Recent Articles
Work life balance for nurse managers
We have seen a lot of interest in nursing staff burnout lately, both through searches that find this blog and our other blog (TravelNursingBlogs.com), but also in the media and healthcare blogosphere in general, and in nursing forums and social networks. It is obvious that the economy and change in working conditions for nurses is taking its toll and nurses may be nearing the tipping point, when their physical and emotional health concerns outweigh their financial concerns. Let’s face it, people can only work 50-60 hours a week for so long.
But this post is about you the nurse manager. How many hours are you working? Are you sacrificing your work life balance at the expense of your emotional and physical well being? If you are, stop. You may be hurting patient care just as much as your burned out staff.
How? As a their manager, your nurses take their behavioral cues from you, so if you are stressed and burned out, that is going to impact them and the patient care they give. It is pretty simple:
Happy Manager + Happy Staff = Happy Patient
And we all know that happy patients come back to your hospital and recommend you to their family and friends, increasing hospital revenue and making your hospital CFO and CMO happy. Plus when hospital revenue is up, so many other good things happen, new programs that help patients can be implemented, additional staff can be brought on to improve nurse to patient ratios and so many other side benefits that come with being a financially sound hospital.
So the real question is how do you achieve that work life balance as a nurse manager with so many people relying on you, your spouse, your kids, your parents, your employees? That is where you have to get creative. And where this series should help, over the next couple of posts I will be bringing you a series of articles to help you find work/life balance as a nursing manager. Stay tuned.
Build your best nursing unit
Right now having a full and consistent nursing staff has probably never been easier, thanks to the current economic drivers masking over the nursing shortage you are probably seeing the benefit being nurses that are more than willing to pick up an extra shift, great older nurses are hanging around a little longer and your internal float pool is overflowing. The challenge now is to manage that situation and take full advantage of the opportunities it gives you and your hospital to address some areas that normally cause nurse turnover and burnout. Some things you can do to fully utilize this time are:
- Improve your nurse retention efforts
- Develop future nursing leaders
- Evaluate unit processes and build teamwork among nurses
- Improve as a nursing leader
- Put more recognition efforts in place
- Improve the participation of the nurses in your units in the decision-making process
- Find ways to establish professional growth opportunities
- None of these initiatives have to cost a lot of money if they are done with some imagination. Here are some resources for each area:
Improve your nurse retention efforts
Use mentors to improve nurse retention
Improve Your Nurse Retention With The LifeWings Program
Improving Nurse Retention in Jordanian Public Hospitals: Discussion
Develop future nursing leaders
Attributes and Competencies Needed by Future Nurse Leaders and Managers*
Transformational Nursing Leadership
Developing Future Nursing Leaders for Today’s Nurse Leader:Â What are my responsibilities?
Evaluate unit processes and Build teamwork among nurses
Building Blocks of Teamwork
Effective strategies can reduce turnover rates, improve group cohesion and nurse satisfaction Â
Quality work environments for nurse and patient safety
Building a Collaborative Nursing Practice to Promote Patient Education: An Inpatient and Outpatient Partnership
Improve yourself as a nursing leader
Nursing leadership
Leadership and nursing care management
What leadership styles should senior nurses develop?
 Put more recognition efforts in place
Ways to Reward Employees (Without Spending a Dime)
10 No-Cost Ways to Recognize Employees
Five Tips for Effective Employee Recognition: How to Reward, Recognize, Award, and Thank People SuccessfullyÂ
Improve the participation of the nurses in your units in the decision-making process
Nurses Transform Unwieldy Decision-Making, Go Back to Bedside
Barriers to effective clinical decision making in nursing
Evidenced Based Nursing
Find ways to establish professional growth opportunities
National Nursing Staff Development OrganizationÂ
NurseLearn
Staff development nursing secrets
How does your hospital grade?
