Recruiting and Retention

According to Wolters Kluwer (2017), there is approximately 30% of the turnover rate of new grads in their first year of practice and as high as 57% during the second year. The expense of training new staff is costly and is correlated to negatively impacting the quality of patient care that is provided (Wolters Kluwer, 2017). The Canadian Nurses Association (CNA) predicted the nursing shortage crisis due to changes in healthcare needs and an ageing population (Whittaker, 2021). In addition, the pandemic has intensified the shortage, which has led to a significant mental-health toll on nurses and resulted in some quitting their jobs (Whittaker, 2021).

We proposed implementing a plan to recruit and retain nurses for years to come while creating an internal Preceptor workshop. Our initial process was to complete an environmental scan to understand retention and turnover issues. Nurses in the 0-5 years with the organization makes up almost (48.1%) of the nursing team, while those with 16+ years is 16.5% of the population. Spectrum Health Care had a 51.9% turnover rate in the last 5 years. Spectrum Health Care is continually hiring nurses and organizing orientation monthly. Recruiting more nursing staff may offer a 'quick fix,' but it will not solve the difficulty of staff retention we are experiencing (Aparício & Nicholson, 2020). I attended orientation for both Peel and Toronto branches. I kept in close contact with the new hires and asked them to improve orientation. Based on the new hire's feedback, we altered the structure of our orientation to have a mix of virtual and in-person training. We collaborated with Hollister and ConvaTec for our virtual training on Ostomy and Wounds. We launched a "flexible days" campaign to attract new hires and partnered with CARE Centre for Internationally Educated Nurses. We assessed trends conducted from exit interviews. Lastly, we created a preceptor workshop.

I have learned a lot from conducting an environmental scan, developing the preceptor program, and educating adult learners throughout the fellowship. However, the most important lesson was applying knowledge learnt through literature and implementing it. The theories my team and I focused on were RNAO’s Knowledge-to-Action (KTA) Framework and Empirical- Rational Strategy developed by Benne and Chin.

The Empirical-Rational Strategy assumes that people are rational and will act in their self-interest when they understand that change will benefit them (Miles & Thangaraj, n.d.). It is implemented by proposing a change to a group that they feel is desirable and in keeping with the group’s self-interests (Miles & Thangaraj, n.d.). In suggesting the change, the proposer will emphasize how the change will benefit the group (Miles & Thangaraj, n.d.). It is successful if the change is perceived as reasonable or beneficial for individuals (Miles & Thangaraj, n.d.). For example, when I suggested the preceptor program to the group, I applied the knowledge learnt from the environmental scan (i.e. reducing workload to allow time to teach new staff) to the preceptors to highlight information of interest to the group. This is how I was able to gain and sustain preceptors for the fellowship.

The KTA Framework, especially the seven phases of the action cycle, kept us on track with the fellowship and guided us along the way. When we hit a roadblock, we often refer to the phases and brainstorm strategies to overcome them. For example, when the preceptor training was completed and ready to implement for our new hires, we quickly realized more preceptors than preceptees. As a result, we needed to find a way to attract more nurses to the organization. Therefore, we used the KTA Framework phases 1, 3 and 4. This resulted in teaming with our advertisement and human resources team to launch the flexible day's campaign and working with CARE.