How you gonna keep 'em down on the farm?

Make the farm integral to their lives, that's how!

EMPLOYEE TURNOVER IS NOTORIOUS IN THE NURSING HOME industry. If you don't think so, check out any want ads in any paper on any given day. Employers are prepared to grovel. They give bonuses to anyone who can lure a friend or relative into the facility. Very often everyone involved stays the prescribed time, collects the bonus, and moves on.

Upright citizens, who would return a lost wallet containing hundreds of dollars in a heartbeat, think nothing of stealing employees from one another. There has to be a better, more civilized way of keeping employees.

During this era of cutbacks and cost containment, how is it possible to keep good employees happy and committed to their jobs? Respond to their needs. Respect their dignity. Give them a sense of autonomy. It works for your residents; make it work for your staff.

The people interviewed for this article came from a wide range of backgrounds. Some had worked in hospitals as CNAs and RNs, some had worked as agency and home health care staff, and others had worked in prisons or were overnight nannies. All of them expressed the same needs and concerns.

The main reason for employment stability is proximity to homes and children. For single parents who are the main support of their families, this is crucial. As a unit secretary told me, she stays on her job and has no intention of moving on because, "I'm close to my kids if anything goes wrong." Being close enough to the school to be able to race over in an emergency is priority to concerned parents.

A family-oriented facility that welcomes children during storm emergencies has a far greater chance of retaining staff members and preventing 'no call, no shows.' There's a marketing bonus for a child-friendly facility--residents look on these children as surrogate grandchildren. They often love having them around, especially if their own grandchildren are too far away to touch base on a regular basis.

The appeal of a family-oriented facility can be a strong anchor during the recent storm of change that is taking place in the health care field. Encourage staff members to really get to know their residents by setting up a primary-care system. It's harder to walk away from a resident when she has become an integral part of your life. After all, the reality is that employees spend more time on the job than with their own families. Recently, a CNA told me, "My nursing home is like a family and the people I take care of are my 'grandparents.'"

Unit managers are the backbone of staff stability. One unit manager, with the persona of a marine drill sergeant, always referred to her CNAs as ladies." They knew she was tough but they knew she respected them. She had a sense of humor that infected the entire staff and made the hard times easier. She was always on the lookout to catch them doing something good and the praise was instant, sincere, and in front of their peers.

If all else fails and you hear through the grapevine that an employee is thinking of leaving, take her aside immediately. Listen to her concerns. Address them as quickly as possible because if you don't, employee dissatisfaction will spread quicker than a winter cold in a pediatrician's waiting room!

Grace Rudolph, LSW, is director of Social Service at Sippican Healthcare Center, Marion, Mass.

THE 10 COMMANDMENTS OF RETAINING STAFF

Without oversimplifying the issue of reducing turnover, here are some simple, common-sense approaches to retaining your staff members. Adopt as many of these as you can.

1 Treat all employees with respect.

2 Honor differences and be open to suggestions.

3 Never lie. Don't offer a benefit unless you can produce it.

4 Be fair in giving honest wages.

5 Give bonuses (movie tickets and a gift certificate for dinner for two, for example) for performance above and beyond the call of duty.

6 Encourage the feeling of 'we're all in this together' among staff members, residents, and families.

7 Offer more benefits for time accrued, beginning with a benefit after one year's employment.

8 Make an example of good behavior and employee loyalty.

9 Encourage staff autonomy.

10 Listen--really listen-- to employee concerns and respond to them in a timely fashion.