A Nursing Leadership Initiative: Keeping the Nurses We Have Jessica Lee Berlin University of Central Florida School of Nursing

Background Demand is simply not keeping up with supply By 2020, demand for RN’s will rise 28% By 2020, supply will only grow 8.9 % (Kooker & Kamikawa, 2011) Cost of RN replacement : $74,888, fiscally (Cottingham, DiBartolo, Battistoni & Brown, 2011) The time it takes to orient a new graduate RN is typically greater than that of an experienced RN

Background By 2018, anticipated 1,039,000 open RN positions (Cottingham et al., 2011) Evidence shows that nurses with experience contribute to better overall patient outcomes (Herrin & Spears, 2007) Organizations need to retain the staff they have

Problem Reasons RN’s leave Lack of appreciation & support Lack of sense of self value Lack of professional growth Lack of leadership support Salary Scheduling & long hours Injury Unable to meet patient needs (Cottingham et al., 2011)

Challenges with Leadership Leadership is a specialty There is a need for education for leaders in healthcare There is a need for a transformational leadership style Many leaders lack graduate level education needed to handle issues (Herrin & Spears, 2007)

Role of Leadership Focus on retention strategies (Toofany, 2007) Problem Solve Encourage teamwork Ensure that leaders are educated on transformational leadership Identifies, assesses and communicates to include the team in the mission and vision of the organization (Rivers, Pesata, Beasley & Dietrich, 2011)

Alternative Solutions Team building initiative (Toofany, 2007) Encourage cohesion through participation in group activities Pacific Northwest Nursing Leadership Institute (PNNLI) Program (Wilson, 2005) Community based education program for nurse leaders to retain staff

Alternative solutions Mentoring (Cottingham et al., 2011) Pair new nurses with experienced nurses Clinical coaching (Kooker & Kamikawa, 2010) Experienced nurses (coaches) trained on culture and mentoring skills

Alternative Solutions Nurse followership program (Crawford & Daniels, 2014) Assesses 5 follower styles: Alienated follower: one who possesses a great deal of negativity Conformists: lacks independent thinking but is actively engaged Exemplary follower: takes on tasks with confidence Passive follower: lacks independent thinking & is not engaged Pragmatic follower: only completes tasks when asked

Solution of Choice Management & Leadership Training

Plan Emotional Intelligence Collaboration Teamwork & Support Systems Change Professional Development

Plan continued Year long training program for leaders 5 modules Emotional intelligence: self awareness Collaboration: problem solving Teamwork: issues that promote effective clinical teams Systems change: understanding causes for resistance to change (Wallis & Kennedy, 2013) Professional development: career pathway, critical thinking & conflict resolution (Twigg & McCullough, 2014)

Benefits of the program Not only will the organization retain staff, leaders will now be: More approachable Educated Able to negotiate with staff and provide effective conflict resolution Able to effectively communicate Able to maintain stability in their leadership position Understanding of staff’s concerns (Duffield, Roche, Blay & Stasa, 2011; Lartey, Cummings & Profetto-McGrath, 2014; Twigg & McCullough, 2014)

Evaluation Management & Leadership Program Leader Effectiveness Retention

Evaluation continued Upon program completion: Increased retention rate greater than before implementation Decreased vacancy rate than before implementation Increased employee satisfaction Improved leader/staff relationship (Herrin & Spears, 2007) Improved communication & creation of positive practice environment (Wallis & Kennedy, 2013)

References Cottingham, S., DiBartolo, M. C., Battistoni, S., & Brown, T. (2011). Partners in nursing: A mentoring initiative to enhance nurse retention. Nursing Education Perspectives, 32(4), doi: / Crawford, J., & Daniels, M. K. (2014). Follow the leader: How does 'followership' influence nurse burnout?. Nursing Management, (8). 30. Duffield, C., Roche, M., Blay, N., & Stasa, H. (2011). Nursing unit managers, staff retention and the work environment. Journal of Clinical Nursing, 20(1/2), doi: /j x Herrin, D., & Spears, P. (2007). Using nurse leader development to improve nurse retention and patient outcomes: A framework. Nursing Administration Quarterly, 31(3), Kooker, B., & Kamikawa, C. (2011). Successful strategies to improve RN retention and patient outcomes in a large medical centre in Hawaii. Journal of Clinical Nursing, 20(1/2), doi: /j x

References Cont. Lartey, S., Cummings, G., & Profetto-McGrath, J. (2014). Interventions that promote retention of experienced registered nurses in health care settings: A systematic review. Journal of Nursing Management, 22(8), doi: /jonm Rivers, R., Pesata, V., Beasley, M., & Dietrich, M. (2011). Transformational leadership: Creating a prosperity-planning coaching model for RN retention. Nurse Leader, doi: /j.mnl Toofany, S. (2007). Team building and leadership: The key to recruitment and retention. Nursing Management - UK, 14(1), Twigg, D., & McCullough, K. (2014). Nurse retention: A review of strategies to create and enhance positive practice environments in clinical settings. International Journal of Nursing Studies, 51, doi: /j.ijnurstu Wallis, A., & Kennedy, K. I. (2013). Leadership training to improve nurse retention. Journal of Nursing Management, 21(4), doi: /j x Wilson, A. (2005). Impact of management development on nurse retention. Nursing Administration Quarterly, 29(2),