriate ways to satisfying their current staff and discover creative ways of both evaluating motivate and satisfy their staff. Regardless of their staff demographics, (gender, age) there’s always room for being unique in engaging staff to perform to high standards while proving excellent care if appropriate actions are in place.

In referencing the issue of recoupment, its’ also important for organizations to be well informed on the current trends when dealing with jobs seekers; knowing what they may find attractive in an employer is key for gathering some of the best talents within the industry. This would be best if it were not the typical short term tactics, such as sign on bonus, relocation coverage and premium packages, for these have shown to work best in retaining and redistributing staff, not necessarily recouping them.

These simple actions can be quite effective regardless of the industry. It’s universal and would even be effective in the R&R for nursing instructors. This is where it’s key. For if there’s little to no one to teach the potential students then, eventually they’ll be no newly educated RN’s. We must meet the wants and desires of key staff, keep them motivated and engaged toward there roles, and see longevity and growth within there jobs.

Implementation& Justification

Implementing these keys things are all in simply creating a good working environments matched with continuous development and personal accommodations. Employees want to

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feel that they are apart of family, an organization that cares and understand there needs. From single working mothers/fathers to newlyweds, they all have unique demands in which there lifestyle must meet in order to be productive both within there career as well as there personal lives.

Key players in any implementation process should involve top level executives. One in particular

would be the chief nurse officer. There role as the top nurse would be to open, engaged

and establishing relationships with fellow nurses. Let staff know that they are the go to

person for any and all matters and allow the CNO to be the representative for all nurses.

Leadership must be involved and set the example, let others know that they are cared for

and are apart of a team. Things such as eating lunch with new, and seasoned staff every

quarter would be a great way for establishing trust, communication and resolving any and

all issues. ("Nurse retention," 2006)

Here’s a key reference in ways of establishing R&R:

Nine Principles to Help Foster Staff Retention

1Respectful collegial

communication and behavior• Team orientation• Presence of trust

• Respect for diversity

2Communication-rich culture • Clear and respectful

• Open and trusting

3A culture of accountability • Role expectations are clearly

defined• Everyone is accountable

4The presence of adequate

numbers of qualified nurses• Ability to provide quality care to

meet client/patient needs• Work and home life balance

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The presence of expert, competent, credible, visible

leadership

• Serve as an advocate for nursing practice

• Support shared decision-making• Allocate resources to support

nursing

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Shared decision-making at all levels

• Nurses participate in system, organizational and process

decisions• Formal structure exists to

support shared decision-making• Nurses have control over their

practice7 The encouragement of

professional practice and continued growth/ development

• Continuing education/certification is supported/encouraged

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• Participation in professional association encouraged

• An information-rich environment is supported

8Recognition of the value of

nursing’s contribution• Reward and pay for performance

• Career mobility and expansion

9Recognition of nurses for their meaningful contribution to the

practice

Source: The Nursing Organizations Alliance, 2005

Five characteristics of successful recruitment and retention programs

ONESustained leadership commitment to workforce as a strategic

imperativeTWO A culture centered around employees and patients

THREE Work with other organizations to address workforce needs

FOUR

Systematic and structured approach to four strategies outlined in the 2002 AHA report, “In Our Hands.” They include: foster meaningful work, improve the workplace partnership, broaden the base to attract a more diverse

workforce and collaborate with other organizations, including other hospitals in the community and schools, to ensure an

adequate workforce in the future.FIVE Excellence in human resource practice

Source: The AHA Commission on Workforce for Hospitals and Health Systems, 2005

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Works Cited

(2009). Graphic on nurses . (2009). [Web Graphic]. Retrieved from

http://nursesaida.files.wordpress.com/2009/12/graphic-on-nurses-by-race-in-pa2.png

Nurse retention. (2006, January 10). Retrieved from

http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?

dcrpath=HHNMAG/PubsNewsArticle/data/0601HHN_FEA_Gatefold&domain=HHNM

AG

Safe staffing. (n.d.). Retrieved from

http://nursingworld.org/DocumentVault/GOVA/Federal/Federal-Issues/Safe-Staffing-

Fact-Sheet.aspx

oetjen, D. (2010). The fininacial managmanet of hospitals and healthcare organizations, 4th

edition. (4 ed.).

retention

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