Iowa Nurse Reporter - June 2022

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Page 18 • Iowa Nurse Reporter June, July, August 2022 The Importance of Caring for Those Who Care In May, nurses celebrated Florence Nightingale’s birthday, National Nurses week, and hosted the time-honored tradition of a pinning ceremony for hundreds of nursing graduates who anxiously prepare for NCLEX and eager to begin their professional nursing practice. This is a generation of nurses whose education faced unique challenges due to COVID 19. While educators were forced to find innovative ways to teach critical content; students found creative ways to apply skills and become proficient in their clinical judgement. Melding the experience and knowledge of expert nurses and the energy and vision of novice nurses will strengthen our profession. Successful transition into practice includes finding (or being assigned) a mentor who can actively listen, provide feedback, encourage and generate enthusiasm for nursing practice. However, finding time to be an effective mentor for nurses entering practice can be difficult to add to an already demanding workload. Dawn M. Bowker, Ph.D., RN, ARNP- BC, SANE INA Director of Public Policy Latoya Stewart shared an early conversation she had with her mentor when she became a nurse manager, her mentor asked, “what would you prefer in a garden, orchids, or weeds?” Stewart quickly responded orchids. The mentor explained that there are two types of nurses, orchids and weeds. Orchids demand more care and attention, and are more sensitive. Adversely, the weeds are resilient, and can grow even in difficult situations. Stewart expressed that she has learned over the years that even weeds need attention. Nurse mentor and mentees need to be tended to and these relationships need to be fostered. Employers need to care for nurses as much as nurses care for their patients. This includes addressing staffing ratios, looking at illness levels and the complexity of patients, and making sure they are not putting nurses in unsafe working conditions by having to care for too many sick patients at one time (Hernandez 2022). In addition to staffing ratios, Larkin, a public policy nurse for the Robert Wood Johnson Foundation articulated three trends in nursing: 1. More young nurses who have just entered the profession leave the profession and leave bedside nursing. According to Larkin, 100,000 nurses left the profession last year. This is alarming and disturbing, because a large percentage of the nurses leaving were under the age of 35. Nurses listed burnout and fatigue as the most common reason for leaving their job. Nurses also cited violence at the bedside both physically and mentally by patients and their families (Hernandez 2022; Scripps National, 2022). Approximately 25% of registered nurses reported being physically assaulted by a patient or family member, while over 50% reported exposure to verbal abuse or bullying (Al-Qadi, 2021). The adverse effect of horizontal violence and interprofessional conflict is a significant issue amongst nurses. The consequences of workplace violence are manifested through increased sick leave, decreased job satisfaction, a high turnover rate, very low productivity, and an increase in error frequency by staff (Al-Qadi, 2021). An alarming 17.2% of nurses leave their position every year due to workplace violence (Al- Qadi, 2021). 2. Nursing is experiencing its sharpest exit in decades; more people are applying to nursing schools than they have room for and the future of nursing is changing. According to the American Association of Colleges of Nursing (AACN) student enrollment in baccalaureate, master’s, and doctoral nursing programs increased in 2020 despite concerns that the pandemic might diminish interest in nursing careers. In programs designed to prepare new registered nurses at the baccalaureate level, enrollment increased by 5.6% with 251,145 students now studying in these programs nationwide (AACN, 2021). Compounding the critical need for nurses, there is a nursing faculty shortage. Over 80,000 eligible nursing applicants were denied admission in undergraduate and graduate nursing programs, most often due to a shortage of nursing faculty. The National League for Nursing predicts there will be 34,200 new nursing faculty needed by the end of 2022 (AACN, 2020). 3. Build self-care modalities in nursing curricula. Nursing programs need to make sure they are building in self-care into curriculum to help nurses recognize what they need to do for their own well-being and learn to be resilient, yet recognize the signs of when they need help (Scripps National, 2022). Neglecting self-care responsibilities can contribute to a cascade of adverse outcomes including musculoskeletal pain and depression. Nurses who are not present and caring for themselves have higher patient falls, medication errors, and lower quality of care scores. This demonstrates how neglected self-care can be detrimental to both the nurse and their patients. Additionally, stress contributes to chronic disease. The stress hormone cortisol and the hormone adrenaline can build up in the bloodstream and lead to hyperglycemia, hyperinsulinemia, arteriosclerosis, hypertension, and a decrease in the function of the immune system. Ignoring stress can also lead to chronic fatigue and/or depression (Kelbach, 2022). Kelbach addresses eight areas of self-care including mental, physical, emotional, spiritual, social, personal, professional, and medical aspects. If you are not engaging in a self-care modality, this article provides ideas on how you can begin a productive self-care routine. The pandemic has shown us that nurses are very resilient, but also very vulnerable. Recent exposure to nurse