By Marti Webb Slay

Keeping staff positions filled in today’s economy is a continuing challenge for hospitals. Two chief nursing officers say that that it is essential to engage with employees and build a culture of teamwork in order to retain associates and build morale.

Russell Harbin, MSN, RN, who serves as CNO at Medical West Hospital, says the nursing staff most often lists workplace stress as the reason for leaving bedside nursing. “We are trying to focus on management being out on the floor with the staff about 60 percent of their day, so the staff doesn’t feel like they’re drowning,” he said.

He strives to be visible by making several daily rounds himself. “When I say visibility, I mean doing more than just asking employees how they are,” he said. “When we see that they are really busy, we want to offer our help, like maybe giving medicine while the nurse attends to something else. We are evolving into a management style where if we have the skill set to do something, we get in there and do it.

“It’s important to provide support on all shifts. Our managers meet with night shift and weekend staff once a month. A lot of times, the night shift and weekend staff tend to be forgotten. We have started focusing on them to make them feel equally important. That has helped our night shift staff feel more engaged.”

Helping new hires fit in is also important. “I personally meet with every nurse who hires into the hospital at the six-month mark,” he said. “They come to my office, and we have a sit-down. I ask about how it’s going for them, how they are doing with their manager, how the orientation went. That’s been very positive, and we’ve gotten great feedback from that.”

Amy Shelton, MSN, RN, who is CNO at Ascension St. Vincent’s, says communication goes both ways, and listening to associates means responding to their concerns. “We have focused on the wellbeing of our associates,” she said. “They’ve said they need a more flexible schedule, and we’ve made that happen. We’ve always let our associates have a voice, but it’s more critical now than ever. Any good leader needs to hear what the associates have to say, whether it’s what you want to hear or not. It’s important that the associate has a voice and that we respond.

“We have associate engagement surveys, and most important, we have taken those results and made changes. We have created forums for the associates to have their voices heard, and we’ve made pathways to make sure responses get back to the associates.”

One such response has been the establishment of a nurse empowerment and engagement council. “We are pulling nurses from all across the health system for this council, and they will be the voice of the nursing community. Any scheduling changes, bonus contracts - anything that will impact nursing - that team will evaluate it and make a decision based on the parameters they’ve been given,” Shelton said. “We have nurses with 40 years of experience and we have some with 20 months with us. They are excited about being part of a team that will impact their work environment.”

“Communications between shifts can also be important,” Harbin said. “During staff meetings, employees have complained that other shifts didn’t work as hard as they did. There was a lot of that back and forth. So management made it a priority to hold everyone to the same level of accountability. We’ve gotten a lot of positive feedback from that. People can’t leave things for the next shift. Spending the time to make sure everyone is held to the same accountability has really helped.

“During the pandemic the thought process was often, ‘If I can get a body here to work, I’m happy.’ Now that things are starting to settle down a little bit, just having a body here may not be the best thing. You have to have everyone on the same page and work with each other equally.”

Shelton agrees that a culture of teamwork is critically important. “Healthcare is all about the group you are working with,” she said. “Patients coming into the hospital are sicker than they’ve ever been. The nurse has so much a responsibility now that to have a good patient care tech or unit secretary or transporter, those support services that are there and committed to the patient is extremely important. It impacts patient care. It impacts retention in a department. The culture and the patient experience comes from the entire team.”