It can sometimes seem that the challenges nurse leaders face on a regular basis can seem unique to them. However, according to Karen Hill, RN, DNP, NEA-BC, FACHE, FAAN and speaker at the 2019 AONE conference, there are four challenges nurse leaders across the country have in common:
1. Closing the gap between skills and competencies
It is not uncommon for nurses with strong clinical skills to find themselves in a management role without the desired training and professional development they need to thrive in their roles.
According to one 2016 study, ‘Improve Nurse Manager Competency With Experiential Learning’, “86% of respondents said they had no formal leadership development when they first became a nurse manager”1.
2. Creating a well-defined scope of the management position
According to Hill, “we have really burdened our nurse managers with so much today. They’re the chief retention officers, the chief strategy officers, and they have to make sure all the patients are happy. They have to meet their budgets and they have to manage a million metrics in addition to having a life”.
To better support nurse managers, Hill encouraged CNOs to ask: “What are the supports that nurse managers need to be resilient in that role?
Additionally, she had also noticed a trend among the nursing directors at her organization. ‘What I was seeing was all the directors getting out of here at seven or eight o’clock at night and not being able to get home in a timely manner,’ she says. To combat overworking its nursing directors, the organization implemented a one-manager-to-25-FTE ratio.
By that [ratio] you’re able to work with the staff and do all of the education with the staff that’s needed and vice versa. It allows the manager to be successful and be the nurse leader that individual could be”1.
3. Developing the next generation of nurse leaders
According to a 10-yearlong study by the RN Works Project, 17.5% of newly licensed nurses leave their job within 1 year and 33.5% left within two. These numbers are especially noteworthy when taking into account the fact that the Baby Boomer generation is in the process of preparing to, or moving forward with, retirement.
To add, “Almost 50% of the nursing workforce right now are millennials. We have to learn how to work with them, how to engage them, and how to maximize that talent capability”1 according to Hill.
4. Retaining talent
This past year, hospitals nationwide have felt the impact of the current job market, which saw “a monthly average gain of 254,000 jobs, a pace of over 3 million a year” according to Forbes1. And if that is not cause enough for concern for hiring managers, the job market also saw an increase of wages and salaries by 3.1% in 2018 alone, culminating in the biggest jump in wages in a decade2. While a strong job market is positive news for job seekers, it can make the hiring process more challenging for healthcare organizations as potential employees have more options to choose from.
Additionally, according to Hill, “I think the costs of [nurse] turnover in the United States is severely underestimated. I’m in southeast United States, and I cannot cover turnover of a nurse for $61,000. They give you a month’s notice when they leave, then you have to submit the request [to fill the position] to the budget control committee, and they have to decide if they want to let you replace it or not.
It takes me, honestly, eight to nine months to replace a nurse. So, I think we’ve underestimated that [cost] in our business case for more resources. One statistic I did want to show you, because I do think this would be helpful on a business case, is a 1% decrease in turnover of nurses is worth about $337,000 a year. That’s a big deal”1.
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In case you missed it:
- The Future Of Nursing Report: 4 Key Insights For Clinical Leaders
- Good Talent Is Hard To Find, But It Doesn’t Have To Be
- Want To Keep Your Nurses Happy? Here’s How
1Thew, J. (May 10th, 2019)Trends Nurse Leaders Are Facing