Recruitment Strategies and Plan for Nurses

Factors contributing to Nursing Shortages

The nursing shortage exists today for many reasons. Employment recruiters work hard proactively to recruit nurses using unique strategies. Human resources managers develop strategic plans to entice nurses to a health care facility. Plans need adopting as soon as possible. The plan will take time and money. Planning effectively will decrease the gap later.

Scheduled to retire soon, Baby boomers will overload the health care industry with age related and chronic illnesses. Soon the baby boomers working in health care will retire. The shortage of nurses today is decreasing; however, experts predict a large drop in near future. The report titled, Who Will Care for Each of Us? America’s Coming Healthcare Crisis, released by the Nursing Institute at the University of Illinois College of Nursing, stated, “ratio if caregivers to people to the elderly will decrease by 40% between 2010 and 2030” (Nursing shortage fact sheet, 2009).                                              

Nursing college programs do not have enough enrollees to keep pace with the nursing shortage. Nurse faculty has a shortage as well, which restricts enrollment,

According to AACN's report on 2003-2004 Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, U.S. nursing schools turned away 15,944 qualified applicants to entry-level baccalaureate nursing programs in 2003 due to insufficient number of faculty, clinical sites, classroom space, clinical preceptors, and budget constraints. In 2002, a total of 5,283 [sic] students were turned away from all types of professional nursing programs as well. Almost two-thirds (64.8%) of the nursing schools responding to the 2003 survey pointed to faculty shortages as a reason for not accepting all qualified applicants into entry-level baccalaureate programs (Nursing shortage fact sheet, 2009).

Staffing shortages increases stress. Stress creates job dissatisfaction. Dissatisfaction is a reason nurses change careers. Turnovers negatively influence health care access,

A survey reported in the December 12, 2002 issue of the New England Journal of Medicine found that 53% of physicians and 65% of the public cited the shortage of nurses as a leading cause of medical errors. Overall, 42% of the public and more than a third of US doctors reported that they or their family members have experienced medical errors in the course of receiving medical care. The survey was conducted by the Harvard School of Public Health and the Henry J. Kaiser Family Foundation (Nursing shortage fact sheet, 2009).

Strategies to Address the Nursing Shortage

High Standards of Professionalism

Continuing to maintain the standards is especially important as the baby boomers leave the workforce creating a gap in care. Patient safety is a priority to ensure quality of nursing care. Standards have to remain high to avoid substantial risk with licensing requirements (The nursing shortage, April 2001 meeting, 2001). Fragmenting care with lower-level paraprofessionals can result in liability. The quality of the educational programs should also, maintain the same competency level.    

Outreach

An effective marketing program to increase nurse education and student outreach is essential to alerting not only the health care industry, but also the media as well (The nursing shortage April 2001 meeting, 2001).  Marketing on the Internet is a valuable source of communication for scholarships, and living expenses that offset out-of-pocket finances.  Face book, and MySpace sites are a good way to connect with people interested in learning more about nursing opportunities. Colleges have on line for nursing degree programs available. Nurse recruiters should not wait to career or college night, but look for direct marketing opportunities not just within the school, but locally connected with internships, and local teen level organizations such as the scouting programs.

Licensing of Nurses

Streamlining the licensing process is another strategic element to decrease the turn-around-time in processing (The nursing shortage April 2001 meeting, 2001). Creating an online application process eliminates the traditional mail time, which slows the process as well.  Those licensed in another state, or globally should have re-licensing done instantaneously. The use of the Internet can verify information rather quickly.

Address Nursing Work Hours and Workplace Setting

In response to the stress from the shortages of nurses, mistakes happen. Nurses can find themselves charged with misconduct, and negligence. On-going training programs will reinforce standard protocols. This will help with delegation of tasks and responsibilities.

Nurses need pay increases to prevent working more than one position.  The amount of overtime required of nurses currently discourages applicants during the interview phase. Pay increases, and increased benefits will offset the need for overtime, by creating incentive to work for the facility. This creates an attractive reputation, and draw potential nurses to the organization. Incentives will decrease nurse to patient ratios as well. The opportunities for misconduct will decrease as a result.

Create a mentoring program establishes higher accountability of new nurses. Reputation is vital in healthcare, so when problems do erupt, word of mouth accounts resulting from nursing shortages will adversely influence the facility, and the customer further.

Strategic Plan Questions: Nurse Recruitment

When creating a plan for nurse recruitment a completed organizational analysis provides needed information. The analysis includes what the organization can do better. The plan needs inclusion of the competitive edge. Incorporate the current position and the future direction for nurses to define an image.   Evaluate and include the needs of the facility, and nursing in 5-10 years. Review the strengths and weaknesses, and the opportunities and threats. Evaluate the profile of a nurse as a customer. Ask the nurses what needs are not for filled, and motivations required. Define what characteristics are a nurse. The final definition is the unique value provided by the facility.

