Recruitment and retention: successful strategies in critical care

Article Abstract:

In the midst of the current nursing shortage, nurse managers of critical care units must be concerned with effective strategies to recruit and retain nurses. Previous research has described factors affecting these issues, including management of the unit and worker isolation, stress, and burnout. At Cedars Sinai Medical Center, highly experienced staff nurses with many years of service had little or no participation in decision-making. Strategies were selected to enhance self-esteem and self-actualization. These strategies included decentralization of decision-making so that unit nurses set up their own work schedules, cooperated with other units to cover shifts, and participated in department-wide committees, such as quality assurance and the staff nurse advisory board. The second strategy was to increase use of primary nursing, in which one nurse provided and directed all aspects of a patient's care, including dealing with family interactions. This program has been modified, but has led to the development of standardized care for patients after cardiac surgery. The third strategy involved providing ways of job advancement for nurses who choose to remain at bedside. This clinical ladder advancement includes a formal petition process in which applications detail the completion of special projects for nurses applying for Clinical Nurse III (most experienced critical care nurses achieve Clinical Nurse II with little difficulty). Although these strategies have been effective, nurses currently are ascribing to the widespread view that health care is a business. Therefore, nurses are now more likely to be interested in competitive wage and compensation packages, rather than in these strategies that deal with the work environment. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Opening a new critical care nursing unit during a nursing shortage: recruitment and retention strategies

Article Abstract:

Finding and keeping nurses remains a constant problem, and the opening of a new interventional cardiology care unit has many potential problems. One such process is described where creative recruiting practices allowed an interventional cardiology patient care unit to open ahead of schedule. Unit leaders were selected from within the hospital, decreasing orientation time and allowing participation of the leaders in early design and activation of the unit. Nurses with critical care or medical-surgical experience were also sought from within the hospital. A free educational and recruiting seminar on the topic of innovative cardiovascular nursing was led by nurses, with the idea of publicizing the unit to nurses in a five-state area. The patient load consisted primarily of individuals receiving percutaneous transluminal coronary angioplasty (a procedure in which balloon catheters are used to widened constricted coronary arteries), and the new unit allowed the patients to be on one unit during the hospital care. This idea of facilitated coordination of care attracted nurses. Orientation of new recruits from non-critical care areas is described, as is cross-training of nurses from other units. A three-day team-building process was facilitated by personnel resources. Staff nurses participated in committees which implemented changes in nursing practice, including the addition of critical care technicians. These changes allowed nurses to more effectively coordinate patient care and to collaborate with physicians. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Symposium on successful recruitment and retention strategies in critical care: overview

Article Abstract:

By the year 2,000 (10 years away), 400,000 critical care nurses will be needed in the health care system, double the current number available. Multiple schemes are presently being used to recruit nurses for the 36,000 current vacancies in hospitals with critical care units. Despite the prevailing shortages, many nursing executives are creating innovative and effective strategies to attract nurses to critical care units. This symposium, which originated in the American Association of Critical-Care Nurses Management Special Interest Group, presents many of these strategies. The articles by Doering, Werkema, Huttner, and Coleman represent different responses to the nursing crisis. (Consumer Summary produced by Reliance Medical Information, Inc.)

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