By Rose O. Sherman, EdD, RN, NEA-BC, FAAN
Many nurse leaders tell me they feel defeated about their high unit turnover often losing valued nursing staff. Some have been in their roles for years and wonder if they are still the right leader for the job. We have all heard the phrase – Nurses don’t leave organizations; they leave their leaders.
And while that may have once been true, it does not explain what is happening today. Nurse retention is so much more complex and falls into the category of a wicked problem. Wicked problems are complex because they are so interconnected with other things.
In a 2021 study published in JAMA with a sample size of 50,000 nurses, the top five reasons given for intent to leave a position included the following:
- Burnout
- A stressful work environment
- Staffing
- Lack of good leadership
- Pay and benefits
When we look at nurse retention through the lens of nurses’ experience in the pandemic, the realities of retention become clearer. When we go through life-quake experiences like this, we reconsider everything in our lives. Study after study indicates that we have a nursing workforce who are burned out and exhausted. Even the healthiest work environments have become stressful, with a fourth surge of the pandemic and staffing shortages.
These factors are coupled with a huge shift in workforce demographics as more Baby Boomer, and older Generation X nurses retire each day. Many of our Millennial nurses, who now constitute almost half the workforce, struggle with childcare and cutting back their hours.
Solutions to wicked problems require a different mindset. There is no one size fits all or easy answers. There is no magic bullet, and some of what you will try may not work. Wicked problems never totally disappear – they can resurface again. When in the wicked space, as with nurse retention, it is not retention that is the problem but rather what leads to turnover that becomes important – and today, that can be one hundred different things.
Wicked problems demand a creative approach. You can’t mandate nurses to stay in your organization, nor should you blame the nurse leaders when they don’t. It means testing and trying some very creative things such as:
- Offer sabbaticals for nurses who are burned out.
- Structure a career plan for new nurses to keep them in the organization and not necessarily on any given unit.
- Creating a swot team of expert nurses to go to units that are overwhelmed and understaffed.
- Developing partnerships with national childcare firms to offer childcare 24/7.
- Expand shift options to 4, 6, 8-hour tours for working Moms and older nurses.
- Hire retired nurses to work with 3-4 new graduates as their care coach
- Provide employee benefits to offer more alternative options such as childcare reimbursement or pet insurance.
- Hold a team draft every year for nurses to seek other roles in your organization.
- Develop a tuition payback for current nursing staff members.
The challenge with wicked problems is that you don’t have control over what happens. Loss of control is the issue that nurse leaders are struggling with today. The only real solution is to get more creative and try new things.
© emergingrnleader.com 2021
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