Have you ever wondered what the nurses and allied health professionals working for you thought of your unit, management style or hospital. Thanks to a new website called NurseRatings.org you may be able to find out. The site is very new and as of yet I have not seen any ratings take place, but I think that it is only a matter of time before traffic picks up for it (I have seen a fairly aggressive advertising campaign for it using Google). When it does, you will have two choices ignore what people say about your hospital or see it as a chance to make some real improvements.
Currently the site lets users rank anonymously on the following areas:
There are a couple of sites that are for patient ratings like, HealthGrades.com and Medicare.gov – Hospital Compare, but this site is a different approach to improving your patient care from the ground up. If all the areas are above are taken care of then there should inherently be good patient care going on at your hospital. I would be surprised if a hospital rated well on NurseRatings.org, but poorly on HealthGrades.com for instance.
Also, from a recruiting the best nursing staff standpoint, this site could be very beneficial or harmful. Seeing the feedback nurses are giving your hospital and making adjustments when appropriate is a great way to improve your overall nursing and allied health recruiting efforts.
Check the site out in a couple of months, I think you will see that there are plenty of ratings on it and some very useful information for all nursing and allied health unit managers, hospital staffing managers and hospital c-level decision makers to look at.
Alphabet staffing?
Over at HospitalImpact.org was a great post about emotionally intelligent patient care using DISC personality profiles (Dominant, Influential, Steady, Conscientious). The thought of personality types in a hospital unit is intriguing for a couple of reasons.
The first being the impact on patient care on an individual basis and being able to recognize what your patients are, which Nick Jacobs’ post talks about.
But it is also interesting to look at it from an intra-unit teamwork aspect. When building a team you have two choices, build it by design or build it by chance. I would prefer to build it by design and by evaluating my current staff and their personality types when I hire new staff I can look for someone who not only meets the clinical requirements for the job, but who also rounds out my unit and/or meshes well with our existing strengths and weaknesses. For example, if I were running an imaging unit I may already have a “Conscientious” X-ray tech “Steady” MRI tech and need to round it out with an “Influential” Ultrasound tech.
It is used in other industries and is definitely something that healthcare providers could use to determine the what kind of patient care a nurse may give or the attention to detail of a tech. Here are some good resources that explain how the DISC personality profiles work.
ChangingMinds.org
ProfilesGlobal.com
Help your young nurses hang in there
An article on Medical News Today discusses the recent healthcare summit at the White House that discussed the nursing shortage and the threat it poses on patient care in the United States. In the article they highlight a study by Dr. Peter Buerhaus that found that 80% of nurses believe the nursing shortage affects their ability to deliver quality care.
The University HealthSystem Consortium (UHC), an alliance of 103 academic medical centers and 210 of their affiliated hospitals, is asking hospitals to focus on nursing staff retention, especially during the economic downturn in support of Obama’s administration’s call to action.
The article discussed the UHC’s call for a greater emphasis on retaining new nurse graduates and highlighted their work with the American Association of Colleges of Nursing (AACN) to create the UHC/AACN Nurse Residency Program. The one-year program provides a curriculum and support aimed at new graduate nurses by giving them the tools they need to survive the intense pressure that comes with being a nurse in a hospital. So far the program has had great results in improving nurse retention. One hospital system that has implemented the program saw its turnover rate for new nurses go from 34% to 7% after just two years.
I don’t know the numbers for other industries, but the number of young nurses leaving the profession seems very high. I have not run across the same thing for allied health specialties like physical therapists, occupational therapists or imaging techs. Is this because of a disconnect between what the student nurse is promised versus the reality, is the atmosphere too intimidating, are they not practicing in the specialty they wanted, are the older nurses hostile to the new nurses? From what I read these are all a big part of it, but with the nursing shortage so high it is important to address these issues as early as possible regradless of which one is the biggest contributor.
One way is implementing the UHC’s program at your hospital or creating your own similar program. Have you?
Another is to give your new nurses the tools they need. If your new nurses are dealing with this, RealityRN is a great website for them to check out. They can let off steam and talk to other nurses who have dealt with first year burn out in their nursing careers and get advice.
Can travel healthcare staff actually save you money?
