While medical technology is booming, the art of caring is becoming a highly profitable field as well. By focusing on employee engagement, hospitals embrace the staff and the highly personable touch they have to offer. The healthcare workers are essential to improving HCAHPS scores and reducing hospital-acquired conditions (HACs) (source).
Employee Engagement versus Satisfaction
Employee engagement and employee satisfaction are miles apart. A nurse can be satisfied with a position, show up to every shift without complaint, and leave for a neighboring hospital that offers a seven minute shorter commute. Job satisfaction rewards the bare minimum of effort and reliability to the hospital. Employee engagement is the nurse’s dedication to working on behalf of the hospitals and patients.
Engagement Prevents Medical Errors
Nurse engagement requires more than showing up with a smile to do the job. It entails an emotional commitment to the company and its goals. A Gallup study showed that the most critical element in reducing medical errors is employee engagement. Engagement matters more than any other single factor including staffing.
How to Foster Employee Engagement
While employees welcome picnics and parties, the most important factors are recognition and feeling connected to nursing management. There is a significant positive link between a high-quality supervisor and nursing engagement. It is vital that nurse managers create an environment of appreciation, trust, and growth.
Employee engagement increases nurse retention and keeps costs down. It reduces medical errors, the transmission of HACs, and the hospital mortality rate. By believing in both the management and hospital, patients and nurses thrive.
In February, the California Future Health Workforce Commission issued their final report describing recommendations to maintain the workforce needed to meet healthcare demands for the present day and the future (source). The California Future Health Workforce Commission was established in 2017 “to help close the gap between the health workforce we have and the health workforce we need.” The commission includes senior leaders from philanthropies across the state (source). The plan develops critical strategies to address professional nurse recruitment.
The Burdens
While the document targets issues across California, the primary concerns are generalizable to the nation. Historically in the U.S., the supply of nurses has not kept pace with demand, predominantly in underserved communities. The impending nursing shortage and an aging population crisis impact communities nationally.
The Strategies
The following key strategies from the report translate well into tactics for professional recruitment.
Increase opportunities to advance in the health professions allows professional development, advancement, and job progression. Increasing job satisfaction and salaries promote staff retention.
Align and expand education and training by anticipating areas of deficits and coordinating community and healthcare stakeholders to encourage buy-in. To guarantee continuing improvement, recruiters must look at the shortage as a process instead of a resolved episode. Healthcare organizations and hospital systems have an essential role in addressing the crisis.
Strengthen the capacity, retention, and effectiveness of nurses by identifying how to minimize burnout and maximize utilizing nurses efficiently.
The California Future Health Workforce Commission report gives recommendations that relate to professional nurse recruitment. By keeping nurses satisfied, promoting community involvement, and reducing burnout the healthcare systems can develop a three-prong approach to recruiting and maintaining a robust nursing staff.
While minority enrollment in nursing programs have nearly doubled in the last twenty years, nursing has a long way to go in appropriately representing minorities in the United States (source). The current enrollment data is insufficient to address the needs of a future diverse nursing workforce. It is imperative to advocate for minority nurses in both higher education and the profession.
Diversity in Professional Nursing
Increasing diversity among nurses is a core value of the profession. The National League for Nursing promotes diversity by endorsing a culture of inclusion and excellence by celebrating a diverse population of professionals. The American Nurses Association has a professional commitment to awareness of diversity issues and the individual nurse’s biases and perceptions. For the culmination of a diverse nursing workforce to take root, schools must aim to recruit, enroll, and retain minority nursing students.
Diversity Among Student Nurses
Modern nursing programs work to disseminate a curriculum that concentrates on how to address health disparities among ethnic minorities and others who face socioeconomic barriers. Early recruitment programs that value diversifying nursing education can bolster student retention and graduation (source).
The Diversity Impact Program
For example, Frontier Nursing University increases student recruitment and retention through the Diversity Impact Program. This program offers cultural awareness and support through a social network, activities, and events during the year to connect students, including a Diversity Impact conference.