suicide is a scream for open dialogue and need to break the culture of silence regarding suicide among nurses. A recent study published by the CDC showed that more than 70 percent of health care workers in the US suffer from anxiety and depression, 38 percent have symptoms of PTSD and 15 percent have had recent thoughts of suicide or self-harm. Policy and Advocacy Given their powerful role in influencing people, policies, and systems; nurses are needed in government positions, on the boards of for-profits and not-for-profit organizations and mentoring the next generation of nurses. Nurses are leaders, and we need them to lead. Systems are only as good as the people in front of them providing the guidance and support and that requires careful listening. What we really need to be doing is making sure that the employers, policy makers and schools of nursing are supporting nurses every day in the job they are doing (Hernandez 2022). References American Association of Colleges of Nursing (2021, April 1). Student Enrollment Surged in U.S. Schools of Nursing in 2020 Despite Challenges Presented by the Pandemic. Retrieved from https://www.aacnnursing.org/News-Information/Press-Releases/View/ ArticleId/24802/2020-survey-data-student-enrollment American Association of Colleges of Nursing (2020). Nursing faculty shortage. Retrieved from https://www.aacnnursing.org/news-information/fact-sheets/nursing-facultyshortage Ahmad, Najaf (2022, May 2). Good things happen when nurses lead. Retrieved from https:// www.rwjf.org/en/blog/2022/05/good-things-happen-when-nurses-lead.html Al-Qadi M. M. (2021). Workplace violence in nursing: A concept analysis. Journal of occupational health, 63(1), e12226. https://doi.org/10.1002/1348-9585.12226 Kelbach J. (2022). The Ultimate Guide to Self-Care for Nurses. Registered Nurses.org Retrieved from https://www.registerednursing.org/articles/ultimate-guide-self-carenurses/ Hernandez, S. (2022, May 13). This data is disturbing: Why over a 100K nurses left their job last year. Retrieved from https://www.kxan.com/news/national-news/this-data-wasalarming-and-disturbing-why-over-a-100k-nurses-left-their-job-last-year/ Scripps National (2022, May 12). Nurses facing workplace challenges amid changing landscape. Retrieved from https://www.wcpo.com/news/national/nurses-facingworkplace-challenges-amid-changing-landscape Stewart, L.L. (2022, May 04). Nursing is not gardening, but you must still attend to the weeds. Medscape. Retrieved from https://www.medscape.com/viewarticle/973271 NursingALD.com can point you right to that perfect NURSING JOB! NursingALD.com Free to Nurses Privacy Assured Easy to Use E-mailed Job Leads
June, July, August 2022 Iowa Nurse Reporter • Page 19 Meeting the Nurse Staffing Challenge, Part One: Recruitment Tips Georgia Reiner, MS, CPHRM, Risk Specialist, NSO The COVID-19 pandemic has prompted nurses to rethink their careers and reinforced the need for healthcare and nursing leaders to shift their approach to nurse recruitment and retention. A 2021 survey by the American Nurses Foundation found that 18 percent of 22,316 respondents planned to leave their current position in the next six months. When the data are sorted by nurses working in hospitals (8,524), that percentage rises to 21 percent. These pandemic-related staffing problems are intensified by factors that existed before COVID-19 and that still plague leaders. For example, hospitals in rural areas continue to struggle more with nurse staffing than those in urban locations. Generational differences also exist, with Generation Zers and Millennials more likely to leave positions compared to Generation Xers and Baby Boomers. The exodus of bedside nurses takes its toll on remaining staff and, in some cases, quality of care. Too often, organizations have viewed nurses primarily as an expense, failing to understand that investing in this workforce yields financial rewards. High-quality nursing care helps to reduce the likelihood of patient safety events and costly medical malpractice lawsuits related to missed errors. Savvy leaders know that ensuring appropriate staffing levels is key to the financial health of the organization, which means engaging in effective recruitment and retention strategies. This article, the first in a two-part series on nursing recruitment and retention, will address recruitment strategies that leaders can utilize to help attract new nurses to their organization. Recruitment Nursing and other organizational leaders need to work closely with human resources staff to ensure recruitment processes are efficient and effective: Craft ads that work. First impressions count. Everyone is your competitor for a limited pool of nursing talent, so do what you can to make your organization stand out as an attractive place to work. Be sure images in recruitment ads reflect the organization, particularly when it comes to diversity. Many organizations feature their own nurses in ads, which has the additional benefit of employee recognition. Try to make your messaging as personalized as possible, emphasizing your organization’s culture and authentically communicating why nurses should want to be a part of your organization. Reach out early. Ask staff who work with students completing clinical rotations to identify those who might make good employees when they graduate. Then get to know the students and encourage them to apply when the time comes. If you lead a specialty unit, invite students to attend meetings (onsite or virtual) of local chapters of the national specialty nursing association so they can learn more about the role. You also may want to partner with local schools to teach a class or workshop so you can connect with students. Promote digital efforts. Organizations’ websites often miss the opportunity to feature nurses. Your facility’s website should have a special section highlighting nursing, including stories that feature individual nurses. You can ask staff to record video testimonials that highlight what they enjoy about working for your organization. In addition, your organization’s job portal and job application process should not be so cumbersome that potential employees give up in frustration. Individualize benefits. Avoid a “one size fits all” approach to benefits. Instead, offer a menu that nurses can choose from. For example, a late-career nurse may be more interested in retirement-matching funds, but a newerto-practice nurse may be attracted to a flexible schedule, tuition or student loan assistance, or child-care benefits. Obtain Magnet® status. Becoming a Magnet®designated facility can be expensive, but many nurses prefer organizations with this designation, so it can be well worth the investment. Magnet® status also may help reduce turnover and decrease patient morbidity and mortality. Provide optimal onboarding. This is often discussed as a retention tool, but it also falls under the recruitment category, as potential employees want to know how supported they will be in their new role. This is particularly true of new graduate nurses, who have seen their recently graduated colleagues rushed into practice as a result of the pandemic. Many organizations are being shortsighted in cutting back on nurse residency programs, which not only attract staff, but also promote a smoother transition into practice, thus increasing retention. Preceptors should be chosen based not only on their level of expertise, but their effectiveness as educators. Orientees (and preceptors) should know that they can speak up if the match isn’t working. Be sure staff feel warmly welcomed. For example, some organizations send a signed welcome card to the employee’s home before their start date. Others post the employee’s name and photo in a visible location on the unit. Check in regularly with new staff to see how they are adjusting, such as weekly for a month, then every other month or so, and then after 6 months. Meeting the challenge Finding creative solutions to recruit nurses is more important than ever. However, it is only the first piece of the puzzle to building a robust nursing team. Creating a safe, supportive work environment that recognizes nurses’ meaningful contributions is essential to encourage nurses to want to keep working for your organization. Part two will discuss retention strategies that healthcare and nursing leaders can employ to help increase the likelihood that they retain current nursing staff. References American Nurses Credentialing Center. Magnet benefits. n.d. https://www.nursingworld.org/organizational-programs/ magnet/about-magnet/why- become-magnet/benefits/ American Nurses Foundation. COVID-19 impact assessment survey – the first year. 2021. https://www.nursingworld. org/practice-policy/work- environment/health-safety/ disaster-preparedness/coronavirus/what-you-need-toknow/year-one-covid-19-impact-assessment-survey/ CNA & NSO. Nurse Professional Liability Exposure Claim Report: 4th Edition: Minimizing Risk, Achieving Excellence. 2020. https://www.nso.com/Learning/Artifacts/Claim- Reports/Minimizing-Risk-Achieving-Excellence Malliaris AP, Phillips J, Bakerjian, D. Nursing and Patient Safety. Agency for Healthcare Research and Quality. 2021. https://psnet.ahrq.gov/primer/nursing-and-patient-safety Pink D. When: The Scientific Secrets of Perfect Timing. Riverhead Books; 2019. Reitz O, Anderson M, Hill PD. Job embeddedness and nurse retention. Nurs Admin Q. 2010;34(3):190-200. Sherman RO. The Nuts and Bolts of Nursing Leadership: Your Toolkit for Success. Rose. O. Sherman; 2021. Wolters Kluwer. Ten recruiting strategies to attract nurses. 2019. https://www.wolterskluwer.com/en/expert-insights/ ten-recruiting-strategies-to-attract- nurses Disclaimer: The information offered within this article reflects general principles only and does not constitute legal advice by Nurses Service Organization (NSO) or establish appropriate or acceptable standards of professional conduct. Readers should consult with an attorney if they have specific concerns. Neither Affinity Insurance Services, Inc. nor NSO assumes any liability for how this information is applied in practice or for the accuracy of this information. This risk management information was provided by Nurses Service Organization (NSO), the nation’s largest provider of nurses’ professional liability insurance coverage for over 550,000 nurses since 1976. The individual professional liability insurance policy administered through NSO is underwritten by American Casualty Company of Reading, Pennsylvania, a CNA company. Reproduction without permission of the publisher is prohibited. For questions, send an e-mail to service@nso.com or call 1-800-247-1500. www.nso.com. SHELL ROCK SENIOR LIVING 920 N. Cherry Street | Shell Rock, IA 50670 | 319-885-4341 We salute our Nurses and entire staff for the loving care they provide our people all year. For more information, contact Suzette Eveland, Director of Nursing Services, Suzette.Eveland@accura.healthcare or Christina Hubka, Executive Director, Christina.Hubka@accura.healthcare Apply online: www.accura.healthcare STATE OF IOWA NOW HIRING Glenwood Resource Center (GRC) is seeking applicants for RNs and LPNs caring for those with Intellectual Disabilities and Physical Disabilities. RN hourly rates starting at: $26.53 - $41.17* LPN hourly rates starting at: $22.48 - $34.14* 1 2 RNs & LPNs Apply online: https://das.iowa.gov Click on Human Resources Click on State employment *based on experience
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