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  1. 1. Retention & Recruitment 1 Retention & Recruitment A growing trend Christopher La Rue OwensKeller Graduate School of Management February 7, 2012
  2. 2. Retention & Recruitment Abstract 2Imagine the future of healthcare. Imagine a now twenty one year old person aging and is nowconsidered to being a “geriatric patient”; Imaging this patient being in need of care and havinglittle to no person interaction. Instead of a well mannered, professional nurse, and or other alliedstaff members there’s a newly generated technological device in which robots can monitor yourevery breath, pulse and current condition and send continuous, accurate reports to one personnelmembers to whom will make visits on an as needed bases. Now think for a minute of two. Is thisthe 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 notthat while this is only a thing of imagination it’s also very possible to happen in the near future ifthe retention and recruitment of key healthcare personnel are not addressed in a efficient andeffective manner. Problem StatementFor the past few years we have all been aware of the posed nursing shortage. We’ve all heard therants and raves of legislative change via the Presidential administration and most of us lookforward to embarking on a country to where both convenient and moderate access of healthcareis available. But what does this mean exactly? How if we are facing a personnel shortage, can weremedy an issue thru adding more consumers to a system with limited and shrinking crucial staffmembers?The fact of the matter is this; according to a recent study the average age of nurses are roughlyforty six; which is only sixteen years from the national retirement age of sixty two. In additionmore than fifty percent of the nursing workforce is close to retirement. As a nation we are seeingrather large increase in patents over sixty five. This demographic has many needs, and will surlyput a strain on the health system. Not to mention the recent reforms in healthcare will givemillions of people access to the healthcare system. With all this in-mind it’s no wonder that morenurses as well as health professionals are needed in response, (BLS, 2010). Problem AnalystsWe are all concerned with the Healthcare reform and some of the key changes in which itsgeared to bring to the nations healthcare system. One most important feature will be its highincreased consumer count that shall grow with every waking day. Looking at the reform on amore 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 employeesand annual wages of less than 50,000 that provide health insurance for its employees. This credit
  3. 3. Retention & Recruitmentcovers of up to thirty five percent for for-profit organizations and twenty five percent for the 3non-profit organizations. Also, could qualify for up to fifty/thirty five percent of employers costonly if purchased through a two year insurance exchange. Another feature is the pre-existingcondition insurance plan. This is a state and federal program that temporarily provides lowpremium coverage for eligible candidates. Theirs also a tax for indoor training services, as wellas Medicare premiums for higher income beneficiaries. This feature freezes the income thresholdfor income related Medicare part B premiums for the years 2011 thru 2019. This supportively issuppose to have more people paying income related premiums all while reducing Medicare partD; this is for those with income of over eighty five thousand individual annual income and onehundred seventy couple. There are more regulations in effect and on the way in the future. in all any business want to make profit, all while sustaining and or providing high qualitycare and establish a good business reputation. Given the current trends in the industry, this it selfis becoming rather challenging. With age come a number of both good and bad things. From abusiness perspective a geriatric nurse can be a double edge sword. While on one hand they arewise and highly seasoned in their profession, their quality of work can very well dwindle and orslowly diminish through poor eye sight, memory lapse, lack of physical strength, at risk sicknessand 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. Ifyou’d view figure 3B, notice the significant age difference in employees. Notice how back inyears 2002-2003 the majority of nursing staff where between the ages of thirty five and fortynine at a whopping forty eight point three percentage. These once middle aged workers have nowtransitioned into the retiring ages currently; mind you this is an illustration of results of nearly
  4. 4. Retention & Recruitmentten years ago. 4("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 ANAs 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:
