Cover Story: Piecing Together a Winning Team
By Don Sadler
Hiring and holding onto the most talented and skilled employees is critical for any business including hospitals and healthcare facilities. This is especially true when it comes to OR nurses.
Well-trained, top-notch OR nurses are in high demand today, which makes it critical that hospitals devise a plan for how they will recruit and retain their OR nursing staff and build their OR nursing teams.
High turnover among OR nurses can be extremely costly to hospitals. In an article on its website, the American Nurses Association cites a study estimating that it costs between $62,000 and $67,000 to replace a single RN.
There are also human costs involved in high turnover, as other nurses must absorb the extra workload when nurses leave, as well as help train new nurses after they are hired.
“Management must realize that nurse recruitment and subsequent retention are competitive aspects of the healthcare business,” the article concludes.
Two Sides of a Coin
Recruiting and retention are two separate sides of the same coin, notes Josiah Whitman, the founder of Whitman Partners, a staffing firm that specializes in the healthcare industry.
“When recruiting, due to the high demand for OR nurses, hospitals need to view those applying for jobs as true candidates, not just applicants,” says Whitman. “You can’t just instruct them to go to your website and fill out an application — you have to be more proactive than that.”
Whitman urges directors of surgical services and surgical supervisors to branch out far and wide in their search for good OR nurse candidates.
“Don’t just post an opening on your hospital’s website or a job board, but also tap your professional networks and LinkedIn connections,” Whitman says. “And ask your existing staff nurses if they know of any good candidates.”
In such a competitive environment, it’s also helpful to try to distinguish your hospital as an employer of choice. If your hospital has won any “best place to work” awards or Magnet status, promote this heavily in your recruiting efforts.
You should also determine what are the most important factors to most OR nurses when deciding where they want to work.
“The number one thing we are asked about by candidates is whether the hospital will pay for continuing education, CNOR certification and ongoing professional development,” says Whitman.
“Candidates also usually want to know about schedule flexibility — for example, many ask about four-day workweeks, or how much they’ll be on call,” Whitman adds. “Achieving work-life balance is usually important to OR nurse candidates.”
Travis Dorvall, RN, CNOR, who works at North Valley Hospital in Whitefish, Mont., says that most OR nurses are looking for a hospital that provides a culture for great patient care, teamwork and the opportunity to work with clinically competent nurses.
“Having a respectful, non-toxic working environment is also important,” Dorvall says. “Most OR nurses want to have autonomy in their practice and be empowered by supportive managers who are willing to back their staff.”
“Top-flight OR nurses today want support from administration to keep up with technological advances, and access to continuing education that will keep them functioning at a high level,” adds Deborah A. Herdman, RN, BSHA, the director of PeriOperative Services at Trinity Health System in Steubenville, Ohio.
“And they want a collegial relationship with the surgeons they’ll be working with, without the burden of chasing after them to complete their paperwork,” says Herdman. “This is another way administration can support OR nurses.”
Right Skills, Good Fit
Despite the competitive hiring environment for OR nurses, you should still take great care in trying to hire nurses with the right skill sets who will be a good fit with the rest of your team.
“Hiring managers should be very selective when hiring OR nurses,” says Dorvall. “The operating room is a unique, highly technical workplace.”
Herdman recommends conducting peer interviews so that the OR staff who will be working directly with the new hire has a hand in selecting future team members.
“Follow up with new OR nurses every week for the first 30 days to ensure that they are receiving a good orientation and the organization is meeting their expectations,” she says.
Joan Anderson, RN, CNOR, the surgical supervisor at Schoolcraft Memorial Hospital in Manistique, Mich., agrees about the importance of getting input from the rest of the OR team when interviewing candidates.
“Everyone on the team is going to be working together very closely,” says Anderson. “So, I always introduce candidates to the staff and ask for their input, which I take into consideration when making a hiring decision.”
Your application and interview process for hiring OR nurses should lay out the specific qualities and expectations you’re looking for in candidates, Dorvall says.
“Have a keen understanding of the characteristics that define the ideal OR nurse for your facility,” he says. “These generally should include, but aren’t limited to, having patient safety as their highest priority, having self confidence, being flexible with their time and workload, being a problem solver, and being able to admit an error.”
Get In Front of Resignations
Once you have recruited the best OR nurses, your hospital should be doing everything within its control to hold onto them. The key, says Whitman, is to “get out in front of potential resignations before OR nurses give notice. Once they have resigned, there’s usually not much you can do to change their minds.”
Of course, offering a competitive salary is important.
“Look at your pay practices and make sure they’re competitive,” says Dorvall. “Also consider implementing strategies to retain staff during low census, such as guaranteeing a percentage of pay if hours are not met. And you should offer and promote continuing education and training for OR nurses.”
But job satisfaction for OR nurses is usually about more than money.
“Like anybody else, OR nurses want to feel valued,” says Herdman.
“In other departments, nurses get feedback from the patients and their families,” Herdman adds. “But OR nurses get very little patient feedback because patients are anesthetized or sedated and spend a short amount of time in direct communication with them. So we need to make sure OR nurses are recognized and rewarded for doing a great job.”
Being flexible to accommodate OR nurses’ needs and unforseen situations is also important, says Anderson.
“I realize that sometimes, things happen and a nurse can’t come in for an unforeseen reason,” says Anderson. “Even though the hospital’s policy only allows for three short-term call-ins, I try to be as flexible as I can in these situations.”
And you can never say “thank you” to your OR nursing staff too often.
“I thank my nurses every day for all their hard work,” says Anderson. “And once a month, I personally buy lunch for everybody. They all know that I have an open-door policy and they can talk to me any time about anything that’s concerning them.”
Finally, it’s important to monitor OR nurses’ workloads and schedules to make sure they aren’t being overworked and getting burnt out.
“Exhaustion is definitely an issue among OR nurses, as is maintaining a healthy work-life balance,” says Whitman. “We have a saying that you need to understand your nurses’ house-spouse-kids in order to know what’s really going on in their lives. And then be as flexible and accommodating as you can with regard to these areas of their personal lives.”