Improve Nurse Retention through Positive Leadership

April 10, 2023

We are proud to share this insightful, informative article written by NaphCare’s Sheila Burns, Accreditation Facilitator. Originally published in the Spring 2023 issue of CorrectCare®, the magazine of the National Commission on Correctional Health Care (NCCHC), this article offers guidelines that define the leadership methodologies behind building a strong, successful workplace culture.

The nursing shortage has been a simmering issue for decades, relieved only slightly in the U.S. by the economic downturn of 2008 and 2009, when many nurses returned to the workforce. Any gains that were made then have since been lost, however, and the extreme challenges of COVID-19 did not help the situation. It looks like the nursing shortage is here to stay, as more nurses continue to retire than enter the profession.

Add to that the fact that correctional nursing is not an obvious choice for most new nurses. Either they have never considered the possibility, or they might harbor some preconception about nursing behind bars that turns them off. It is true that correctional health care is not everyone’s cup of tea; it takes a special kind of person. Staff shortages are a serious problem.

It’s hard to stay positive in light of these challenges, but positivity is exactly what nurse leaders need to practice to attract and, more importantly, retain their employees.

Good First Impressions

In correctional health care they say that discharge planning should start at booking. Similarly, recruiters and nurse leaders need to address the retention issue from the first contact with an applicant. First impressions do count! An organized recruiting process, with a dedicated contact person and regular communication, can really encourage the applicant and create a positive impression of your organization and the field as a whole.

For starters, ensure that lobby security staff are aware an applicant will be arriving and have a staff member ready to meet the applicant and escort him or her to the interview room. A welcoming, well-coordinated interview process will help the potential new staff member feel more secure and positive about the position, the workplace, and the field.

Support and training are key elements to staff success, regardless of how long a nurse has worked with you. Orientation time needs to reflect a new employee's requirements, not the workplace’s requirements. I know you want them up and running the cart next week, but some people just need a little bit longer to gain confidence and competency; it is well worth making that investment if it means hanging on to a good nurse.

Mentorship or preceptorship for new recruits is a very useful retention tool. Having a peer or supervisor assigned to support and work with the new staff, show them the ropes, be available to answer questions, and guide them on their journey is invaluable. Not only does it help the new staff member, but it is also a highly effective way to recognize the mentors’ skills and show them they are valued. Feeling valued and included in the workplace improves staff morale and promotes retention.

Creating a Positive Workplace

As leaders, it is vital that we work toward creating a positive workplace. Studies show that the way in which a workforce is led is by far the biggest factor affecting morale and retention.

Think about this question: What makes you qualified to lead? Did you go to leadership school? Probably not. But leadership takes skills and knowledge, just like any job. Think back to when you were a brand-new nurse in your first role. You rode a huge learning curve to master time management, medication management, medical devices, patient assessments, medical records, and much more. Yet most of us do not get formal training in how to manage, lead, or be effective in a leadership role. Most of us have to learn those skills on the job. How?

As a leader, it is important that you self-reflect on questions such as these: How do you talk to your staff? How do you manage conflict? What tools do you use to develop staff morale? Where do your weaknesses lie? Take some time to think of the answers to those questions and then ponder the effect your style may have on your team.

Leadership styles vary, but some have been proven to be more successful than others. The only way to have a successful team is for you, the leader, to show by actions and words that you care about your employees and about the standard of care being delivered. If you don’t set that tone, then you can’t expect good performance from your staff.

Red/Green Tool

Using a tool to assess how your team is functioning can be a great starting point. A quick and easy one is the Red/Green tool. If you have a leadership team, get together and do this exercise – or just do it on your own.

Get two pieces of paper and write “Red” at the top on one and “Green” on the other. First, think about a negative, miserable workplace. What does it look, feel, and sound like? Brainstorm if you are working with others. Record what you come up with on the “Red” piece of paper. Examples could include silence, staff in silos, conflict, and high sick rate.

Then think about how a happy, productive workplace looks, feels, and sounds. Examples might be laughter, helping each other, and covering for each other. List those on the “Green” sheet.

Sit back and assess where your team is in relation to what you’ve written. Circle the words on the sheets that are seen in your department. Be honest. You can bet that there will be a mixture of both.

With that information, create a plan for managing any “Red” aspects – there are bound to be some – so that you are moving toward the “Green.” The key to success is for the leaders to behave in a “Green” way every day; people who are positive will start to follow.

In my experience using this tool, I found it took a lot of patience, time, and energy to turn a toxic environment into a positive one – several months, in fact. But what you will find is that people who want that “Green” environment will follow you very quickly. Those are the staff members you want to start recognizing and placing as mentors.

This caring-based model can help generate a team atmosphere in which positivity is the expected norm. If new recruits feel cared for, there is a higher chance that they will go on to care for their teammates and, in turn, become caring mentors. With this cycle, a positive team dynamic is developed and a healthier work environment is created. And who wants to risk leaving a great workplace to go somewhere else that may be toxic? Research shows that if employees are happy, they are reluctant to leave, even when there are other opportunities available to them.

Being a positive leader, actively listening to your employees, supporting their needs, incorporating their ideas, and encouraging their growth will go a long way to reducing staff turnover