3 Keys to Unlocking Nursing Excellence

The top concerns of nurse leaders are related to nurse recruitment, nurse retention, and nurse engagement. A HealthLeaders Intelligence Report details the challenges.

The top three challenges facing nurse leaders are not unexpected:

• Nurse retention (61%)
• Nurse recruitment (59%)
• Nurse engagement (35%) (Nurse leadership development came in a close fourth at 33%.)

But another finding of the HealthLeaders Intelligence Report: Nursing Excellence: Leadership Development, Culture, and Retention, which queried 266 respondents, was unexpected.

At the HealthLeaders Media 2016 CNO Exchange in November, how to attract and keep nurses was a major topic of discussion during the event's breakout sessions.

And during my conversations with nurse leaders from around the country, I have noticed more and more acknowledgement that both nurse engagement and nurse leadership development influence nurse retention.

In fact, there are a number of concurrent sessions and poster presentations on nurse engagement on the docket at the AONE 2017 annual conference which starts Wednesday in Baltimore.

What did surprise me about the report's findings was that only 10% of the respondents said generational differences were a challenge.

I've heard many nurse leaders say that millennials have very different work habits and preferences than the generations of nurses before them. A significant portion of our discussion at the CNO Exchange focused on how millennial nurses seem to prefer to move from job to job every few years and, if new opportunities are not available, they will leave an organization to find them elsewhere.

In fact, the decade-long RN Work Project study has found that roughly half of all newly licensed RNs leave their job within two years.

Success and Stumbling Blocks
Almost three-quarters of the Intelligence Report's respondents (71%) said their organizations' RN turnover rate over the past 12 months was less than 20%. The others 25% said their turnover rate was 20%.

Nurse leaders are using many tactics to help boost retention rates, but the top four strategies that were showing success are:

1. Flexible scheduling (53%)
2. Communication improvements (51%)
3. Orientation programs for new nurses (48%)
4. Salary increases for all nurses (48%)

Also in the mix of successful nurse retention tactics were work environment improvements (42%), tuition reimbursement for advanced education and certification programs (42%), and shared governance (41%).

Only 14% of the respondents reported that retention bonuses for new nurses were a successful strategy.

While recruitment and retention of nurses may be the biggest challenges nurse leaders face, they reported the biggest stumbling block in creating an effective nursing program at their organizations was difficulty changing the organizational culture (32%).

An abundance of other priorities (17%), an abundance of higher priorities (14%), and lack of funding (12%) were other hurdles they faced in developing their nursing programs.

When asked if cost containment efforts had affected the quality of their organizations' nursing care, 42% of the respondents said that there had been no change in the quality of nursing care, while 31% said these efforts caused a minor decline (26%) or a major decline (5%) in care quality.

For more data and analysis, download the free report.