How to Retain the Indefatigable Nurse

By Keith Carlson via Multibriefs

When we use the word "indefatigable" in conjunction with the word "nurse," it is an almost perfect pairing of noun and adjective. Indefatigable can be defined as industrious, tireless or unflagging, and that is a powerfully accurate description of the majority of hard-working nurses who serve as the very mitochondria of healthcare.

If healthcare employers want these nurse mitochondria to be their most effective, they need to double down on their nurses and put some skin in the game when it comes to retention.

The (Tired) Untiring Nurse

Dangerous nurse-patient ratios, mandatory overtime, lack of time for self-care, ineffective management, bullying and other negative forces all contribute to nurse fatigue, burnout, and attrition. In this complex, 21st-century healthcare space, nurses must steel themselves for the challenges of delivering optimal care in frequently suboptimal workplace environments.

When admitted to the hospital, anyone in their right mind would want their nurse to be untiringly attentive, whether in an outpatient clinic, the ICU or a dialysis unit. The nurse wants it, the patient wants it, and the system demands that the nurse step up to the plate and bat 1.000 every time. The pressure and the human stakes could not be higher.

This call for nurses to perform at the top of their game in a frequently unforgiving environment is a sign that something must change. Healthcare employers seeking untiring nurses must meet those nurses with sensible supports that make such high-level nursing practices possible.

Fair staffing, an emphasis on self-care, skillful management practices, and positive workplace cultures are just a few places to begin.

Feeding and Watering the Unflagging Nurse

Healthcare employers obviously invest a great deal in the screening, hiring and onboarding of new nurse employees.

However, we also know that nurse attrition can be quite high, often due to poor management, lack of support and other organizational/managerial issues. We also know that up to 30 percent of new nurses leave the profession in the first few years.

If employers seek loyalty, hard work and the highest levels of performance from their nurses, those indefatigable nurses should thus be seen as precious commodities worthy of a positive, safe, and healthy workplace and work culture. Nurses are not just financial liabilities and so much cannon fodder — they are the driving force of the care that facilities seek to provide. Without a dedicated nurse workforce, facilities would be essentially cut off at the knees.

The feeding and watering of unflagging, hard-working nurses isn’t rocket science, yet many healthcare institutions miss the mark when it comes to retention. While trinkets and flowers during Nurses Week are a nice touch, the retention of committed, high-quality nurse employees take more than a Nurses Week luncheon.

So, where does the thoughtful healthcare executive team begin when planning a well-rounded nurse retention initiative? Here are some basic ideas:

1. New graduate residency programs are a powerful onboarding funnel that grow new nurses into competent and productive team members.
2. Well-designed mentoring programs help new and seasoned nurses to fulfill their professional and career.
3. Dedicated charge nurses and managers who don’t carry patient loads are a boon to busy units in need of hands-on management from leaders who truly have time to support their direct reports.
4. A workplace free of bullying, harassment, and intimidation is crucial. A process for documenting, reporting, and following up aberrant behavior is incredibly important and rarely implemented. Follow up should include removal of all bullies from the workplace.
5. Team structures should allow for all nurses to receive at least a 15-minute break and 30-minute meal break during each shift. Nurses who are hydrated, fed, and rested are less likely to make errors and more likely to perform most efficiently.
6. Nurse-patient ratios and staffing practices must lend themselves to optimal care. The human bottom line (patients and staff) must be given equal weight in relation to the financial bottom line.

It Takes Commitment

Leaders in nursing and healthcare have a responsibility to nurture and retain the cream of the nursing crop. In the United States and countries around the world, we face a rapidly aging population and exponentially increased numbers of insured citizens in need of care.

We urgently need to stop the attrition of nurses from the profession and keep them happy, healthy, feeling appreciated and professionally satisfied. Commitment and forward-thinking retention strategies are key, and it is up to employers, executives and leaders to seize the moment and support nurses in the manner they deserve.

Yes, the feeding and watering of an effective, high-quality nursing workforce isn't rocket science, and the leaders out there in the healthcare space are in a position to make sure these positive solutions become the norm.

The nurse mitochondria are mighty indeed — giving them the best will only increase their ability to consistently serve at the top of their game.

Keith Carlson, RN, BSN, NC-BC, has been a nurse since 1996. He is the blogger behind the award-winning blog, Digital Doorway and a widely read freelance nurse writer. Keith is also the co-host of RNFM Radio, a popular Internet radio station devoted to the nursing profession. Under the auspices of Nurse Keith Coaching, Keith's passion is helping nurses and healthcare professionals create ultimate satisfaction in both their personal and professional lives.