Want to boost nurse recruitment and retention? First, ask yourself these 4 questions

As the demographics of the nursing workforce changes, healthcare organizations must remember to change their hiring practices and job descriptions to fit with the next generation of nurses' needs and wants.

Teresa M. Stephens, PhD, RN, an associate professor at the Medical University of South Carolina's College of Nursing in Charleston, discusses what nurses today want in a job as well as what nurses should look for when considering a new job offer.

Note: The following responses were edited for length and clarity.

Question: What are nurses looking for in a job?

Dr. Teresa Stephens: Today's nursing workforce includes four generations, with millennials and Gen Zers being the largest groups who are seeking new job opportunities. These professionals have preferences and expectations that are vastly different from previous generations, including work-life integration and a sense of meaning/purpose in their work.

They are seeking a job that allows them to prioritize family and offers flexible scheduling and autonomy. They also want a work environment that promotes a sense of community and belonging. These preferences are not isolated to just millennials and Gen Zers. As awareness about burnout and its root causes continues to increase, nurses of all generations are learning the importance of these job characteristics.

Q: What can healthcare organizations do to more effectively recruit and retain nurses?

TS: We must begin by recognizing that a radical transformation must occur, beginning with our own mindsets about how we define the work of nursing, in both practice and academia. Historically, nursing has been built upon the foundations of strict hierarchy, authoritative 'command and control' leadership, and a very narrow and oppressive view of nurses' role in healthcare. Current policies and hiring practices in many organizations are still built upon these premises, which are deterrents to today's professional nurses seeking career opportunities.

Organizations will need to adapt and evolve quickly if they want to attract new talent. This requires a true mindset shift for leadership and a willingness to examine current practices that may be preventing them from recruiting and retaining nurses. Here are some key issues that should be considered:

First, how is nursing valued in your organization? Is nursing prominently featured on your website? Social media accounts? Job seekers will be looking at these and will be drawn to organizations that demonstrate a commitment to nursing. What type of nurse residency/orientation program is offered? What support services are available to new graduate nurses?

Second, do you offer flexible scheduling and/or eight-hour shifts? Recent evidence clearly depicts the negative outcomes associated with 12-hour shifts, and new nurses are keenly aware of this. They are also recognizing the impact a 12-hour shift has on family, causing them to seek job opportunities that allow them to prioritize their family life. Many organizations are exploring flexible scheduling options with great results. These decisions should include the perspectives of nurses at all levels as well as the nursing students who are potential hires.

Third, who is leading the organization? Are nurses part of the leadership team? Do they have a voice in the decision-making process? How is nursing featured in the organization's mission, vision and values? Are millennials and Gen Zers part of the leadership/administrative team? What kind of leadership mentoring program is offered for new nurses who are interested in these opportunities?

Fourth, are nurses encouraged and supported to pursue personal and professional goals? Are nurses supported in full scope of practice based on licensing or certifications?

Q: How can organizations differentiate themselves from the competition with regard to nurse job offers?

TS: They should be actively rethinking every policy and process related to hiring and promotion as well as talking to every new nurse hired during their first six months to gain valuable feedback. New graduate nurses are excellent resources when seeking to gain an informed perspective about your organization since they have recent memories of working at other clinical sites.

Look beyond your own walls to identify new ways of doing things and to shed biases or blind spots. Rethink leadership, specifically moving toward a flattened hierarchy with shared, team-based leadership. Focus on the work environment and address any 'bad apples' who are killing your culture.

Q: What should nurses consider before accepting a job offer?

TS: Consider the following:

1. Visit the workplace unannounced (if possible) — what do you see? Hear? What does it feel like to be in that space? How do employees look? Act?

2. Are organizational leaders involved in the community and in social media? What are their personal values? How do they participate in the advancement of nursing (publications, professional organizations, presentations, service, etc.)?

3. Does the organization embrace shared governance and a commitment to a just culture?

4. How does the organization show its commitment to nurse well-being?

5. How is innovation and technology utilized to promote quality and safety in patient care? How are nurses utilized in these efforts? Are nurses involved in telehealth? IT?

6. How is teamwork promoted? Are nurses included as partners in team-based care?

7. What do other employees say or not say? What do previous employees say?

Q: What is your advice for nurses who want to negotiate a better offer?

TS: Be informed and prepared. Gather the evidence, and be willing to negotiate or adapt. Be willing to relocate if necessary. Prioritize knowing yourself and what are 'must haves' versus 'like to haves.'


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