Five nurse recruitment and retention strategies for home-health agencies

Nurse Leader Insider, April 23, 2004

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Home health agencies (HHAs) are all too familiar with the phrase "nursing shortage." Sandra Gunn, RN, BSN, clinical manager at St. Joseph's Home Health Care, a hospital-based agency in Augusta, GA, deals with the nursing shortage every day. She offers the following five nurse recruitment and retention strategies for HHAs.


1. Give your nurses shift options and be flexible.

Many nurses enter home health because of the flexible hours. Their schedules change according to their lives. Allowing staff to switch shift time or shift type-changing days or going from a 10-hour shift to a 12-hour shift-may convince those wavering to stick around.


2. Offer benefits and incentives.

Recently Gunn's nurses started telling administration that they do not need health insurance because they are covered under their spouse's plan. So the hospital instituted a "no-benefits pay" option. "We had a lot of people coming in who said, 'I'm married. My husband has insurance. I really don't need this. Would you consider paying me more money if I don't take the benefits?' So we did that," says Gunn.


3. Create a comprehensive, mandatory orientation program for all new nurses.

Gunn finds that when nurses learn correctly from the beginning, they enjoy their work more and are likely to stay longer on the job. "Those are the nurses you usually lose, those that get frustrated. We've worked really hard on our orientation program to continue to beef it up and make improvements."


4. Include your staff in agency decision-making. Ask your nurses for their opinions.

The small gesture could make them feel appreciated and in control of their careers. Plus, they may have solutions that never occurred to administration. Gunn says that only positive ideas and feelings have come from asking her agency's nurses what they think.


5. Keep your patient census at a level you-and your nurses-can handle.

Despite the desire and pressure to take every case, determine whether your staff can provide proper care before accepting a new patient. Developing a system where nurses have one-on-one time with their patients-without worrying that other patients are waiting for care-could be one solution to the nursing shortage problem. "If you could have that patient-to-nurse ratio where it needs to be, so that the employees still felt they were giving good quality care, then I don't think nurses would leave the profession and I don't think you would see such a shortage," says Gunn.


--Adapted from Home Health Accreditation and Reimbursement Report

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