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This excerpt, chapter 12 from the book Nursing Management: Principles and Practice, edited by Mary Magee Gullatte, RN, MN, ANP, AOCN®, FAAMA, is part of a series of clinically relevant reprints that appear periodically in the Clinical Journal of Oncology Nursing.
"Change your thoughts and you change your world."
-Norman Vincent Peale
For decades, efforts to maintain adequate levels of RNs in the healthcare workforce have centered on recruitment. The current workforce challenges and opportunities related to the national shortage of RNs in health care are outlined in chapter 9. This chapter will focus on creating a culture of retention as one key strategy to decrease nurse turnover and cost. Surely the answer to RN vacancies lies in a strong and solid recruitment effort; however, once recruited, greater emphasis must be placed on retention. Consider that for every two nurses recruited, one or more could leave. Tens of thousands of dollars are spent each year on nurse advertising and recruitment strategies to hire RNs at all levels and across multiple specialties. Turnover comes at a high price to the organization and to the staff left behind who just spent weeks, physically and emotionally, precepting and acculturating the new hire in orientation and to the work environment.
Nurse managers find themselves facing an ever-challenging global nursing shortage. The current shortage of registered nurses in the United States is expected to intensify as baby boomers age and the need for health care grows (American Association of Colleges of Nursing, 2003). This shortage, to rival none in history, is sparked by a multitude of factors: aging nursing pool, fewer women choosing nursing as a career, and others outlined in chapter 9. To meet this challenge, healthcare employers have initiated multiple strategies, from foreign nurse recruitment and sign-on bonuses to creative benefit packages, such as maid service, dry cleaning pick-up and delivery, and car washing. Although these tangible amenities are nice, they seldom result, alone, in retaining a satisfied employee (Ropp, 2003). Recruitment bonuses serve the purpose of alluring the nurse to the organization, but it is often a quick fix. Once the bonus is received, the employee, if primarily motivated by money, is out looking for the next big payday. Often these grand sign-on bonuses serve to...