What Makes Nurses Happy?


By Debra Wood, RN, contributor

Hospitals cannot function without nurses and many facilities have learned that retaining the nurses they have beats bringing in new ones. The key is finding out what makes nurses happy enough to stay.

“It behooves us to have a stable nursing workforce that is committed and engaged,” said Marsha King, RN, MS, MBA, CNAA, chief nursing officer at Saint Joseph Regional Medical Center in South Bend, Indiana. “It increases nurses’ satisfaction, patient satisfaction and clinical outcomes if you have a stable nursing staff that stays and know the policies and procedures. It’s also contributed to physician satisfaction.”

Saint Joseph Regional is located in an area with several nursing schools. King said she has no trouble recruiting and has noticed a difference in the work environment, turnover rates and general satisfaction since reducing nurse-patient ratios, involving nurses in practice governance and improving the support of new hires. The hospital works with the Studer Group, a consulting firm in Gulf Breeze, Florida, which promotes engaging nurses in the workplace.

Bob Murphy, RN, Esq., a national speaker with the Studer Group, called it a deliberate process. He finds all nurses want to work on a good unit with a good boss and high-performing nurses want to develop further and contribute more.

When nurses leave, the hospital has to spend more money recruiting and orienting, up to $200,000 for a critical care nurse, Smith said.

Just what does it take to keep a nurse happy? The consultants offer very similar strategies.

Studer coaches recommend leadership rounds to communicate and engage staff, 30-day and 90-day questionnaires with new hires, and recognizing and rewarding staff.

“The first 90 days is critical,” said Murphy, adding that asking the questions along with peer interviewing can cut first-year turnover in half. “It’s a huge tool to keep nurses.”

Saint Joseph Regional has almost entirely eliminated 90-day turnover. Leaders at the hospital meet with new nurses at 30, 60 and 90 days, asking whether the job is what they anticipated; who on staff has been helpful; any ideas they have for improving the facility’s safety, quality or satisfaction based on their past experiences; and suggestions for what might make the job better. At 90 days, they also ask if the new nurses know of anyone else who might want to join the team.

Rounding for outcomes helps leaders ensure nurses have all the equipment and supplies they need to do their job, harvest ideas and show genuine concern for staff. Leaders then must act to resolve problems.

“We try to create an environment that is open, so they will feel comfortable telling us what works and doesn’t work,” said Leah Carpenter, RN, MPA, chief nursing officer at Memorial Hospital Miramar in Miramar, Florida. She goes on rounds twice daily. “Our philosophy is we don’t have all of the answers, so we surround ourselves with people who are the experts.”

Carpenter appreciates feedback from bedside nurses and expresses that. She also sends personal, handwritten thank you notes to staff members doing a good job.

Saint Joseph Regional rewards nurses with passes for lunch or “St. Joe Dough” for use in the gift shop. In the summer, leaders will bring an ice cream cart to the units, and when a floor is exceptionally busy they will often order pizza for the staff.

Some hospitals have taken away reserved parking spaces for leaders to create a more personable work environment. Other facilities have implemented a briefing before every shift to encourage staff and remind them about the commandments of good patient care.

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