Three Goals for the Shift - Emerging Nurse Leader

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

Frontline nurse leaders and charge nurses nationwide report that staffing shortages on every shift are now quite common. Even if health systems try to negotiate agency or travel contracts, it is not guaranteed. In a recent interview in the NY Times, the CEO of Aya (one of the largest staffing agencies) reported that they are only successful in filling about 10% of their contracts.

The burden of staffing shortages often falls on the shoulders of charge nurses who themselves are sucked into the staffing vortex. Maintaining stability in teams is challenging. I always urge leaders to be transparent about what is happening. This is a complex situation, and we need to acknowledge that along with the strategies we are using to deal with them.

I recently had a conversation with an experienced charge nurse about her strategies to work through staffing shortages. First and foremost, she said it is important to thank those who show up. She observed that it may seem unprofessional to thank people for coming to work but with so many nurses using sick leave and FMLA – showing up matters. Do this at the beginning of every shift, she urged and at the end thank them for what they have done.

She offered another strategy that I found very interesting. I am a big believer in goal setting, she said. I think right now, everyone needs to know what matters and what doesn’t. It keeps staff grounded and focused during the shift. On every shift when we are short-staffed, I set three goals. That is about all anyone can remember. She offered the following examples of the three goals she might set for a shift:

Everyone leaves on time – a must, she said. We all leave together and work to achieve that.
Everyone has a backup buddy to help them with care.
A mid-shift check-in huddle, especially if she is working with nurses with little experience.
No patient falls today – especially when there are high-risk patients on the unit.
Everyone takes a 30-minute break – no excuses.
Our patients will get the best care we can give but tonight we don’t have time to do __________________.
Come back to end of shift huddle and tell us what made you smile today – so find something to make you smile.

Charge nurses today are walking a fine line. Their goal should be to find the balance of providing stability while giving the nurses who work with them hope and inspiration that the future will be a little less chaotic. This is not easy to do, and I think strategies like three goals for the shift play an essential role in doing that.

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