Portal de Periódicos da CAPES

Attracting and keeping new graduates

2007; Wiley; Volume: 85; Issue: 6 Linguagem: Inglês

10.1016/j.aorn.2007.05.003

1878-0369

Jane C. Rothrock,

Organizational Change and Leadership

In fall 2004, I met with a group of sophomore nursing students from Duquesne University, Pittsburgh, Pa. My niece was among the group of young women for whom I hosted a dinner and discussion. I didn't try to recruit them to perioperative nursing, but I did talk with them about perioperative nursing; RN first assistants; advanced practice opportunities; and the ways our profession allows one to grow, stretch, and learn. These young women were already active in the National Student Nurses Association. They were eager, participated in a lively discussion, had aspirations to continue their nursing education, were already developing professional attributes, and had already assumed leadership roles. In May 2007, I was their commencement speaker. These new graduates know what they want from a position within the profession. Although they did talk about salary with recruiters, they wanted no more than a wage that will allow them to pay the rent, buy groceries, and take vacations. They weren't yearning for a new Mercedes or a six-week cruise to the Greek Isles. What they wanted most is what they have come to value—a position within a nursing unit that offers camaraderie, provides for continuing education, grants appropriate respect to every nurse, assures adequate staffing, and enjoys an excellent institutional reputation. I am happy to report that one of these women has accepted a position in perioperative patient care. I want to be able to tell all new graduates and students currently enrolled in nursing programs that the OR is a friendly place in which to work and one where people get along and respect each other, that is adequately staffed by nurses who enjoy good benefits and continuing education, and that has an outstanding reputation in the community. Will I be talking about your OR? Recruitment and retention continue to be key words in 2007. The cost of staff turnover is substantial and significant—orienting and educating new staff members, overtime pay to cover staffing shortages, added agency expenses—and these are only the "on the surface" costs. Without an adequate and experienced staff, error rates may increase and patient satisfaction may decrease. Add the issue of low morale and nurse dissatisfaction and you don't need much more discussion about the importance of retaining staff members and recruiting bright, eager new staff members to achieve and sustain excellence in perioperative practice settings or any nursing setting. Create and support a culture of excellence—Studer aptly notes that when nurses leave, they are not looking for another position but another hospital. Thus, your institution must truly desire to become a place where the best nurses want to work. Get to know employees—Token efforts to communicate with staff members don't work, but genuinely talking with them does. Studer suggests making rounds to ask and answer the question "What do you need to do your job well?" Little things matter—What may be a little thing to a CEO, director of surgical services, or nurse recruiter, may be a much bigger thing to a nurse. Manage up—Give credit where credit is due, pass along positive comments, and spread the good news about a colleague's success or accomplishments. Pass the good news up the line of communication. Meet with new staff members—Fully one-quarter of employees who leave a health care position do so in the first 90 days. Ask new staff members the hard questions, such as "How does working here compare to what we said during your interview?" or "What is working well for you?" or "Are you experiencing any problems that might cause you to think about leaving?" What attracts new graduates and keeps experienced nurses is the caring, nurturing culture of the organization. Such a culture results from careful planning and steadfast leadership. In this context, don't ascribe attributes of leadership only to the CEO, nurse manager, or someone else who has a mere positional title of "leader." None of these people know the perioperative care setting as well as the nurse who works in it. Indeed, for the culture of our OR to sustain itself or change for the better, we must each lead from the middle of our position. Virtually every perioperative nurse I have ever known has shown some very strong leadership attributes. Your peers or manager may seek you out for a certain type of problem or issue because they value your counsel, or you may be asked to lead a project for the same reasons. You are the one who is in the middle of what is going on, and you are the one who leads the group from the middle. You can create a culture in the OR that represents perioperative nurses' vision of quality patient care. I also believe that the care you deliver is humanistic, personalized, patient centered, safe, and of high quality. Although personalities differ from OR to OR, one culture can fit all when we each lead from the middle to achieve the vision and values of perioperative patient care. It is not about the latest technology. Rather, it is about the latest best practice, doing things right the first time, recognizing the unique needs of each patient, and achieving these in a workplace that is warm and caring for patients and personnel. Recruiting new graduates and retaining experienced nurses is not just up to the CEO; it is up to each of us. If we each undertake the effort to ensure that our nursing colleagues feel worthwhile and that they are making a difference in what is most important to them—good patient care—we will get those bright, eager, new graduates, and we will keep them. Welcome, class of 2007, to our nursing specialty.