As the nursing shortage grows, stressing an already burned out workforce, the remedy of retention has become obvious to hospital executives, but some nurses say they're often left out of conversations about this solution. What they really want may not always be wellness programs or appreciation days that hospitals develop.
2023 is different. The nursing workforce is no longer navigating the challenges of a global pandemic, but rather recovering from one. The pandemic brought many challenges and weaknesses in U.S. healthcare to light, but three years later, some say there may be a disconnect.
Defining 'wellness' for nurses can help define retention
Several hospitals and health systems have established wellness programs to support nurses, but is it enough?
"When I was the CNO in a hospital setting, we hired a consultant to come in and do a burnout survey for us with all of our nursing team members," Patti Artley, DNP, RN, chief nursing officer at Medical Solutions, and former chief nursing officer at the Medical University of South Carolina said. "We found that the units were not all in the same place. There were some units that maybe didn't have as much COVID impact, or they were not challenged as much by ratios because they had vacancy. Regardless of whatever the issues were, we recognized a lot of variability in what their needs were. Some were as basic as they really need to get their breaks and their lunch, whereas others were more concerned about self actualization and said they needed more joy in their work. Our nurses needed different things in different places to support their wellness."
Celeste Armstrong, RN, an operating room nurse leader at MidState Medical Center in Meriden, Conn., told Becker's she has found the same thing. Wellness looks different for nurses in different units, who have different backgrounds, needs and desires.
"I've had multiple members of my staff tell me that they've actually accessed our work mental health services and found counselors through the program, which was actually surprising to me, because I've also heard people say, 'I just don't have time to do that,'" Ms. Armstrong said.
But, there is another piece of the puzzle, she explained. Nurses leave because they lack support and finding out what they really want and need is the ultimate retention strategy.
"Whether that be supporting them in their continued education, making sure they have all of their supplies, making sure they have all the resources and knowledge necessary to be able to do their job. I also need to be flexible because people need to have balance,
Ms. Armstrong said. "They need to be able to step away from work and fill themselves up because nursing is a really difficult job. So I really try to be mindful of allowing people time off of work when we can get them time off of work. That in itself is a big retention strategy."
Preparing for new nurses' wants and needs
More than 18 percent of nurses quit within their first year on the job, according to the American Nurses Association.
New nurses are interested in continuing their education, work-life balance, and mental health, leaders say, which is in line with similar desires expressed by Gen Zers in the American workforce.
Understanding this and preparing accordingly can help hospital and health system leaders recalculate how to attract, support and retain the newest members of the nursing workforce.
"More nurses are enrolling in graduate level educational programs to increase their knowledge and to have opportunities to seek employment in advanced practice roles and leadership positions," Francine Laterza, EdD, RN, the director of nursing and an assistant professor at St. John's University in Queens, N.Y. told Becker's. "These opportunities can lead to higher job satisfaction, increased salaries, maintenance of work-life balance and overall wellbeing. Support of advanced nursing education is crucial to maintaining a thriving, professional nursing workforce and decreasing burnout."
Working 12-hour shifts, weekends, nights and holidays is something leaders at hospitals and in academia could also work to better prepare new nurses for, Dr. Artley said.
"I think one of the things that hospitals have to really be working on is how do they expand the number of clinical sites. I was constantly pressed in an academic medical center to expand those," Dr. Artley said. "I recognize the limitations that exist, but I think we really have to determine a path more creatively for shifts on weekends and holidays if necessary. Nursing is not just a Monday through Friday day shift, and I think approaching clinicals in this way would also prepare the nursing students for those off shifts. You don't come out of college working day shift and not working weekends and that can be challenging. I think that that's something we have to be able to do to better prepare new nurses for."