Create a Plan

              After completing the questions, the next step in the process is to use the information to create a plan.  Keeping the plan in-line with the mission and vision, create a nursing recruitment vision, and mission. This will help develop consistently, and specifically address the plan. Limit the plan to a few key objectives, from two to five. Create deadlines, over the period of a year to gauge the process, and track progress. The goals should be measurable, quantifiable, and support the objective.  Assess available resources. List the barriers. The major barriers are time and money. Check the feasibility of the goal, monetarily. Each goal needs a list of to do’s. Use the barriers to develop action items for each goal. Then assign responsibility.  

The Proposal

During a severe shortage rewriting the definition of misconduct to exclude refusal to work over-time, and working a double shift. Inclusion of ‘normal’ staffing levels and ‘short’ levels require incorporation into the misconduct revision. The revision must include the maximum number of hours to work during pay periods. During shortages, ongoing training at the department level will prevent errors in patient care.  Training includes efficiently managing added responsibilities.  A nurse supervisor should be on duty when ratio’s are too high, nurse to patient.  An alternative plan to manage the shortage if not already in practice must provide options other than overtime.

Survey other Facilities             

Proactive solutions and assessment of information regarding other facility practices can help gauge what changes are working and what are not working. Other facilities may have learned what works through trial and error. Learning the results will afford the organization to adopt or avoid strategies.  Human resources management associations should create a clearinghouse for collaboration through health care associations to have open exchange of ideas to streamline processes.

Additional Educational Opportunities

              Providing financial support for nursing school programs form with partnerships, and employees. At the completion of the program, require a commitment with a minimum number of years.  Some employees cannot afford to return to school, so providing stipends could offset living expenses. Combine work, with practical experience opportunities, which provides credit for experience during the school sessions. Health care training programs for returning students after absence with remedial pre-requisites incorporated into the ongoing education development program instituted at the workplace and with the nursing programs so the employee will earn credits toward the degree program. Add an incentive program’s to RN’s, and post bachelorette educated nurse managers the opportunity to split time between teaching nursing courses, and practical work.

Shenandoah University in Virginia announced in November 2008 that the school of nursing formed a partnership with Inova Health System to support the school’s accelerated BSN program. Through a two-year agreement, Inova will award $7,500 scholarships to up to 55 students who make an employment commitment to Inova after graduation. The health system will also contribute $500,000 to fund new classrooms, skills/simulation labs [sic] and/or administrative spaces and provide additional clinical rotation slots at three Inova hospitals.

Incentives for the Plan: budgetary constraints

When the assets are not available creative ways to recruit becomes a higher priority. Some examples of benefits are not budgetary are creative flexible schedules. Use the PRN pool as an option, with seniority status to obtain additional hours. Offer an on-site child-care center. Provide meals at a low-cost, or free. Finally offer free parking.

Budgetary Constraint Hiring Practices

Sometimes budgetary restraints require creative hiring practices.  Some inexpensive advertising is not just in newspapers, but also, list with trade magazines, online sites, virtual job fairs, and employment page on the facility website. The use of material that flatters the facility is a marketable device. Institute an employee referral program, use e-mail database with cookies that will provide updates automatically to the list. Hold a virtual career fair. Searching employment websites like Monster.com that has resumes listed on the site for potential employees. 

Networking is another, avenue. Keeping abreast of job fairs, career days at the elementary, middle, high school, and college level school level, too. No one is too young to decide on a career. Specialized health care associations have yearly conventions. Interact with state association members, managers, and board members. They list newly credentialed members. College councilors and faculty of education programs have a good insight on the students. Work with the county and state education department to create internships for students, and volunteering opportunities. Some states require volunteering as much as 75 hours that starts at the elementary level. This is a requirement for graduation in Maryland.

Conclusion

              Correcting staff shortages requires creativity. The nursing job market is competitive, and influencing factors, such as the baby boomers, lack of nurse faculty, and the need for more educational choices have overwhelmed the health care industry.

Recruiters try to stay ahead of the game with using a number of different resources and techniques from recruiting in other facility parking lots, to the referral program. Human resources managers make strategic plans to increase nurse recruitment. Effective plan developing takes time and money. Managers have to learn to work without financial incentives, at times incorporate this into the plan. Plans should require short-term strategies, and long-term strategies. Long-term planning will increase the nursing gap if implemented correctly. 

  

References

Nursing shortage fact sheet. (2009, September 28). Retrieved November 17, 2009, from American Association of Colleges of Nursing: www.aacn.nche.edu/Media/PartnershipsResource.htm

The nursing shortage April 2001 meeting of the New York State Board of Regents Memo. (2001, April). Retrieved November 17, 2009, from The Office of the Professions : http://www.op.nysed.gov/nurseshortage.htm

 Appendix 1

The sky is the limit for hiring, and incentives

·       Loan forgiveness

·    Bonuses

o      completion of probation period bonus

o      Seasonal bonus,              

o      staffing shortage bonus,

o      night shift bonus

o      hiring bonus

·               Pay for Relocation

·       Certification pay,

·    Employee referral fee,

·       no benefit option

·       Create a team or outsource

o      locate critical care nurses within a 20 mile radius

·       Speed counts

o      electronic boards externally, and internally

·       Linked with local, national, and association specific boards

·       Subsidized child care

·       Nursing educational

o      other healthcare workers within the facility

o      in-house training programs

o      rotations for different departments to keep skills fresh in other area’s

o      specialization fields