No more pizza parties. Everyone loves to eat, but what staff needs to stay committed to your facility doesn't have pepperoni on it.
So how do you keep staff around long enough to be considered permanent? It seems like 6 months is permanent in a nursing facility now, sadly even for facility leadership roles.
The term “staff appreciation” is overused and overrated.
A quarterly pizza party is a running joke. The role many facilities have labeled as “staff development” is just as sad. If your staff development person tracks infections and annual competency requirements, it’s unlikely they are developing anything, other than a hand cramp from data entry. These are necessary tasks and a valuable role to be sure. My staff development coordinator was invaluable after we took over a building with a very fresh jeopardy survey.
The problem is, it doesn’t show staff any appreciation and doesn't affect retention rates.
Here are the key takeaways:
Turnover in long-term care is well over 50% and directly affects star rating, quality measures, and survey outcomes. This is worth your investment.
The average turnover for an aide or LPN is $2500-3,500.
Pizza is great, but not for appreciation and retention. Think about needs.
This needs to start from the top of your organization as a focus and priority
It has to be structured and there has to be accountability for managers who don’t do it. Because for nursing leadership, it’s often a happy afterthought or an “I wish I could”.
It doesn’t have to be so inflexible. We can work with people and still be fair and consistent.
Here are some of my favorite ideas to consider implementing:
True Staff Development; Career Advancement - Programs like tuition reimbursement, CNA training programs, and administrator in training (AIT) programs are absolutely huge for employees working their way into better roles for their career advancement.
Professional Development - Encouraging and reimbursing nurses for pursuing certificates, specialization, and advocacy roles in organizations are very attractive for RN’s and almost non-existent in long-term care.
Extra Money By Merit - Bonuses based on work-performance, attitude, team-work, and engagement are key for recognizing those excelling in direct-care roles at facilities. Bonuses for picking up shifts are at times a necessary evil but become an addiction and then a prerequisite, becoming a demand for getting shifts covered. They also contribute to unsafe conditions and furthering burnout.
Leaders showing up with gratitude. Presence is everything. Coming in at 12 am, 5 am, and 9 pm to talk with the staff, ask them how things are going, and thank them for their hard work was something I truly enjoyed doing. For staff who had never had their manager do this, they always looked terrified like I was walking in just to make sure they were surprised when I fired them. I would try to bring ice cream, baked goods, or candy with me to leave for them. I wasn’t in a hurry. I came to listen. When there was critical staffing at a facility I came into, it was all hands on deck for the nurse managers for showers and meals until positions were filled and staffing was stabilized.
Finding Some Flexibility - Talk about the most rigid and demanding type of job you could ever have. I have worked in almost every clinical position in a facility and none of them I would classify as having a “flexible” schedule. The final type of appreciation I am advocating for isn’t something I have always excelled at. It is easy to get stuck in a mindset of inflexibility in a world as tightly regulated as long-term care. One area nurse managers can improve on is fair and consistent flexibility. We can do better to be more clear about what is important and work with people when they need it. Allowing staff more autonomy and flexibility when it’s possible.
Benefits - Many long-term care companies don’t offer enough time off, for vacation or sick time, or any within the first 90 days. Unfortunately, lack of flexibility in these areas causes a significant loss of staff who desperately need it. If we are begging and pleading with staff to come in early, work a double, stay late, then they should get that flexibility from us in return. Can their next shift be covered, can they have a paid day off, can they come in two hours late after they stayed over until midnight to help? If not, they should.
Competitive Wages - If the salaries at your facilities are not competitive with the local factory pay, you can forget being fully staffed with aides or LPN’s until there’s a shut-down. I know raises aren’t always a realistic “fix” for retention or recruitment, but salaries have to be competitive for current staff to feel valued and prospective staff to come on board. If they can make the same pay at McDonald’s, they will.
Some other ideas I loved from this article on staffing address that if salary increases aren’t feasible, staff appreciation and retention still is. “Employers can improve direct care jobs without increasing hourly pay, said Katie Lynn-Vecqueray, director of employer membership at WorkLife Partnership, a Denver-based organization that helps employers retain employees.
Long-term care facilities can give care workers free meals, create support groups to help them manage stress, or let them take mental health days, for instance. After low pay, Lynn-Vecqueray said, stress is a major reason why direct care workers quit.”
There’s no good reason every single employee shouldn't get a meal on their shift.
A 30-minute lunch break isn’t even long enough to leave and get lunch unless the facility is a reasonable distance from food options.
Mental Health & Wellness Support - My most hopeful and least observed idea yet. Let’s start to acknowledge and address the fact that staff is carrying the emotional weight of working in long-term care and still managing their own problems outside of work.
If your organization needs help strategically implementing these changes in the culture of your company and its leadership, schedule a call, and let’s discuss your needs to determine if we can help. We work directly with the facility and corporate leadership to change the mindset and approach to staffing in an intentional manner with amazing outcomes for residents and revenue.