Retention

I.    Approaches Underway by Task Force Member Organizations

Greater New York Hospital Association (GNYHA)

• Designed and implemented a five-part series: Nursing Leadership Seminar Series for nurse managers that was attended by approximately 250 nurse managers
  
  
• With the Department of Health (DOH), developed Health Workforce Retraining Initiative (HWRI) to focus funds on providing workers with skills that will help them meet the demands of their jobs
  
  
• Founding member of the Coalition to Protect America's Health Care, an organization of hospitals, hospital associations, and businesses that successfully campaigned for relief from the Balanced Budget Act's Medicare and Medicaid cuts
  
  
• Identifying a pool of foreign-trained nurses to participate in a work-study program in collaboration with CUNY that would prepare nurses for R.N. or L.P.N. licensure examinations
  
  
• Formed a strategic alliance with NursingHands, Inc., which provides GNYHA member institutions with access to services including job postings, employer profiles, and a nurse resume database

Healthcare Association of New York State (HANYS)

• Initiated the Workforce Investment Now (WIN) Coalition with other provider associations to promote collaboration on workforce shortage solutions focusing on resources; educational support; promotion of health careers; regulatory barriers; and workplace environment
  
  
• Sponsoring a series of educational programs focused on the magnet hospital recognition program during this fall
  
  
• Sponsoring a series of educational programs highlighting successful strategies for communicating value and respect and providing recognition and reward for health care workers during this fall
  
  
• Introduced a special Workforce section to their Web site
  
  
• Developed an on-line Job Bank
  
  
• Published Health Systems Strategist: Health Care Recruitment and Retention Best Practices
  
  
• Published Health Systems Strategist: The Crisis in Care, which examines potential solutions to the nursing shortage

New York Public Interest Research Group (NYPIRG)

• Supporting appropriate legislation related to the nursing shortage and patient protection.

New York State Department of Health (DOH)

• Releasing Request for Proposals for the next round of Health Workforce Retaining Initiative (HWRI) grants to recruit, train and upgrade healthcare workers, including nurses. New York State has committed $573 million for these grants.

New York State Legislature

• Propose relevant legislation to expand and retain the existing nurse workforce.

New York State Nurses Association (NYSNA)

• Convened an Invitational Roundtable on the Nursing Workforce which created four workgroups to deal with specific issues related to the nursing shortage:
  • Education Issues
  • Workplace/Employer Issues
  • Governmental Issues
  • Professional Associate Issues
    
• Actively supporting legislation to:
  • Create enforceable staffing standards in hospitals and other healthcare organizations
  • Establish staffing ratios in nursing homes
  • Protect the title "nurse"; require hospitals and nursing homes to disclose and report nurse-to-patient ratios and the mix of licensed and unlicensed personnel
  • Require whistleblower protection for nurses
  • Stipulate maximum number of consecutive hours during which a nurse may work
  
  
• Incorporating magnet hospital principles into contract negotiations

New York Organization of Nurse Executives (NYONE)

• Continue to partner with other groups in opposing legislation for staffing ratios
  
  
• Commissioned two national experts, Mary Wakefield, PhD, RN, and Peter Buerhaus, PhD, RN, to develop seminal research on the nursing shortage
  
  
• Commiting educational programming to develop and enhance the characteristics demonstrated in the Magnet Hospitals study in order to improve the work place, retain expert staff and ensure patient safety

Central New York Summit on the Nursing Shortage

• Syracuse University College of Nursing hosted a Central New York summit to coordinate efforts of regional stakeholders regarding the nursing shortage. Outcomes of the summit include:
  • Developing a regional recruitment video on nursing
  • Encouraging a Future Health Professional Club
  • Supporting key Central New York leaders in recruitment and retention strategies
  • Developing ways to recruit men into the profession by promoting the presence of technology within the profession

II.    Possible Approaches Identified in the Literature Discussed by the Task Force

• Decrease the wage gap between various health care providers and design salary and benefit packages to reward professional competency, including:
  • higher wages
  • bonuses
  • flex time
  • retirement plans
  • education packages for workers' dependents
  • subsidized loans for homes and cars
  
  
• Develop clinical and administrative career ladders for nurses.
  
  
• Establish recognition and reward programs.
  
  
• Provide health care executives and nurse leaders with the skills for valuing employees so that the contributions of nurses will be appreciated.
  
  
• Create organizational environments where:
  • treatment is fair and respectful
  • communication is open
  • work is important and challenging
  • schedules are predictable and flexible
  • opportunities exist to learn and grow
  • performance is recognized and rewarded
  • job control is shared with employees
  
  
• Give nurses control over their practice environment, including decentralized decision-making at the unit level.
  
  
• Retain older RN's in the workforce, as:
  • preceptors
  • mentors
  • in-house consultants to other clinical nurses
  • advisors to new RNs
  
  
• Monitor patient outcomes that are affected by nursing/staffing.
  
  
• Improve the quality of nurse staffing data by adopting definitions for calculating full and part-time equivalent employees; define patient acuity indicators and appropriate nurse staffing ratios
  
  
• Report nurse staffing data by inpatient and outpatient setting, specific nursing unit and nursing practice team (primary, team, functional)
  
  
• Encourage hospitals to adopt best practices associated with "magnet" hospitals as a mechanism for providing excellence in nursing
  
  
• Organize nurses' clinical responsibilities at the unit level to promote accountability and continuity of care
  
  
• Give RNs greater autonomy over their legal scope of practice
  
  
• Provide more predictable and flexible work schedules
  
  
• Provide incentives to attract nurses no longer practicing back into practice
  
  
• Increase re-entry and refresher courses to tap nurses no longer practicing back into practice