Mass Exodus Issues: How To Keep Your Nurses and Staff Around!

I overheard a conversation in the cafeteria between a manager and a long-time nurse of hers. She was asking that nurse about her thoughts on what would make her nurses want to stick around. I was sitting there thinking ,“Well this will be interesting….” I could have turned around and burst out with a ton of answers for them, but I held my tongue and just listened in. Being on the float team, I typically float to those units that are the most short staffed. That is part of the reason most hospitals have float teams. However, whenever I float to those short-staffed units, it becomes very clear to me in most cases, of why these units have little staff. I will talk about these reasons in just a second, but I want to touch on one main thing:

Nursing is our career. We are all here because we need to make a living. We need to take care of ourselves and our families. That’s just what you have to do in life. Nurses are unique in that we give of ourselves in ways that no other professions do! We are dealing with the most intimate issues and hardest times of peoples lives! We deal with emotions from families that only come out in hard times, and make for very difficult situations! We are pulled and tugged in many directions, cleaning up bowel movements, spilling urine on our scrubs, running down stairs to the cafeteria to build after hour meals, catching vomit in basins, sticking patients with needle phobias, fighting alcohol withdrawal symptoms, and charting it all “at the same time.” Some of you reading this may think, “Well who the heck would want that job?” Let me tell you something… I don’t LIKE cleaning up poop! I don’t enjoy emptying vomit basins, sloshing around as I carry it to the garbage can! I don’t enjoy suctioning trachs! I do it because I CARE! And just like every other nurse in this world, THEY CARE TOO! They have a desire to love and take care of people! This is why nurses are so unique. Their hearts go so deep that despite all of the disgusting and inhuman tasks I just listed, we do this to the best of our ability because WE CARE ABOUT PEOPLE!

When the question gets proposed from a manager or higher ups of “What will keep staff around”….Let me let you chew on this quote for just a second.

“The deepest principle in human nature is the craving to be appreciated.”

–William James

This doesn’t go for Nurses. This is a fundamental concept that includes every human being on the face of this planet, in every position! We, as humans, have the desire to be loved and appreciated! We want to feel valued in what we do! Nurses day in and day out work so hard taking care of LIVES! We all became nurses because we want to focus on the care of our patients. Unfortunately, charting is a big part of what we do and the focus is going to continue to be on that. Charting covers a hospitals butt, not the heartfelt conversation that you took time to have with your patient, that made their day (that was undocumented of course). What I want managers and higher ups to understand is that I get that your job is to focus on us nurses and hold us accountable for the needs of the hospital and the floor. Your job is to make sure that we’ve done our jobs as nurses,  documented appropriately, and complete every task that is required in a days work. This is SO important to the hospital that they’ve created RN positions AWAY from patient care, just to make sure these things are done! (That could be an extra body on the floor!) You want to not only uphold the quality of patient care, but also honor the business side of things. I’m okay with that because I WANT to do what is expected of me! BUT I need you to hear me loud and clear in what I’m about to say. I want to know that you appreciate what I do! I want you to talk with me about the improvement you’ve seen in my charting since my transition to this new hospital. I want to hear you say that you are proud to have me on your team and to represent you! I want you to say that it meant so much to you, watching me bend over backwards for that difficult family all in the name of Patient Satisfaction! Because ultimately (and sadly) we know that benefits us all! I want you to acknowledge me! I NEED you to acknowledge me! I’m not talking every time that you see me, but please just genuinely thank me here and there for all that I’m doing! I want to feel appreciated! And when I feel appreciated, I want to work even HARDER for you, because your words of affirmation mean that much!

I feel that genuinely appreciating your staff is the #1 way that you can keep people around, but I’d like to touch on a few others:

Adjusting A Floor’s Attitude:

