Helping nurses find that sweet spot is good for everyone.
Improving retention in the nursing profession begins by understanding the needs of your staff. Start by analyzing what nurses need to do their jobs safely and effectively.
What is work-life balance? It means different things to different people. To some, it means being able to leave work on time or access earned paid time off easily. For me, work-life balance means I work for an organization that listens to and respects my needs as a nurse. Thus, it is an important factor in my choice of employers.
Nursing is my second career. Before becoming a nurse, I ran my own business and could control how much I worked. Working for someone else, however, can quickly change one’s ability to achieve that balance, which can be quite an adjustment.
As a new nurse, I did not think very much about work-life balance. I was committed to my nursing career and would do almost anything to be successful. But things can change quickly. Our parents get older and need more care, we want to attend our children’s events, and we want to spend time with grandchildren. When these situations arise, achieving work-life balance can be difficult. That’s why having leaders who understand the need for that balance is so important to nurses.
1 million by 2024
According to the American Association of Colleges of Nursing, our profession needs to replace more than 1 million nurses by 2024. Contributing factors are retirement of baby boomer nurses, job dissatisfaction, and stress associated with increased nursing responsibilities. In light of these statistics, it’s more important than ever for nurse administrators to understand what affects retention rates. In the ambulatory surgery center where I work, six of 15 nurses are approaching retirement. That is 40 percent of the nurses assigned to that unit!
Our nurse leadership has taken this to heart. We wanted to know what our nurses consider important when deciding whether to stay at our facility. In casually talking with them, we found a common theme—they did not like how our paid time off (PTO) process worked. For the majority, it was a source of contention. They considered the request process cumbersome—not conducive to a proper work-life balance—and the main reason they would leave.
After that discovery, we set out to understand what work-life balance meant to each nurse. Through focus groups and surveys, we discovered, as stated above, that it meant different things to different people. Some wanted easier access to their paid time off, meaning they didn’t like having to come to the facility at 6 a.m. to request time off—they wanted to be able to submit the request from home. To others, the uncertainty of whether or not they would be granted time off to participate in a child’s field trip or attend graduation was most important and added the most stress.
Step 1 to understanding nurses’ needs: Ask
With this information in hand, we began to review the PTO request process for possible changes. We sifted through many suggestions, including changing from eight-hour shifts to 10-hour shifts and splitting up departments so operating room nurses would be in a different pool from preoperative nurses and recovery room nurses. Both recommendations offered the nurses easier access to PTO but, of course, needed to be thought through very carefully to maintain our excellent service and patient safety.
Working with several nurses, we prepared mock schedules and compared them to current daily staffing levels to ensure they were adequate for quality patient care and the changes would not negatively affect morale by putting additional burden on staff members working during their absence.
After three months of review, we implemented the changes identified above. We separated the departments and went to 10-hour shifts in the preoperative and recovery room areas. These changes immediately resulted in improved morale. Staff members now have an increased sense of control and empowerment regarding their schedules and a much-improved work-life balance.
Improving retention in the nursing profession begins by understanding the needs of your staff. Administrators should start this process by analyzing what nurses need to do their jobs safely and effectively. If you ask, they will tell you that one of the things they need most is easy access to the time off they have earned. When the PTO request process is so cumbersome and difficult to use that many give up on it altogether, you end up with disgruntled nurses. That leads to a “domino effect” exodus of nurses looking for other opportunities, which means a decrease in retention.
At a time when we are all busier than ever, helping nurses achieve acceptable work-life balance should be a high priority for every nursing leader. It starts with simple conversations with your staff. From experience, I know that asking the nurses you oversee about their needs and respecting their desire for optimal work-life balance contribute to a sense of empowerment, improved job satisfaction, and increased nurse retention. They will appreciate the effort you make in helping them achieve work-life balance, truly a win-win situation. RNL
Elizabeth “Betty” S. Harmon, MSN, RN, CNIV, CAPA, is interim nurse manager of operations and program manager at Davis Ambulatory Surgery Center in Durham, North Carolina, USA.
Editor’s note: Elizabeth “Betty” Harmon will present Achieving Work-Life Balance in an Ambulatory Surgery Center on Monday, 17 September 2018, at Sigma’s Leadership Connection in Indianapolis, Indiana, USA.