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"Turnover is good" (and other surprises overheard in healthcare)

Molly Rowe, for HealthLeaders Media, May 9, 2008

Healthcare leaders spend a lot of time predicting and planning for the future, but when it comes to hiring and retaining employees, I hear a lot more about future problems than I hear possible solutions. One healthcare futurist told me that hospitals must make themselves places that people are "dying to work at," but nobody is very good at defining what those hospitals will look like.

Regardless of what the future holds for healthcare and hospitals, most experts agree that recruiting and retaining enough employees will take a lot of change—something that healthcare isn’t always good at. So smart leaders are already changing the way they look at staffing.

An HR leader of a multi-hospital system recently told me that her organization makes a point to talk about people—not just systems and process—in every senior management meeting. And I’ve noticed lately that other healthcare leaders have changed the way they talk about their work force and how they hire. Here’s some of what I’m hearing:

"We don’t own them." Gone are the days when organizations could cage their nurses in one department because they feared another organization would "steal" their nurses. Today, smart organizations have learned that they don’t own their nurses; so, if they don’t offer experience and learning opportunities, other organizations will.

Some hospitals are offering their nurses travel and job-sharing opportunities. Cold-weather hospitals, for example, might allow nurses to travel to Florida for the winter months, then return to their jobs in the spring.

Or, if a good employee at a community hospital does leave to try a job at a larger tertiary system, the community hospital leaves the door open for that employee to one day return. Smart organizations already know that giving their employees exposure to the outside world will keep them on the inside in the future.

"They don’t always have to be nurses." How many nurses does it take to run a hospital? It sounds like the start of a bad joke, but some organizations have discovered that they don’t need as many nurses as they once thought. Forward-thinking hospitals are using nursing assistants, other staff, even family to take on roles that don’t require a nursing degree.

"Newspaper want ads don’t work." Your next good employee isn’t sitting home with a newspaper and a highlighter. Today’s candidates are online, in social networks like Facebook, and writing blogs, so that’s where your want ads should be. Some leaders tell me they spend their print-advertising budget on relocation services because it’s a much more effective recruitment tool than an ad in the local newspaper.

"Neither do sign-on bonuses." As one healthcare leader told me, sign-on bonuses are "an addiction that is hard to break." Whenever hiring gets tough, someone will say, "What about sign-on bonuses?" But, sign-on bonuses, in the long run, only temporarily fill a hole while ticking off other employees. If you want to attract good employees, pitch your organization’s learning opportunities. Signing bonuses only attract people who are looking for sign-on bonuses. Once the bonus is spent, they’ll be off to find another one.

"Turnover is good." Inconceivable! This is the one that surprises me most, even though it makes perfect sense. Increasingly, CEOs tell me they don’t want everybody—even when faced with shortages—so they’re committed to hiring only good employees and weeding out bad ones. They’ll even hire the right person who has no experience before they’ll hire the wrong person who has an impressive resume.

"Who cares about the hospital next door?" It’s no longer enough just to emulate the hospital next door when it comes to finding and keeping good employees. Recruitment and retention—if you want them to be effective—must be based on the best practices out there, regardless of whether or not they’re found in healthcare. That’s why many of the work force changes I’m hearing about come from outside of healthcare.

What about you? How have your staffing philosophies changed? What are you doing to make your organization a place people are dying to work at—both today and in the future? I’d love to hear about it.


Molly Rowe is leadership editor with HealthLeaders magazine. She can be reached at mrowe@healthleadersmedia.com.

1 comments on ""Turnover is good" (and other surprises overheard in healthcare)"


caduceangroup (5/13/2008 at 10:28 AM)
As the VP of an established executive search firm focused on the healthcare industry, I can vouch for many of Ms Rowe's points about the direction of recruiting and retention. Some observations: 1. While many of our clients are feeling the combined pinch of career nursing professionals aging out and the the dearth of qualified, committed nurses coming in, the best ones hold fast to the quality vs. quantity system. Most have built reputations as elite academic medical centers and/or specialty hospitals who can expand the new hire's horizons in ways a high-paying, corporate-owned facility never will. 2. Many nursing dept.'s are open-minded about heeding our advice to use progressive recruiting strategies that attract talent from either out-of-state or from other clinical fields than the one currently vacant. Example: many Florida nurses hail from the NorthEast and some want to return to the culture and climate there. Others realize that fat paychecks don't make up for being bored and forgotten. 3. Physicians are becoming much more adept business owners, and are bargaining at higher levels. This can actually be a bonus when hospitals are prepared to fund and support those who can build thriving captive-ambulatory centers. This extends their reach into their communities while magnifying the billing revenue between 2-4X's the inpatient rate. 4. Finally, the really smart ones are opening the bottle-neck of too little educational opportunities by building full-service, accredited schools themselves. James Weston Vice President The Caducean Group, Inc.