Shorter Tenures and Tours of Duty

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

Where is all of this going?  It is an interesting question recently posed by a perioperative nurse leader frustrated by the turnover in her OR. Training for the OR can take a full year and sometimes longer. It is a significant investment. For years, nurses who went into the OR were trained and, for the most part – reliably stayed with their team and organization for years. But not now.

Like many leaders, this perioperative manager struggles with the changes she sees in how new staff view their careers. Young nurses inform nurse leaders almost on arrival that their first position is just a stop on the way to something bigger and better.

Some of the turmoil is undoubtedly due to changing post-COVID life choices. But there is a more significant trend here. Gallup researchers warn employers that the most critical risk in business today is a new generation of workers who will operate more like independent contractors and gig workers rather than loyal and committed to organizations and teams. It has enormous implications for costs, outcomes, and quality. Some leaders already see nurses they describe as “serial orientees.”

The term tours of duty used to describe the phenomena we see today was coined by Reed Hoffman, the founder of LinkedIn. Military careers are built on the concept of tours of duty – no one stays in any role for a long time. Moving on is an expectation and part of the employment contract.

Like many others working in HR, Hoffman warns leaders to wake up and realize that the employer/employee contract has changed permanently. He points out, “If you think all your people will give you lifetime loyalty, think again: Sooner or later, most employees will pivot into a new opportunity. Recognizing this fact, companies can strike incremental alliances.” A tour of duty also establishes a realistic zone of trust. Lifelong employment and loyalty are not part of today’s world, pretending they decrease trust by forcing both sides to lie. The employee may not get lifetime employment, but they take a significant step toward lifetime employability with the skills developed during a tour of duty. Consulting firms like Deloitte now say that most “tours of duty” are less than three years. Today in nursing, the tours seem much shorter than that.

Most nurse leaders now tell me that “their well-oiled teams who could do anything” may be gone forever. Nursing leadership in acute care settings will be more like being an NCAA Basketball coach, where team members can join the NBA in as little as one year, and team roster management is their number one function.

Nurse managers will need to stop thinking of teams as static groups of individuals who work together across time and lead with the idea that team composition may change at any time. Teaming will be a new skill. Care delivery may need to be done differently. Fighting this new reality is likely futile, and nurse retention needs to move from the unit level to the health systems level. The best organizations will want to ensure that valued nurses do their “tours of duty” within their health systems.

© emergingrnleader.com 2023

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