Top Concerns of Nurse Leaders

Earlier this year, the 2017 HealthLeaders Media Nursing Excellence Survey was tallied and the results published. Nurse executives and leaders identified the following three challenges as their top concerns: staff retention (61%), recruiting nursing staff (59%), and nurse engagement (35%). Not surprisingly, these three things are all inter-related. Recruiting dedicated nurses becomes a never-ending task if a hospital can’t retain them, and nurses who are not engaged with their work will be hard to retain.

The survey revealed that one of the most important factors linked to lower nursing staff turnover was shift length. A large majority of survey participants (62%) said the typical shift at their facility was 12 hours—and the data found that the hospitals with these longer shifts were also the most likely to report nurse retention as a top challenge. Leading strategies for decreasing turnover and increasing retention included flexible scheduling (53%), improved communication between staff and administration (51%), orientation programs to help new nurses adjust (48%), and salary increases (48%).

A common saying about staff retention is “people join companies, but they leave managers.” It takes strong leadership to create a positive workplace environment and a culture of engagement. When nurses are engaged they feel energetic and dedicated to their work. They become immersed in work activities and strive for clinical excellence. Engagement has also often been described as the opposite of burnout. When nurses are engaged, everyone wins.

Chief Nursing Officer for the Northwest Wisconsin Region of Mayo Clinic Health System, Pam White, DNP, RN, NE-BC explains it this way:

Everyone knows that providing healthcare in today’s reimbursement state is challenging. As nurses, we need to continue to focus on the needs of the patient by providing care that is efficient but compassionate and effective but evidence-based, despite the extra pressures to do otherwise. It’s important that nurses play an active role and have a voice in helping to shape and advocate for the healthcare environment that meets our patients’ needs.

When nurses are engaged in their jobs, their patients also win: research published by Gallup indicates that the level of nursing engagement at a facility is a reliable predictor of mortality and complication rates.

The survey analysis noted that a method to measure nursing performance is an essential factor to engagement. A whopping 76 percent of the survey participants stated they used the Medicare instrument known as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) as a performance measure. Ironically, the HCAHPS survey does not reflect clinical excellence or patient outcomes, but rather the patients’ perceptions of nursing staff’s communication skills, food quality, noise level, and overall hospital environment. The National Database of Nursing Quality Indicators (NDNQI), which measures clinical factors, was used by far fewer hospitals (42%) to measure nursing performance. These responses seem to reflect the two different faces of nursing’s mission: both to provide direct care and to enhance the patient experience.

Vice President of Nursing at Geisinger, Terri Bickert, DNP, RN, NEA-BC is optimistic about the future saying, “I don’t have any concerns. I know nursing will rise to all challenges presented. We will keep the best and brightest becoming nurses and continue being at the side of our patients and leading our communities.”

Do you have an interest in applying your clinical expertise to a nursing management or leadership position in the future? Nurse managers and leaders set the tone for the work environment within their hospital, handle recruitment, personnel and other human resource issues, and much more.

American Sentinel’s online MSN, Nursing Leadership and Organizational Management degree and DNP, Executive Leadership specialization are designed for experienced nurse professionals who seek to develop both management and leadership skills. Through case studies and hands-on course work, nurses examine the various human resource challenges facing an organization as well as the dynamic nature of the strategic planning and management processes. Courses cover long-range planning, including budgeting, analysis and reporting.