In October last year we conducted a survey on the healthcare staffing industry. Our goals were to learn how we can improve hospital’s experiences with staffing companies and how we could better help hospitals meet their staffing needs.
We asked two simple questions:
- How would you rate your experience working with healthcare staffing companies / Medical Solutions?
- What is the primary reason for your score?
We have compiled the responses and broke them down into several common themes split between two categories:
- What you like about staffing agencies
- What you don’t like about staffing agencies
Here are the results if you are interested: Healthcare Staffing Satisfaction Survey Results
One common challenge hospitals that utilize travel nurses face is how to get them to buy into their hospital’s culture even though they are only there temporarily. Because this is a difficult thing to achieve many times, it may be easier to just dismiss the problem as just the nature of the travel nursing industry, but a nurse who buys into the hospital is going to be more engaged and more than likely going to deliver better patient care.
You are also potentially selling your hospital as a permanent job to a traveler so you want to make sure that the culture they experience is one that they would want to embrace on a full-time basis. And don’t forget how the Internet has changed what potential candidates know about your hospital with forums and sites like HealthcareTravelBook.com and NurseRatings.org that let nurses review the hospitals they work in.
Travelers are often known for traveling to avoid the hospital politics and drama so they can just focus on patient care, but that doesn’t mean that they don’t want to work in an environment where they feel needed, respected and motivated.
So what is the answer? How do you get a travel nurse to buy in?
Here are just 10 ideas:
- Don’t assume it is impossible
- Knowing it affects patient care, make it a priority
- Make culture part of your screening process when hiring travelers
- Show travelers immediately how they fit into your culture when they arrive
- Discuss your culture with the travel nursing companies you work with and let them know it is part of how you evaluate a candidate
- List your core values in the job descriptions you send the staffing companies you work with
- Assign a Core Values Coordinator role to one of your best perm staff who can help travelers understand your hospital’s
- Create a culture guide for travel nurses to have when they start – list any office etiquette or unwritten rules they need to know
- Try to create a culture they want to embrace – don’t force it
- Get their feedback – ask what they have seen or experienced at other hospitals that made them feel part of the culture during other assignments
What things do you do? What is your opinion on cultural buy in for travel nurses?
If your hospital is part of or planning to be part of one of the Recovery Act Beacon Community Program participants or any of the other HITECH Act programs then you are probably excited to be part of a program that will improve patient care for people. But on the other hand you may be worried about the stress that taking the time to learn new technology will put on your nursing staff and their ability to deliver patient care during the conversion process.
Helping with patient care
One way to deal with this is through the utilization of travel nurses who can step in and fill gaps in patient care while your perm staff goes through their training on the new systems. This works out well because of the temporary nature of travel nursing assignments as well as the flexibility most travel nursing companies can accommodate when it comes to extending assignments if the training and implementation takes longer than expected.
Helping with systems
Another benefit of having travel nurses in your facility during this process is that many have experience with multiple different records and computer systems. This experience can make them valuable resources in the process of training your permanent staff as well if they have experience in the one you are moving to. In addition, even if they have not had direct experience with your new system, their ability to and background in having to learn new systems quickly when they move to a new assignment could also be an asset to your unit during this time.
So if your hospital is planning on making this move, then be sure to contact your travel nursing company to make arrangements to ensure you will be sufficiently staffed when the time comes. And if you are unsure if your hospital is preparing for this, check with your IT department to see what they are planning.
If you have ever had a stressed out nurse who just needed a break (including yourself) then the Scrubs “Meditation in Minutes” Tool at ScrubsMag.com may be a great tool for you to use.
It was created with the input of Jason Evan Mihalko, PsyD, and Leslie Davenport, psychotherapist and author of Healing and Transformation Through Self-Guided Imagery and offers relaxation techniques that can be done in different time allotments.
There are exercises that take:
- 1 minute
- 2 minutes
- 5 minutes
- 7 minutes
- 15 minutes
It is an easy to use tool, which is a good thing; you don’t want a tool that is supposed to help you relax be hard to use. You just click on the time you have to relax and a little pop up with the suggestion appears.
Try it out the next time one of your nurses looks a little stressed and let us know how it works.
One key to nurse retention is the morale of your nurses. However, there are things about the morale of your unit you can control and things you can’t. Things like your budget, staff numbers and patient levels are unfortunately things that you are responsible for, but don’t have complete control over, which of course is a stressful situation to be in.
The key is to not let the things you don’t have control over negatively affect the things you do, like the patient care your nurses deliver, the experience patients’ families have and of course your staffs morale. And one of the best ways to improve all three of those areas is through humor; both having a good sense of humor yourself and promoting it and cultivating a culture of it in your staff.
Here are some great resources for helping you encourage laughter in your unit.
One of the easiest ways to make the most of travel nurses and to have them fit your culture better is to simply make them less “travel” and more like “semi-perm”, Which means having them work at your hospital longer than the typical 13 week assignment.
The question is how do you do that. There are two areas you will need to address to accomplish this.
First, you need to work with your travel nursing company to let them know you want travelers to stay longer than 13 weeks or you want to extend a travel nurse’s assignment.
Second, you need to make sure that when a traveler is at your hospital that they actually want to come back; assuming you like them and respect their clinical abilities.
