Effective healthcare in the United States is threatened by a shortage of nurses. One way to reduce this shortage is to retain experienced and over-50 nurses. To do this, employers must meet the specific needs of these nurses and address issues that affect their morale and job satisfaction. Donna Herrin, senior vice president and chief nurse executive for Methodist Healthcare, talks to CareerBuilder about some of the most important factors for retaining experienced nurses.
There is no single standard for the number of registered nurses required by the U.S. health care system, but regardless of the statistics we choose to cite, the shortage of nurses is a serious problem in health care facilities around the nation, and is only expected to become more serious in the future.
The demand for nurses is expected to increase at rates of 2 percent to 3 percent annually in the next 10 years, meaning that the system needs to produce 30 percent more nurses than currently exist. 116,000 vacant nursing positions were reported nationwide by the American Hospital Association in 2007, resulting in a vacancy rate of 8 percent. While the number of students enrolled in nursing programs has increased this decade, schools say that due to a shortage in faculty, they are limited in the number of students they can accept.
Insufficient staffing levels lead to a variety of ill effects. Nurses report higher stress levels, reduced quality of care, and a greater interest in changing assignments. The average age of a nurse is also climbing, and that introduces a new set of challenges.
Nurses in their 50s who have been raising children for decades are returning to the work force; nurses in the over-50 group now make up nearly 30 percent of the total work force. The ability of the health care system to retain these nurses is just as important as the challenge to educate new nurses.
Donna Herrin RN, MSN, is the senior vice president and chief nurse executive of the Methodist Healthcare system in Memphis, Tennessee. She says that the weak economy may drive some retired nurses back into the workplace, but the emphasis in practice is on improving work place conditions so that experienced nurses want to stay.
For example, nurses require assistance with lifting, and Herrin says that having lift equipment in place and assistive personnel to help move patients enables them to extend their time in the workplace.
Nurses are plagued by job-related back pain more than workers in any other profession. According to one survey, two-thirds of all orthopedic nurses and more than half of all ICU nurses suffer debilitating back pain at least once in their careers.
In the course of one shift, many nurses assist patients in and out of bed, onto carts, and into wheelchairs. In their daily work, they regularly move heavy equipment and furniture. Hospitals are acknowledging this aspect of nursing by increasing expenditures for lift equipment and nursing assistants.
Herrin lists a number of other quality-of-work-life needs that must be met in order for nurses to successfully perform their jobs. One of them is larger text and readouts on computers and other medical equipment so that their work is accurate and they do not have to strain to read. As in any workplace, larger screens and larger text are important in maintaining productivity and improving morale for aging workers.
Another is flexibility in terms of benefit packages. For example, an experienced nurse may have relatively little need for additional training, and may wish to trade their educational benefits for a decreased premium on their health insurance. Alternately, a nurse possessing health benefits through a spouse may wish to choose a higher wage rate instead of the health benefit. Herrin says, "As individuals' needs change over time, health care organizations that are responsive to those changes find themselves in a better position."
Flexibility in scheduling was one of the earliest advances in modern hospital management, but the use of the Internet to supply online shift bidding or shift auctions is still a relatively new tool. Third-party software can save hospitals administrative dollars while offering nurses a persuasive variety of premiums and other benefits.
While some health care systems hesitate to ask nurses to compete against one another in an effort to underbid for shifts, the overall staffing and budget effectiveness of bid systems has gained them wider use.
Some health systems are looking into the different roles that nurses can fit into aside from the full time hands-on delivery of health care. As mentors, teachers, and coaches, experienced nurses can be a valuable source of support and wisdom for new nurses, so that as new nurses gain experience they will have the knowledge and stability of the "sage nurse" to call upon. There appears to be much innovation in the health care system in terms of making the right kinds of offers to people, but some health care organizations are much further ahead than others.
While Herrin talks a lot about an improved work environment in hospitals, she warns not to downplay the issue of compensation:
"Some experts say money isn't important, because what's important is that nurses have a great manager, and they have a flexible schedule, and they have a great team. The more experienced a nurse the higher those factors will be on the value continuum, but money is always there as a foundational piece. Appropriate compensation is what is important.
Nurses really want to keep patients safe, to save lives, and to help people when they are at their most vulnerable points. That's the essence of nursing. Nurses are typically thought of as providing caring, but we must not forget that professional nurses are expected to think critically, analyze scientific data, and respond quickly and accurately in emergencies. To say that compensation isn't important because nurses want to care is really an error. It's all in the balancing of total compensation and work satisfaction."
With these factors in mind, Herrin points to a document prepared in 2004 by the Nursing Organizations Alliance called Principles & Elements of a Healthful Practice/Work Environment. The intent of this document is to promote principles and practices that create a better, safer, and more productive health care environment.
The main features of the article include:
A rebalancing of all of the factors affecting the work experience of nurses is critical to keeping them on the job. For nurses, a healthful work environment, balanced and appropriate compensation, flexibility in terms of scheduling and benefits, and a greater degree of recognition and collaboration are all key to the future of health care in the United States.
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