As the number of hospitals offering advanced services continues to grow, recruiting and retaining highly skilled cardiovascular and other specialty healthcare professionals — particularly nurse managers — has become a high priority, especially now, when shortages of many types of skilled professional healthcare staff exist. As we recruit for hospitals across the country, Corazon experience reveals that approximately 25% of requests received over the past two years have been for nurse managers.
In March 2012, the U.S. Bureau of Labor Statistics (BLS) reported that job growth in the healthcare sector was outpacing the growth realized in 2011, accounting for one out of every five new jobs created last year. As the largest segment of the healthcare workforce, RNs likely will be recruited to fill many of these new positions. However, according to the “United States Registered Nurse Workforce Report Card and Shortage Forecast” published in the January 2012 issue of The American Journal of Medical Quality, a shortage of registered nurses is projected to spread across the country between 2009 and 2030.
Today, as organizations struggle with new healthcare reform requirements, along with advancing to accountable care organizations (ACOs) or other coordinated care models, experienced nurses with additional skills in many areas, from management to evidence-based research, are in high demand. As a result, the nurse manager role is becoming significantly more important than ever. Because nurse managers have contact with nearly all departments within the hospital and often serve as the connection between staff nurses and upper management, they have much to contribute to patient care by means of quality and efficiency. Further, they have begun to assume responsibility for human resources, budgets, patient safety, and quality reporting, and also must manage organizational decisions that affect particular departments.
Based on a finding from the Nursing Management Aging Workforce Survey released in July 2006 by the Bernard Hodes Group, 55% of surveyed nurses reported their intention to retire between 2011 and 2020. The majority of those surveyed were nurse managers. In addition, according to the RN Work Project, a national study of nurses funded by Robert Wood Johnson Foundation, about one in five nurses will leave their jobs within the first year, and more than one in two will leave within seven years.
In our experience, the majority of nurses leave due to
- Empowerment. Nurses are seeking collaborative environments where they are respected in decision-making processes.
- Scheduling. They are looking for employers that offer flexible scheduling to help them balance their professional and personal lives.
- Continuing education opportunities. Nurses are pursuing jobs that will assist them on furthering their career while realizing opportunities within the organization.
- Mentoring programs. Nurses want opportunities at hospitals that offer programs to assist them in advancing and transitioning their career.
So, how can an organization address the need for a qualified nurse manager or director amid this shortage? The answer isn’t easy!
With the number of accomplished clinicians already limited, many hospitals are further restricting the candidate pool by seeking applicants with specific education and work experience. While clear expectations of job qualifications are a must, keeping an open mind is equally important when searching for candidates. Strict and inflexible requirements for specific education or degrees, years of experience, and other criteria can make an already challenging search even more so.
Corazon recommends being somewhat broad in “required” qualifications, and using a focused and unbiased screening and interviewing process as an effective means for finding the ideal candidates to move through the hiring process. Indeed, achieving balance between having too many unqualified applicants and very few or none who meet too-strict requirements is key.
Due to these shortages and the recruitment difficulties for this position, Corazon believes organizations should be looking to recruit individuals with the intent of professional development. Mentorship is one way to effectively accomplish this goal.
Making mentorship work
When recruiting, be sure to consider nurses who have vision and demonstrated accountability. The person being hired must understand the hospital’s future plans as well as have good judgment and team-building skills to collaborate with others. The majority of clinicians, particularly nurses, never work alone. They have interdependence on physicians and other disciplines, so nurse leaders must understand how to integrate all of those roles into patient care.
There also should be a plan in place and an organizational and/or departmental commitment to mentoring and educating nurses. It is imperative, given the number of changes in the healthcare environment today, that nurse mentorship is made a priority. Alignment of organizational and mentoring goals is essential to a successful approach. An effective mentorship program depends heavily on a stable infrastructure, including managerial and executive support, scheduling flexibility, incentives, and recognition. The program also needs to be deeply rooted in the organizational culture.
Mentoring can no doubt strengthen the nursing workforce and, in turn, improve the quality of care and patient outcomes. Thus, it’s not just mentors and mentees who benefit from these programs; patients and their families will ultimately receive better care. Mentoring also helps healthcare organizations retain nurses and nurse educators, which can curb the pervasive shortage discussed above.
A plan of action
Step #1 – Evaluate internal vs. external mentoring programs.
