'Stop promoting people!' (and even more surprises overheard in healthcare)

Molly Rowe, for HealthLeaders Media, May 16, 2008

Last week, I wrote about some of the surprises I'm hearing in healthcare when it comes to recruitment and retention—sentences like "turnover is good," "signing bonuses don't work," and "we don't own our nurses." I heard a lot more about this subject over e-mail. Here's what readers had to say:

The med/surg unit should be a destination (not a rest stop). On the subject of "owning nurses," Kristen Baird, an RN and healthcare consultant, points out that external competition isn't the only competition hospital units worry about: "Medical/surgical units have not historically been a 'destination' unit for nurses, but rather the incubator for growing skills to better prepare them for other, perhaps more desirable units. The result is that nurses tend to work 1-2 years on these units and transfer into other areas that require previous med/surg experience. The managers of these med/surg units are in a constant flux and often resent the other departments 'stealing' their nurses. The system or organization may breathe a sigh of relief that the nurse didn't leave them for a competitor, but. . .often, the med/surg director is left scrambling to fill vacancies created by nurse transfers to other departments.

"This revolving door is nothing new, but we never seem to learn from this and haven't created processes and systems to allot for the short-term stint in med/surg and use it as a springboard to grow our future, expert workforce. As I see it, the issue comes down to a myopic view of departments as siloed business units with a finite allocation for FTEs. Wouldn't it make sense to proactively see the med/surg units as both a destination specialty and the training ground for specialties? If we can embrace this mindset, the med/surg units could be funded in part by education and development with FTEs designated as 'training tracks'."

"Stop promoting people!" As Val Kraus from Boulder Community Hospital writes, promotions aren't always good for the organization or the person being promoted. "The biggest thing that my facility is trying to do is stop promoting people just because they do a good job at the task level. I have had to demote individuals because previous people said, 'They are good at ________, surely they will be good supervising that group.' This is a painful process but should start decreasing now that we are setting up controls to hinder that."

"It's us, not them." I've written about bad leaders before, but one reader says it much better: "Most hospitals have leadership teams that have more in common with the dysfunctional parents on a Super Nanny show. The parents are upset with the kids but the reality is the parents are the problem. Unfortunately, the average hospital CEO would not tolerate a Super Nanny 'heart to heart' to face the brutal facts," wrote Daniel King, retired president of a St. Louis-based medical practice.  

There's no denying that finding and keeping good employees is a hot topic, so please keep the e-mails coming. Let me know what you're doing, what works, and even what doesn't. And don't forget you can also read and comment online.

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

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