Last week Jason Lander over at Staffing Robot posted about the “Top 10 reasons to use temporary healthcare professionals.” The list was very thorough, though I did comment that I would add improved patient care and safety to the list. What struck me was the timing of the post. We had just published a white paper and staffing calculator for our client hospitals that addressed many of these same issues, especially the morale of the perm nursing staff and and the hidden cost savings that occur when units are properly staffed.
It looks like there is still a lot of education that still needs done on the value of supplemental staff for hospitals. Although the focus of the white paper was on nursing, many of the same principles apply to allied health professionals like PT/OT, Imaging and Lab techs and therapists. Here is a link to download our nursing staff value calculator and white paper if you are interested.
Best of the healthcare staffing web
We are always trying to provide you with the best content on the internet when it comes to nurse and allied health staffing issues. And one way to do that is to bring you other sites that we think are doing a great job. So keep a look out for this new monthly feature and be sure to send us any sites that you as a nursing or allied health decision maker find useful in your daily life at the hospital.
Nurse retention – how do you make them stay?
In an article I just read, a recent study published in Nursing Economics is discussed. It takes a look at nurse retention. It found that they are more likely to stay committed to their hospital and be satisfied with their jobs if a variety of factors exist.
These factors are really not that earth shattering. They are simply practices any hospital, or company for that matter, should try to have as part of their culture stratgegy.
The factors include:
Variety
Autonomy
Supervisory support
Work-group cohesion
Procedural justice (rights are applied universally to all employees)
Promotional opportunities
Collegial nurse/doctor relations
Given the immense benefits of retaining nurses (cost savings from reduced turnover, better patient care, less nurse burnout and consequently leaving the profession) it seems like these would be some simple things hospitals can do. Notice only one was in any way tied to pay or compensation. The rest had to do with giving them respect as professionals and treating them right. That should not really be that hard.
Here is a link to the nurse retention article. What do you think is the easiest of these measures to take at your hospital? Answer in our first Healthcare Staffing Blog poll.
Overtime and hospital staff burnout
In the current economy we are seeing many hospitals relying on their own perm staff to fill a lot more overtime hours than in the past. For some nurses and therapists this is a welcome boost to their paycheck, while for others it may be something they feel obligated as caregivers to do. No matter the circumstances it will eventually start to wear them out. There is plenty of research available showing the negative effects of too much overtime, everything from nurse burnout, to costs associated with nurse turnover, to putting patients at risk. So what can you do as a unit manager to help ease the effects of overtime on your staff?
Your ability to help them through hiring more nurses or therapists may be limited unless you can convince the financial decision makers of the savings that come with being adequately staffed. But there are things you can have an impact on.
Since you know that too much overtime is going to eventually lead to burnout, you will want to keep an eye on the signs of burnout among your staff. It is also important for you to avoid burnout yourself, so that you can be there for your staff when you sense that they are stressed and give them advice and tips for managing their stress. Below are some links that give you practical advice on how to spot and respond to you and your staff’s burnout.
Battling Burnout: Maintaining Enthusiasm in a Challenging Environment
StressedOutNurses.com
Times flies, but you don’t have to
Help staff handle stress by boosting resiliency
Nurse retention through meditation
Nursing Burnout Prevention
Why Emotions Matter: Age, Agitation, and Burnout Among Registered Nurses
Nurse Burnout is it preventable?
I’ve been reading a lot about nurse burnout lately. There is a ton of information on the web about it, from the signs associated with it, ways to cope with it, its impact on patients and its financial implications.
For a nurse manager there are some practical measures you can take to help reduce nurse burnout in your hospital unit. Key to this is being able to understand where it is coming from, what causes it and recognizing the symptoms. Here are some links to some great resources to help you recognize and deal with nurse burnout in your staff:
Addressing Nurse Burnout – Changing Culture Is The Cure
Institute for Healthcare Leadership
Just remember that left unaddressed nurse burnout can eventually lead to losing a valuable member of your staff and that can have a real impact on the patient care you are able to provide.