I can’t tell you how many floors I have floated to where the nurses were just down right nasty! Bad attitudes are for the birds! I really think when this is identified, a manager should step up and intervene! Take your nurses into a huddle or meeting and explain to them what you are seeing! Do your part by fighting for your nurses: encourage them, praise them, and take action! If they have bad attitudes because they are overworked and spread too thin, then keep fighting for your nurses! Go to the higher ups and explain that you are losing nurses because they are being spread so thin! When nurses are set up for failure (high patient to nurse ratios), you better believe they’re going to have a bad attitude! How can I have a good attitude when I feel that no one is fighting for me and implementing good, safe, quality, nursing care is impossible! Then we leaved stressed thinking of everything that we forgot to do! Supplemental staff and higher ups aren’t jumping into help! You know how many nurses talk about this? On those days that it’s an acute shortage, don’t tell me you can’t hop in! You have a license just like me! I’ll never forget watching an assistant nurse manager I had at my first job go around and take vitals on EVERY SINGLE PATIENT on the floor! We had 2 tech call outs! The lone tech was taking call lights and the ANM was taking vitals. She didn’t have time! None of us do! But we nurses find a way to do it every day, because we have to! And sometimes that means charting until 2130 all to be back at 7 to do it again! That ANM would normally be sitting in her office and dealing with business things all day. She was always busy! But she recognized in those hard times that we needed help! Instead of pushing it on the nurses, she jumped right into action! It was reasons like this one, that broke my heart leaving this unit! It was amazing and leadership had a great attitude and outlook on team work! They lead by example, and we followed! Even the hard times weren’t as bad because they literally did everything they could to help! You wouldn’t believe what refilling my needy patient’s water jug would mean or assisting someone to the bathroom while I’m consumed! I understand nursing shortages happen and it goes in waves on floors. An extra body goes a long way! It makes me WANT to stay and work for you, and I appreciate you when you hop into action on those kind of days or find someone to help me! I still keep in touch with this manager and keep her updated on my life because she was absolutely amazing! She was a true example of an amazing nurse, manager, and human being! She made a difference and it will alway stick out in my mind!

Be genuine!

I get that with management you have to keep a safe distance because the universal rule seems to be that managers can’t be your friend. Let me tell you something. My manager is one of the kindest people I know! She’s great at the “business/management” part, and amazing on the personal side of things. She has the balance down and I guess that’s what makes her a good manager. She has a heart! If something comes up with what I’ve missed or done wrong, she doesn’t come running with an accusatory finger point. She asks about the situation. She talks through it. We discuss it. We talk about what maybe could be done next time. She then AWALYS asks “ Is there anything I can do for you?” and unlike many others, I KNOW she means that! I appreciate this more than she knows, because I have had managers that are all business and are just so focused on the problem and not a care about the persons feelings! These are YOUR staff! YOU are helping them grow! YOU are helping them learn! With your own child, you don’t just scorn them and push them away. You correct them, talk about why it was wrong or unhelpful, then you hug them and send them on their way with words of affirmation. As a manager, you obviously won’t be as affectionate towards an employee, but you get the concept! It works! And we grow to love and respect you in return! There are certain issues that truly need more serious consequences and action taken, but in most cases with the minuscule things, they can completely kill our morale if dealt with negatively! Come along side your nurses and encourage them! Be genuine!

I’m sure there are a million other ways that you can help retain staff! These are the ones that stick out and mean the most to me on a daily basis and I wanted to share. Not just to keep staff around, but to make it a better workplace for EVERYONE! I had a staff meeting this morning and it was just completely different from all of the meetings I’ve had in the past. The manager started it out with a joyful tone and praising some of our nurses and techs. We all clapped for them, joked, and were able to be genuinely happy for each other. We KNOW how hard each other works! My Float Team is absolutely amazing! We also were able to openly voice our concerns for issues going on: another difference. My managers opened that discussion and it was extremely beneficial. This meeting inspired me for this post! I was thankful for this different approach this morning! No one is perfect. There are a TON of AMAZING managers out there! And I’m aware that management is not always the issue with staffing shortages! These are a lot of things out of your control too, some in which I mentioned. I know your job isn’t easy! I know you are pulled in many directions for completely different purposes! You are trying to keep your staff morale up, and unit cost down. I would never want to put my foot in your shoes! So THANK YOU to all of the managers out there doing their best! I want you guys to know this! There are nurses out there like myself who WANT to see good in the hospital and on our personal units. They WANT to see nurses happy and succeeding! EVERY hospital struggles. I want you to grab some of these hard working nurses and ask them collectively how we can make it better for everyone! Open that discussion. Encourage them to lead by example with good attitudes and helping hands. Coming from the girl who was in Therapy for 3 years in college, I know talking about your feelings is healthy and fruitful! Ask them for ideas and help! You CAN turn your unit around and push through the storm that your unit may currently be in. It takes a Village. We’re all in this together. Let’s work hard to love and support each other. In the end, we ALL just want to take good care of others feel appreciated in return!

Your Heart is Mine,

Kelsey

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