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Tips from a recruiter.

Pat Hulec, RN, BSN, an instructor with the Nursing Home Area Training Center of Beachwood, OH, includes work as a nurse recruiter in her 15 years' experience as an RN. At a recent training session for administrators and DONs she outlined some of the advantages and disadvantages of recruitment tactics of the 1990s. The following is based on her remarks.

Tactic 1: The Finder's Fee: Paying a staffer to locate a new staffer for the facility is a very effective short-term measure. It enhances probably the most effective recruitment tactic of all: word-of-mouth. Operationally, you might pay, say, $50 for a nurse's assistant, $100 for an LPN and $500 for an RN; you would spread the payment out over the probationary period for that new staffer. The drawbacks are, first, some staffers might resent those differential payments, thinking that you personally value some people more than others; second, there is no connection at all with being able to retain that staffer you've hired.

* Paying Above-Market Salaries: The attractions of this to new employees are obvious, but this is a last resort in the case of extreme emergency. The risk is, of course, that you will eventually be driving other salaries in the facility upward. You may also start a recruiting war with other facilities in the area and cause a lot of resentment.

* Paying Start-Up Bonuses: These are a more reasonable way of coping with staffing emergencies and can be very effective. But you have to be careful. Bonuses are, again, no guarantee of retention, and there have been reports of staffers staying just long enough to collect the bonus and then moving on to another job. Sometimes staffers don't like the idea of receiving an apparent "pay cut" in their second year; even though they may have received a raise, it may not "make up" for the loss of the bonus. The responsibility is on you, the administrator or manager, to come up with ways to retain these staffers once you've attracted them with bonuses.

Concerning retention, there are some issues that merit close attention. It is being found increasingly that working conditions and management's perceived fairness and flexibility are more important to retaining staffers than salary and benefits. You have to look at your staffers' situations: Are they in a good mix with their fellow staffers and working well with their immediate supervisors? Is one unit experiencing more turnover than another? It may be because those staffers don't feel that they have a chance to develop and use their skills, or that their supervisor can't or won't make decisions or creates unnecessary stress in some ways. You may want to address the stress problem or reassign certain people or perhaps break up the unit altogether.

Another important factor: Are staffers being recognized for what they do? Simple acknowledgments, even for something like best record for punctuality or fewest missed days, can be very important.

The basic thing is to figure out what it takes, within reasonable limits, to foster loyalty among the staff.

* Adjusting Hours: One approach to this would be to offer part-time staff an incentive to work more hours or a more inconvenient shift or weekends. You can base this on a "frequent flyer" arrangement, offering "points" for the added work and basing pay on the points accumulated.

At the opposite end of the scale are so-called flex-hours, adjusting hours to accommodate the needs, for example, of working mothers with children in school; a 9 a.m. to 2 p.m. shift is an example of this. You must be very careful and very clear in how this is laid out, though. If certain time periods or situations are not sufficiently covered by staffing, you can end up with a scheduling nightmare and major headaches for everyone concerned.

* Educational Support: Used appropriately, this can serve as to staff not only to sign on and stay, but to move up the career ladder and solve staffing shortages throughout the facility. Helping an LPN achieve an RN degree with tuition support -- on average, this runs about $1,000 per year per nurse -- can go a long way toward creating a loyal staffer. Similarly, nursing assistants can be helped in attaining an LPN -- and a surprising number of these go on to gain RN degrees; the nursing facilities that assisted these people made a big difference in their lives.

Other approaches include employing student nurses during summer vacation. Some are interested in acquiring experience in long-term care, and nurses with that kind of experience are still not all that easy to find. Maybe with a judiciously placed start-up bonus upon graduation, you will gain a valuable and experienced staffer.

Still another approach is to guarantee valued nurses who take leave the same pay and benefits when they return -- a sort of "lifetime membership" program, and a good way to retain valued staffers over the long run.

* Professionalize The Job: Becoming increasingly popular in hospitals, and more and more so in long-term care, is giving RNs the responsibility for case management. The RN develops the care plans for select groups of residents and sees to it that they are staffed and implemented. She or he is given the opportunity to use not only clinical, but management, skills, and this can be very rewarding.

Unfortunately, in the "real world," there is a downside to this. As we know, nursing homes are being asked to take in sicker and sicker patients, and just at the time when budgets are shrinking. The upshot of this is that the facility moves from "team management" involving a variety of staffers to so-called case management, which translated means that the RN does everything, including managing diets and emptying waste baskets. This is producing some very stressed-out RNs, and you will find it happening just about everywhere.

The answer to that one is not easy to come by, and probably is not entirely up to the administrator. But public support for long-term care is another story.
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Title Annotation:nursing home employee recruitment tactics from Pat Hulec, Nursing Home Area Training Center instructor
Author:Hulec, Pat
Publication:Nursing Homes
Date:Mar 1, 1992
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