  5. 5. Retention & Recruitment 5As a potential nursing student myself, I’ve gained some much needed insight on higher educationand the various paths and or barriers in potential students’ educational endeavors. I’ve researchedvarious accredited Universities and trade schools. What I‘ve discovered is a strong demand forhighly grade point averages and firm background in science. For me, myself, I found it quitechallenging to enter an attractive BSN program. Even though I recently obtained a BS in businessmanagement, my overall grade point average hinders me from being a desired candidate. I believethat my situation as well as many others are the same in that there are many people to whomwant to enter the licensed profession, but are faced with scholastic, financial and some what’sbias barriers in doing so.There are a number of various ways in which people can enter the nursing field. The most typicallevels RN, (registered nursing) are bachelors level, Associates, and Diploma. Even though these areoptions many facilities are cutting back on the retention of candidates to whom has less than aBSN degree. This can be interrupted as higher education equals higher quality personnel. Becauseof the cost and difficulty of admittance into some RN programs a lot of people are taking evenlower roles in the allied force as Certified Nursing Assistance, and Licensed Practical Nursing. Thiswill 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 havingaccess 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 formernursing school student from that very same school. She informed me of her experiences with thedepartment and stated that she decided to switch her major because of the nursing facility and
  6. 6. Retention & Recruitmentstaff. She was reassuring that It would be in my best interest to consider another school. She alsostated how it was rumored that the school may even be loosing their nursing accreditation. This is 6all because of the nursing instructors disconnect with the new generation. There’s a barrier amongthe two and not only that many instructors feel under compensated for their roles as instructorsand there for only perform to the level of which they receive… little to nothing. It was stated thatinstructors 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 SolutionIt is within the best interest for an employer to focus on appropriate ways to satisfying their currentstaff and discover creative ways of both evaluating motivate and satisfy their staff. Regardless oftheir staff demographics, (gender, age) there’s always room for being unique in engaging staff toperform 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 onthe current trends when dealing with jobs seekers; knowing what they may find attractive in anemployer is key for gathering some of the best talents within the industry. This would be best if itwere not the typical short term tactics, such as sign on bonus, relocation coverage and premiumpackages, for these have shown to work best in retaining and redistributing staff, not necessarilyrecouping them.These simple actions can be quite effective regardless of the industry. It’s universal and would evenbe effective in the R&R for nursing instructors. This is where it’s key. For if there’s little to no oneto teach the potential students then, eventually they’ll be no newly educated RN’s. We must meetthe wants and desires of key staff, keep them motivated and engaged toward there roles, and seelongevity and growth within there jobs. Implementation& JustificationImplementing these keys things are all in simply creating a good working environmentsmatched with continuous development and personal accommodations. Employees want to
  7. 7. Retention & Recruitment feel that they are apart of family, an organization that cares and understand there needs. 7 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 orientation1 communication and behavior • Presence of trust • Respect for diversity Communication-rich culture • Clear and respectful2 • Open and trusting A culture of accountability • Role expectations are clearly3 defined • Everyone is accountable The presence of adequate • Ability to provide quality care to4 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 practice5 leadership • Support shared decision-making • Allocate resources to support nursing Shared decision-making at all • Nurses participate in system, levels organizational and process decisions6 • Formal structure exists to support shared decision-making • Nurses have control over their practice7 The encouragement of • Continuing professional practice and education/certification is continued growth/ development supported/encouraged
  8. 8. Retention & Recruitment • Participation in professional association encouraged 8 • An information-rich environment is supported Recognition of the value of • Reward and pay for performance8 nursing’s contribution • Career mobility and expansion Recognition of nurses for their9 meaningful contribution to the practiceSource: The Nursing Organizations Alliance, 2005Five characteristics of successful recruitment and retention programs Sustained leadership commitment to workforce as a strategic ONE imperative TWO A culture centered around employees and patientsTHREE 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 practiceSource: The AHA Commission on Workforce for Hospitals and Health Systems, 2005
  9. 9. Retention & Recruitment 9 Works Cited(2009). Graphic on nurses . (2009). [Web Graphic]. Retrieved from retention. (2006, January 10). Retrieved from dcrpath=HHNMAG/PubsNewsArticle/data/0601HHN_FEA_Gatefold&domain=HHNM AGSafe staffing. (n.d.). Retrieved from Fact-Sheet.aspxoetjen, D. (2010). The fininacial managmanet of hospitals and healthcare organizations, 4th edition. (4 ed.).