Extending travel nursing assignments
Let’s start by looking at the idea of having travelers work longer assignments. The 13 week assignment is the industry standard, but it is by no means set in stone. A good travel nursing company is going to be able to accommodate your wish for either longer assignments on the initial contract or extending a traveler to a second 13 week contract. If this is not something welcomed by the companies you are working with then you may want to consider shopping around.
By having travel nurses work longer periods of time at your hospital you are able to get the economic advantage of using travel nurses, while at the same time overcoming the common challenge of them not always fitting into your unit’s personality or knowing your protocols, procedures, systems and software.
Re-recruiting travel nurses
Now let’s look at the area of making sure that travel nurses actually want to extend at your hospital. Obviously you need to make sure that the traveler is one that you want to extend, which all comes down to the quality of the travelers you work with. Here is a past article we wrote on how to make sure you hire qualified travel nurses.
After that though, whether a traveler wants to stay at your hospital comes down to some things that are out of your control and other factors that are in your control. We don’t need to focus on the ones that are out of your control, but quickly, they are things like your hospital’s location, the indiividual travel nurse’s nomadic tendencies (a fancy way to say how long can they even stand staying in one place), the weather, if they like traveling, etc.
Now onto things you do have control over. One of the biggest reasons a traveler will stay at your hospital is simply because they feel welcome and needed. There are two easy ways you can make sure this happens. Providing a good travel nursing orientation and a travel nurse friendly culture.
We have written extensively on both of these areas in the past, so we don’t need to rehash them all here. Instead here are the links to those posts.
Travel nurses and hospital culture – Make sure they fit
Makeover your unit by integrating travel nurses
How do you orient travel nurses?
Phone interview questions to make sure travel nurses will be a cultural fit
Although there are things that travel nurses themselves and travel nursing companies can do to help improve the travel nursing product, there are also things that you can be proactive in to make the most of it to serve your patients right now. And having them stay longer is one of the most effective.
One continual challenge of using travel nurses to meet staffing needs in your hospital is the culture fit of the nurse into your unit. This is understandable considering how short of a time they are in your hospital and how little information you have about them before they get there and vice-versa. Compare this to what you would know about a potential permanent nurse who you were able to interview in person and it is easy to see how ensuring a culture fit using a traveler RN can be a challenge.
This is an area where staffing companies should definitely always work on improving, but as a nurse manager or HR professional there are some things you can do internally as well at your hospital.
One of the simplest is to take the time to outline exactly what your culture is and communicate it to your contacts at the travel nursing companies you work with. Whether it is a page on your website or a culture manual just for travelers, the mere act of putting it together will not only help you lay out what you expect of travelers when they arrive, but will also help you see any areas that may pose a challenge for a traveler when they arrive and consequently get your brain started on simple solutions.
Finding the time to do this may not be easy, but it needs to be looked at as an investment of your time. The more effective you are at eliminating poor culture fits up front means the less time you and your travel nursing company will have to spend dealing with them as personnel issues later. Culture training needs to be part of your travel nurse orientation process.
This website has a lot of good articles, tips and tools for building a great culture so check it out.
And for a look at one of the most famous company culture icons of business check out Zappos’ culture section of their website.
If you want to be a better nurse manager then makes sure you check out these characteristics of an effective nurse manager collected by asking nurses themselves what makes their bosses great.
This article gives clear advice on why using teams of front-line nurses to improve your hospitals processes instead of relying management to come up with them.
Joint Commission works with hospitals to improve patient hand-offs
Some of the nation’s leading hospitals are working with the Joint Commission Center for Transforming Healthcare to develop innovative way to eliminate provider miscommunication during patient turnovers (these miscommunications are responsible for about 80% of serious medical errors). See what you and your hospital can start doing now.
One common complaint that hospitals tend to have with travel nursing companies is the “salesman” approach.
What does that mean?
It is what occurs when a travel nursing recruiter or client manager over-promises on a nurse’s fit for the position and the nurse does not live up to the expectations.
Unfortunately, once this happens with one or two companies it is easy to believe that this is what all companies will do.
Trusting that a travel nursing company is going to deliver quality candidates is vitally important to ensure good patient care at your hospital. This is particularly true if using travelers is part of your staffing strategy on a regular basis. So if this is your experience, here are some previous posts I have written that will give you some more background on and help you do more research into the process that the companies use to evaluate the qualifications of their travelers and what they do to determine they are a good fit at your hospital.
- Evaluating a Company’s Nursing and Allied Health Candidates
- How to evaluate a traveler’s resume
- Why should I use one company over another to meet my healthcare staffing needs?
- What types of nurse staffing do travel nursing companies provide?
- What skills or competencies do healthcare staffing companies require for travel RNs?
- How nurse managers can improve a hospital’s use of travel nurses
This PDF looks at the findings of the program that The Robert Wood Johnson Foundation (RWJF) launched called Wisdom at Work: Retaining Experienced Nurses in 2006. The goal was to build an evidence base for what works to retain experienced nurses in hospital settings and to develop a better understanding of the impact of existing interventions on the work environment for older nurses.
This article describes a plan of succession to bring new nurse managers on as the Baby Boomer generation nurse managers start to retire.
This insightful article looks at what nurse managers can learn when they go back in the trenches.