Retention

Retention & Recruitment

1

A growing trend

Christopher La Rue Owens
Keller Graduate School of Management
February 7, 2012


Abstract 2

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


covers of up to thirty five percent for for-profit organizations and twenty five percent for the
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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


ten years ago.
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("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


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 6
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


feel that they are apart of family, an organization that cares and understand there needs.
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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

Respectful collegial • Team orientation
1 communication and behavior • Presence of trust
• Respect for diversity
Communication-rich culture • Clear and respectful
2
• Open and trusting
A culture of accountability • Role expectations are clearly
3 defined
• Everyone is accountable
The presence of adequate • Ability to provide quality care to
4 numbers of qualified nurses meet client/patient needs
• Work and home life balance
The presence of expert, • Serve as an advocate for nursing
competent, credible, visible practice
5 leadership • Support shared decision-making
• Allocate resources to support
nursing
Shared decision-making at all • Nurses participate in system,
levels organizational and process
decisions
6 • Formal structure exists to
support shared decision-making
• Nurses have control over their
practice
7 The encouragement of • Continuing
professional practice and education/certification is
continued growth/ development supported/encouraged


• Participation in professional
association encouraged 8
• An information-rich environment
is supported
Recognition of the value of • Reward and pay for performance
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nursing’s contribution • Career mobility and expansion
Recognition of nurses for their
9 meaningful contribution to the
practice
Source: The Nursing Organizations Alliance, 2005

Five characteristics of successful recruitment and retention programs

Sustained leadership commitment to workforce as a strategic
ONE
imperative
TWO A culture centered around employees and patients
THREE Work with other organizations to address workforce needs
Systematic and structured approach to four strategies
outlined in the 2002 AHA report, “In Our Hands.” They
include: foster meaningful work, improve the workplace
FOUR 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.).

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