By implementing a model where student nurses embrace and encourage cultural awareness, student retention and satisfaction improves. Creating an engaging model that embraces cultural diversity is imperative to minimize student attrition. When student nurses support each other, it enhances the outlook for the entire nursing profession.
Nursing entrance exams make or break a student’s chances for nursing school enrollment. By offering a challenging entrance exam, higher educational institutions screen initial applicants before admission. These tests assess the academic competencies and potential nursing capabilities of students. The chosen nursing entrance test varies by institution.
What is the best admission exam?
In 2015, a study statistically analyzed the pre-admission nursing exam results over five years to determine which tests predict success in an associate degree nursing program (source). The tests surveyed were the Pre-Admission Examination for Registered Nurses (National League of Nursing), the A2 admission assessment from Health Education Systems Inc. (HESI), and the Test of Essential Academic Skills (TEAS) from Assessment Technologies Institute (ATI). The analysis demonstrated that the HESI A2 examination scores correlated with success in the nursing program.
How many retakes is too many?
In 2018, studies addressed how nursing admissions should confront the issue where one student takes the entrance exam multiple times. The examinee scores higher with each attempt. The limitation of the study was that it only evaluated those students who scored high enough on the TEAS to be admitted to nursing school and completed the first semester. The results showed that the assurance of nursing success relates to the average of all test attempts. Admission for both ADN and BSN programs should depend on the mean of all score data. However, there must be a limit. Individuals who take the TEAS six or more times have significantly lower nursing performance than their peers (source).
Questions remain regarding the ideal entrance exam and the number of test retakes. It is time to establish a rigorous competency for nursing admissions that is expressly related to program data about student success.
Caitlin Goodwin MSN, RN, CNM is a Board Certified Nurse-Midwife and freelance writer. She has ten years of nursing experience and graduated with a MSN from Frontier Nursing University.
In the nurse recruiting industry, the more applicants that you attract, the better. However, hospitals desire quality over quantity. Shifting your recruiting outlook to the Lean principles of recruiting can ensure a qualified pool of nurses.
Lean Thinking: A Resource for All Industries
Toyota Motor Corporation developed Lean thinking as a tool to maximize available resources to provide value. Lean targets are eliminating waste and increasing efficiency in four areas: removing non-valued activities, decreasing wait time, reducing errors, and boosting customer satisfaction.
While nearly 70% of U.S. hospitals implement a process improvement framework in their transformation journey, the extent and experiences differ (source). Only one in eight hospitals are at a mature phase of implementation. A performance management scorecard can align healthcare and recruitment objectives by focusing on specific metrics by like quality of hire and service, efficiency, responsiveness, cost, and productivity.
Streamlining Problem-Solving
Lean thinking draws its power from creating standardized solutions to common problems. However, it’s imperative to persistently reevaluate the metrics to validate progress and find innovative opportunities. Organizations on a Lean transformation journey have positive outcomes like a shorter time to fill available positions and improved nurse retention. Optimal results occur when the hospital culture supports the Lean model from the top to the front lines (source). By applying the Lean principles, recruiters can focus on activities that develop better candidates.
Lean recruiting simplifies methods and improves performance, while cutting costs and providing better patient outcomes. With a looming nursing shortage and healthcare vacancies stagnating across the board, the traditional recruiting model must change. While there is no quick or easy fix to this long-term issue, Lean recruiting is making positive progress.
Caitlin Goodwin MSN, RN, CNM is a Board Certified Nurse-Midwife and freelance writer. She has ten years of nursing experience and graduated with a MSN from Frontier Nursing University.
Caitlin Goodwin MSN, RN, CNM is a Board Certified Nurse-Midwife and freelance writer. She has ten years of nursing experience and graduated with a MSN from Frontier Nursing University. 
Caitlin Goodwin MSN, RN, CNM is a Board Certified Nurse-Midwife and freelance writer. She has ten years of nursing experience and graduated with a MSN from Frontier Nursing University.