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Grassroots recruiting. (Retention and Recruitment).

Executive Summary

* With the many concerted efforts to recruit nurses, a focus on grassroots recruitment is suggested.

* Ideas for this strategy are presented along with rationale for considering this approach to retention and recruitment.

GIVEN THE CONTINUING nursing shortage, many efforts are being made to stimulate an interest in nursing as a professional consideration. Johnson & Johnson recently introduced a multi-year $20 million campaign to attract women and men to nursing. In addition to a Web site ( about the benefits of a nursing career, they are sponsoring a national advertising campaign. You may have seen the very appealing television ads celebrating nurses and their contributions during prime time at the Opening Ceremony of the 2002 Winter Olympics. This greatly enhances the image of nursing and helps to provide a positive environment for recruitment.

In individual facilities, a focus on grassroots recruiting is worth considering and can be built upon national efforts, such as the Johnson & Johnson campaign. Grassroots means working with each recruit individually. Grassroots recruiting involves strategies to provide face-to-face contacts to influence individuals being recruited. The influence may involve any number of factors related to what nurses need and want.

An evidence-based framework for recruitment and retention was outlined in the American Organization of Nurse Executive's Nurse Recruitment and Retention Study (2000). The results suggested determining what nurses want, which is often a reflection of where nurses are their careers or personal lives. Different strategies can then be developed to recruit nurses, also keeping in mind the facility and market. Grassroots recruiting would go even further. For example, nurses who are parents with young children would be interviewed to determine their particular needs and goals.

Once it is determined what nurses want, it is critical that the organization delivers on any promises made to the recruit. If parents with young children need day care for sick children, then it should be available or alternatives provided. Promising that it will be available soon, and then not delivering sets a bad tone for recruitment. Nurses will be quick to point out to other nurses that the organization did not deliver.

Getting Started

There are many ways to begin setting up an in-depth grassroots recruiting strategy. As already mentioned, finding out what nurses want is important. There are many references in the literature as to what nurses want, for example: internships and professional development (Olson et al., 2001), job sharing (Gliss, 2000), shift work (Fitzpatrick, While, & Roberts, 1999), leadership (Boyle, Bott, Hansen, Woods, & Tauton, 1999), and professional salary model (Avigne, Guin, Pittman, & Surdez, 1998). In addition, there is an increasing amount of literature about hospitals which have been designated as magnet facilities by the American Nurses Credentialing Center. The literature describes what characteristics are important in recruiting and retaining nurses (Aiken & Havens, 2000; Havens & Aiken, 1999). Nurse focus groups in your own facility are also fruitful for providing an indication of what nurses want.

Once factors are identified, brochures may be developed to give in-depth information on programs such as an internship. This may be combined with other recruitment information that has been identified as important to nurses, such as shifts, job sharing, opportunities to participate in research, how the facility handles high census, and how replacements for sick call and vacation are provided.

There is also a lot of legislative activity currently directed toward money for educating nurses and nurse faculty. There is also legislative activity aimed toward improving the nursing work environment, mainly through limiting mandatory overtime and mandating patient-to-nurse ratios. If this is happening in your state, it is important to include information regarding these efforts.

Grassroots recruiting takes this information and goes directly to the nurses being recruited and influences them with information about the facility in face-to-face encounters. Making the face-to-face contact may be difficult, but there are several grassroots methods that can be tried.


First, calling nurses who have left your facility is worth the effort. A telephone marathon can be set up and nurses called individually by another staff nurse, manager, supervisor, administrator, educator, or physician who worked with them in the past. Hopefully, human resources can easily provide the employment information on individuals who have left, including information from exit interviews. In that way, reasons why the person left can be addressed during the contact. Records also should be kept of the individuals contacted so followup calls can be made and information sent.

Postcards are also a way to do grassroots recruiting. Announcements of new programs and information important to nurses can be included on the postcard along with a telephone number, FAX, and e-mail address at the facility for the nurse to contact. It is important that nurses can easily reach the facility, and get an immediate response. More importantly, it helps if nurses can reach a live voice rather than voice mail. A lot of selling can be done when talking with nurses, an opportunity lost to voice mail. Many nurses also give up in frustration if they always reach voice mail and/or do not receive a return call.

Students are also an important focus in grassroots recruiting. They usually are a captive audience in a facility. Organizing welcoming lunches for them and their faculty is important along with providing educational opportunities that are meaningful and memorable. Even students in their first semester of nursing practice remember a facility that was a positive work and learning experience. Needless to say, staff nurses can have an enormous influence on students, both positive and negative, and happy staff nurses make good grassroots recruiters.

Students, like most nurses, also like giveaways. Items that are helpful to practice make memorable gifts, such as stethoscopes and quick reference guides.

Visits to schools and colleges of nursing during job fairs are also important. Actually, data should be kept of contacts with schools and students so a routine appearance by someone from the facility takes place. Students are worth the effort since there is usually some indication of their skills as a practitioner while they are students, and therefore an evaluation can be made of their fit with the patient care unit. They also usually need less orientation than other new employees because they are already familiar with the patient care unit and/or the facility.

Other strategies for grassroots recruiting include sponsoring booths at conferences and conventions, and making trips to cities in other markets and setting up an open house in a hotel conference room. Ads in the local paper of the city are a good way to invite nurses to the open house along with flyers dropped off at schools and colleges of nursing. An open house in the facility is also a good idea and can focus on students or RNs. Ads and flyers are again a good way to announce the open house.


These are just a few examples of grassroots recruiting. In general, grassroots recruiting is thought to be time and resource intensive. However, there is an abundance of data about the high cost of recruiting and orienting a new employee. Grassroots strategies do involve time and money, but focus on what the individual wants so a good fit can be made between the nurse and the facility, leading to a positive and, hopefully, long association.


Aiken, L.H., & Havens, D.S. (2000). The magnet nursing services recognition program: A comparison of two groups of magnet hospitals. American Journal of Nursing, 100(3), 26-36.

American Organization of Nurse Executives. (2000). Nurse recruitment & retention study. Chicago: Author.

Avigne, G., Guin, P., Pittman, L., & Surdez, M. (1998). Moving from an hourly pay model to a professional salary model. AORN Journal, 68(3), 400-402, 405-408.

Boyle, D.K., Bott, J., Hansen, H.E., Woods, C., & Tauton, R.L. (1999). Managers' leadership and critical care nurses' intent to stay. American Journal of Critical Care, 8(6), 361-371.

Fitzpatrick, J.M., While, A.E., & Roberts, J.D. (1999). Shift work and its impact upon nurse performance: Current knowledge and research issues. Journal of Advanced Nursing, 29(1), 18-27.

Gliss, R. (2000). Job sharing: An option for professional nurses. Nursing Economic$, 18(1), 40-41.

Havens, D.S., & Aiken, L.H. (1999). Shaping systems to promote desired outcomes. The Journal of Nursing Administration, 29(2), 14-20.

Olson, R.K., Nelson, M., Stuart, C., Young, L., Kleinsasser, A., Schroedermeier, R., & Newstrom, P. (2001). Nursing student residency program: A model for a seamless transition from nursing student to RN. Journal of Nursing Administration, 31(1), 40-48.

SUEELLEN PINKERTON, PhD, RN, FAAN, is an Independent Consultant, Indialantic, FL. Comments and suggestions regarding this column can be sent to
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Author:Pinkerton, SueEllen
Publication:Nursing Economics
Geographic Code:1USA
Date:Mar 1, 2002
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