We hire nurses for their hard skills. They leave for lack of soft skills.
Nursing schools often focus on developing the hard skills of nursing, but pay too little attention to the soft skills that contribute so much to nurse retention.
One of the most significant challenges for nursing leadership is recruiting and retaining nursing talent. For far too long, nurse leaders have focused almost exclusively on developing hard skills, those competencies used in direct patient care that are tangible, practice-specific, and rooted in the sciences. Development of hard skills—think fundamentals of nursing, pharmacology, care plans, clinical rotations, etc.—is initiated at the beginning of nursing education and continues into practice after graduation. Ingrained in students and perfected in practice, these skills, the foundation of nursing practice, are vital to achieving positive patient health outcomes and also are directly tied to healthcare cost and reimbursement.
As nurses, we are all familiar with nursing theorist Patricia Benner’s novice-to-expert progression. Healthcare organizations invest millions of dollars annually in developing the hard skills of staff nurses. This investment buys them increased likelihood of positive patient outcomes and improved practice competency while providing nurses with continuing education opportunities and enhanced confidence to practice. A win-win, right? Then why do we still have a retention issue?
The reality is, our struggle to retain nurses is not due to lack of hard skills development but to our shortcomings in developing soft skills, those intangible competencies that help nurses relate to and interact effectively with people. Too often we assume that, by mentioning communication, advocacy, and interdisciplinary care to nursing students, we sufficiently prepare them to interact well in healthcare settings. The need for soft skills is not limited, however, to the healthcare setting and care-specific communication. Soft skills encompass communication, emotional intelligence, leadership, time management, patience, persuasion, conflict resolution, teamwork, motivation, engagement, resiliency, integrity, work ethic, etc. It could be said that hard skills are what we do and soft skills are who we are, but if a nursing student or novice nurse lacks soft skills, they can be developed.
You’re leaving already?
Because of technological and sociological factors, nurses who are members of the millennial generation may face significant challenges when it comes to soft skills development. In 2016, millennials—those born between 1978 and 2004—surpassed the number of baby boomers in the workplace. Millennial nurses, the future of nursing, present nursing leadership with a challenge when it comes to retention. The Robert Wood Johnson Foundation reports that one in five nurses leave their first job within their first year of employment, and one in three leave their first job within two years of employment. The direct cost of nurse turnover to an organization ranges from $22,000 to $65,000 per nurse.
Millennial nurses were born in a time of historic changes in technology, access to information, and travel. They were born in an era when it became possible, with a few keyboard clicks, to acquire information from top institutions anywhere in the world. According to the Pew Research Center, four in 10 millennials hold a bachelor’s degree and are pursuing graduate degrees at a younger age. Travel is not an obstacle, nor is it limited to two weeks per year. This generation can and often does go anywhere in the world.
How do these changes affect soft-skill development for millennials? Such skills are rooted in an individual’s sense of belonging and feeling of connectedness to a community. Verbal conversations, in person or by phone, have been replaced with text messages and emails. Social media have blurred the line between public and private. The busyness of life is glorified and, as a result, the inclination to disconnect and resolve issues is not developed. Millennials, like the rest of us, can escape from the stressors of life and often do. It may be an escape to technology, or it could be leaving a place of employment for another opportunity.
Key to retention—soft skills
To retain millennial nurses, soft skills development is crucial. When nursing leaders have a problem with retention of millennials, the cause seldom relates to their hard skills—they can access resources to develop those skills with ease. No, the challenge comes with human interaction and relationship building. Nurses are on the frontlines when human beings are at their worst. Pair that with a myriad of other issues encountered in the practice environment. When a leader places a new nurse in a high-stress environment without providing the support needed to develop soft skills, burnout, turnover, and poor retention can be expected.
Soft skills are needed for every aspect of a patient’s care management. In a single shift, soft skills are vital to:
- Consistently demonstrate professionalism.
- Communicate care needs to other members of the interdisciplinary team.
- Communicate with the patient.
- Effectively manage time and provide basic care needs.
Beyond direct care, soft skills are also vital for meeting nurses’ self-care needs. We don’t talk enough about the importance of self-care in improving retention, but burnout and decision to leave are often exacerbated by nurses’ lack of self-care soft skills needed both inside and outside the work environment. Soft skills are vital to:
- Resolve conflict with colleagues.
- Negotiate safe patient assignments.
- Identify and advocate for a work schedule that facilitates self-care.
- Effectively communicate with supervisors and leadership.
- Cope with professional and personal stressors.
- Respond appropriately to incivility.
These are the issues that often drive millennial nurses out the door. This generation will not “grin and bear it.” For them, the world is small, accessible, and worthy of exploration. When you are well-educated and armed with nursing’s highly transportable skill set, you can explore opportunities, and millennial nurses do.
They understand the depths of their nursing freedom as no generation before them has, and we need to celebrate that instead of condemning it. This is the most incredible time to be a nurse. Thanks to technology, social media, and the Institute of Medicine’s The Future of Nursing report, our profession is finally poised to take its rightful seat at the forefront of patient care decision-making. The future of nursing includes millennial nurses understanding their power.
Five strategies for developing soft skills of millennial nurses
Below are five strategies nursing leaders can use to facilitate soft skills development in millennial nurses.
- Lead by example. Millennial nurses value leaders who demonstrate integrity and model the behaviors they require from millennials. Failure to lead by example increases resistance and decreases retention. How are your communication skills? Are you effective at building genuine relationships with those around you? Are you present and engaged, or are you distant? What would your team say about you and your level of soft skills development?
- Recognize their potential. When you lead soft skills development with “You are valuable and have great potential” instead of a judgmental attitude, millennial nurses will respond more positively. Lead from “You are my replacement, my future. I want you to be your best!”
- Meet them where they are. They are not you. You are not them. Your aim is to help them develop the soft skills that will help them, not replicate who you are or how previous generations have handled things. Find ways to incorporate technology. Ask what motivates them. Do not assume.
- Educate, don’t punish. Provide formal education opportunities for soft skills development. If and when an error occurs, see it as an opportunity for education and growth. If something offends you, do not react by responding immediately. Take a step back and craft a response that includes “why.” In other words, respond to millennials as you would want them to respond to you. You are modeling the soft skills you want to see in them.
- Remember that soft skills are life skills. Soft skill development is vital not only for nursing but for all aspects of life. Demonstrating interest in a nurse’s development as a whole person and not just as a nurse will help him or her feel valued.
Can you imagine where nursing could be in the next 10 years if we take the time to develop soft skills in millennial nurses? I can. RNL
Kimberly A. Hires, PhD, RN, founder and chief executive officer of The Nightingale Firm, is a professional speaker, trainer, and coach with The John Maxwell Team.