There are many benefits to developing mentorship programs internally. Doing so can showcase the executive team’s commitment to emerging talent and strengthen networks of influence across the organization. It might seem more cost-effective to use internal mentors, but savings in fees might be offset by the time mentoring takes away from completing everyday job responsibilities. Also, training potential mentors in mentoring skills will carry an expense. On the other hand, in-house mentors have the advantage of already knowing the background and issues of the particular organization, which reduces briefing time, and may reduce mentoring time as well. If a relationship of trust already exists with the mentee, it can provide an invaluable head start.
External mentors are usually new to the organization. While they know less of the specific background/situation, such a scenario can provide more objectivity. Experienced mentors are likely to build trust rapidly, and it might be easier for candidates to disclose difficult information to an outsider. Sessions are less likely to be curtailed by nagging work concerns, and the candidate may work harder as a result of the visible investment by the organization.
Additional value can also be derived from a hybrid of the two types of mentorship. If there is an internal employee who has the knowledge and experience to be an effective mentor, but lacks the time to adequately take on a protégé, consider supplementing the relationship with an external resource. In this scenario, the hired mentor has the availability to answer questions as needed and work toward project development. At the same time, the in-house contact can be available to lend expertise in situations specific to the organization or which require working knowledge of the hospital’s history. The in-house mentor can even join some of the sessions with the outside organization to lend context to the conversations and blend what is being done through both relationships.
In the types of programs Corazon offers, clinicians are groomed clinically, operationally, and financially in order to move efficiently and effectively into management roles. Our experts work collaboratively with mentees to manage real-world situations and define practical strategies with or without a specific project for focused implementation or improvement support during the mentorship. We find this arrangement can work best to fine-tune both strategic AND tactical perspectives, along with both theoretical and real-world scenarios.
Step #2 – Identify effective mentors.
The ideal mentor is not always the most experienced or the most productive, but rather an effective communicator who is accessible and willing to enter into a mentoring relationship. The desirable qualities of effective mentors are aligned with the skills of communication, relationship building, and collegiality. A mentor should first be considered a role model in his or her area of expertise. Equally important, however, is demonstrated commitment to the mentoring process by being accessible and friendly. Establishing and maintaining the mentor-mentee relationship cannot be overemphasized because it is the relationship that serves as the cornerstone for mentoring success.
Step #3 – Choose the type of mentorship.
The type of mentorship used will depend greatly on organizational culture, structure, priorities, and resources, as well as the mentor and mentee’s preferences. Once a decision has been made on the type of mentorship program your organization will offer (Figure 1), it is important to outline the responsibilities of the mentor and protégé. We recommend the following responsibilities to facilitate an effective relationship and in turn help with the bottom line:
- Have a clear understanding of expectations for your mentee and clearly communicate those expectations;
- Create goals, milestones, and deliverables;
- Advise, don’t dictate;
- Recognize your mentee’s weaknesses and build on his/her strengths;
- Evaluate progress;
- Be reliable;
- Follow-up on success after mentoring is complete; and
- Provide the organization with an evaluation of the experience.
- Have a clear understanding of professional goals;
- Create goals with milestones and deliverables;
- Clearly communicate your expectations of the relationship;
- Be open and accepting of constructive feedback;
- Celebrate success; and
- Provide the organization with an evaluation of the experience.
Step #4 – Implement the program.
A scope of responsibility and evaluation process for performance and progress is necessary at the start. Once these items have been addressed and it’s time to implement, schedule an introductory training session for mentors. Even the most experienced employees will get a better handle on their mentoring responsibilities, and this can set the stage for mutual clear understanding of responsibilities and expectations for the experience.
A meeting between the program lead and each mentoring pair should also take place. During this time everyone can get on the same page regarding goals, expectations, and other elements of the program. This is also the time to address meeting frequency, how long the program will last, and other details.
Regardless of your goals for mentorship, the best option is to identify employees who have drive and a vision for themselves and your organization. Without those critical components, no amount of mentorship or professional development can take an average employee to new heights as a truly effective leader. Mentorship is not the ultimate solution to any/all employees, but rather, can serve as an effective means to grow an already effective employee into a higher-level position. Implementing an effective mentoring program can serve to improve employee retention and overall performance as well.
Corazon offers strategic program development for the heart, vascular, neuro, and orthopedics specialties, and consulting, recruitment, interim management, and physician practice & alignment services to clients across the country and in Canada. To learn more, visit www.corazoninc.com or call (412) 364-8200. Jessica Barrick can be contacted at firstname.lastname@example.org and Michael Church can be contacted at email@example.com.
- Buell C. Models of mentoring in communication. Communication Education. 2004; 53(1): 56-73.