Years ago, I saw an ad by a state dental association that read, “You don’t have to brush all your teeth. Just the ones you want to keep.” The wisdom of that simple statement applies to the patient experience and hospital culture as well. You don’t have to thrill them all – just the ones you want to keep. But think about how this applies to co-workers and providers too.
I was working with an organization that suffered from high turnover in nursing. They were paying a big price for this turnover in several ways. First, they were spending a fortune on travelers. Second, their existing staff was working overtime and stressed by the chronic uncertainty that comes with using travelers and having to constantly orient new nurses. They were burning out.
The administration was under constant pressure to hire more NOW to provide relief to the existing staff and to reduce the cost of travelers. Their quick fix was to offer big sign on bonuses which proved to be short-sighted. It could help attract, but not retain.
When I asked about what the exit interviews showed, I got blank stares. They had never done exit interviews on nurses or anyone else. Years of important data had slipped through their fingers.
With some digging, we were able to talk with some of the nurses who had left within the past year. The interviews showed that the new hires did not feel supported by the existing staff. They reported several examples where they felt isolated and even bullied by some of the old guard – the same people who were screaming for more help.
This organization clearly had some hospital culture issues that had to be addressed. I wish it was an isolated incident, but the truth is that I’ve seen it dozens of times. The people screaming the loudest for more help are unwittingly perpetuating the shortage.
My message to them was, “You don’t have to create a welcoming and supportive environment for all new hires; just the ones you want to keep.” With some coaching, I’m glad to report that turnover has dropped and the team is much more cohesive than when we first met.