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8 Strategies for Improving Nurse Engagement

Overcoming staff shortages while still providing quality patient care has challenged many healthcare organizations. To confront this, leaders are avidly seeking nurse engagement strategies. They want to stop losing nurses while improving their ability to retain them. What are the biggest nurse engagement issues and the best approaches to solve them?

Why is nurse engagement important?

Filling positions with quality talent is always a top priority. But organizations may get stuck in a cycle of staff loss and hiring. And they will likely stay in this urgent recruitment mode unless they provide a high-caliber employment experience that makes their nurses want to stay.

Vacancies are not only a threat to the quality of care you provide — they are also costly to fill. Recent estimates indicate that the average cost to replace an RN is now over $52,000. Every additional 1% in turnover can cost an average hospital over $380,000 in a year.

Forbes lists three main reasons why employee engagement is good for organizations and employees. Consider whether your organization struggles in these areas:

  • Well-being — Do your nurses love to come to work each day? Do they feel safe, successful, and fulfilled in their personal and professional missions?
  • Performance — Are your nurses performing to their full capabilities and potential?
  • Longevity — Do your nurses feel a sense of loyalty to your organization?

Factors that contribute to a lack of engagement

Few healthcare organizations intentionally create a work environment that harms their employees. But complex demands can cause shifting priorities. These pressures can negatively affect nurses’ experience on the job — a reality that was occurring long before the COVID-19 pandemic. Here are the top factors that can cause a lack of engagement (and eventually turnover), as cited in our 2022 Nurse Salary Research Report.

Low compensation

Higher pay was the highest-rated retention factor in our survey. In a competitive market where labor is scarce, nurses know they can find opportunities elsewhere and will not tolerate a significant pay discrepancy.

Long hours

Work-life balance was the next most-cited retention factor for nurses in our survey. It is no longer acceptable for nurses to compromise their well-being by routinely working well beyond expectations. Nurses may also need more flexible shift options.

Fatigue and burnout

If nurses are experiencing fatigue, they may be sustaining unreasonable workloads. The COVID-19 crisis understandably led many nurses to experience burnout. Continued overwork can affect well-being, which will inevitably harm engagement.

Minimal benefits

Along with compensation, benefits are important to nurses. Survey respondents listed tuition reimbursement, childcare, and other desired benefits. Top perks also included bonuses, profit sharing, malpractice insurance, and funded educational opportunities.

Lack of support

An organization’s support of its employees can take many forms. For example, organizations that do not work to be inclusive of employees of color can seem unsupportive or even hostile. Safety — both physical and psychological — is an expectation that employees want to be able to count on.

Inadequate leadership

Employees often leave a workplace solely because of their manager. Less-than-satisfactory interactions with their manager can damage an employee’s experience, regardless of their overall opinion of the organization.

Limited resources

If your employees do not have what they need to perform their duties properly, they may look for an employer that invests more in resources. Organizations might skimp on professional development, employee recognition, or even workplace supplies. Daily obstacles can frustrate staff beyond repair.

Lack of collegiality

Finally, employees quickly sense whether their organization’s culture is collaborative or lacking in teamwork. Leadership sets the tone, which is conveyed to (and through) staff. Nurses need to feel they are valued members of the organization and that their colleagues care about them.

Relias Vitals+Vision Podcast

Listen as we sit down with Vince Baiera, Partner for Post-Acute Care at Relias, to discuss onboarding and retention in health care. Vince shares some best practices in hiring, training, and engaging employees to help retain them in the organization.

Strategies to improve nurse engagement

Initiatives to improve nurse engagement can give your organization a significant return on investment. Here are some strategies we recommend.

1 – Find the best fit

Immediately after hiring, organizations can increase nurse engagement with a quality onboarding process. An onboarding solution that provides pre-hire assessments to determine new nurses’ aptitudes, skill levels, and preferences can significantly increase the likelihood that they will be satisfied and productive in their roles.

Personalizing the process takes into consideration that each nurse is unique in terms of background, knowledge, and professional goals. A “one-size-fits-all” approach most likely will not yield the same results for everyone. The best solutions match nurses with the care specialty they are best suited for and can even determine growth and leadership potential.

2 – Provide recognition

Employee recognition programs do not have to be costly or extravagant to be effective.  A 2021 Achievers Workforce Institute survey examined 3,500 employees’ sense of belonging at work. It found strong connections between employees’ sense of belonging and higher levels of engagement, mental health, resiliency, and productivity — and lower levels of fatigue and emotional exhaustion.

Recognition can be as simple as a weekly announcement of individual employee or team accomplishments or a software platform that enables staff members to recognize each other for a job well done. However, it could also take the form of a clearly communicated career path progression that informs an employee about opportunities for advancement.

3 – Support your nurses

The Society for Human Resource Management (SHRM) defines support as “employees’ beliefs about the extent to which their organization cares about and values them.” Support on the job can be something as simple as providing a mechanism to solicit employee concerns and working to address them.

Support can come in different forms and change depending on circumstances. In some instances, support might mean providing additional staff, physical assistance, or supplies. In others, it could mean holding regular huddles or check-ins with your nurses.

4 – Cultivate empathy and trust

Empathetic leaders seek to understand the needs of their employees. The Center for Creative Leadership reported that employees who feel their managers understand their perspectives have better job performance. It is notable that being compassionate and connecting with others may not involve anything more than being a good listener and communicator, yet it is enough to increase productivity.

Harvard Business Review related trust to empathy, citing a study in which emotional acknowledgment, or verbally recognizing others’ feelings, can help cultivate interpersonal trust. Interestingly, this study found that acknowledging negative emotions when employees need to vent can strengthen relationships more than acknowledging positive ones.

5 – Focus on teamwork

Effective teamwork is central to the success of nearly any healthcare organization. Providing reliable, high-quality care and avoiding costly errors depend on it. Research studies have examined what comprises a high-functioning team and found that the central factor is good communication. Each member of the team needs to know what to do and when for the best result, and communicating well and often will keep your nurses engaged and focused.

One common pitfall is merely dividing the labor without ensuring that strong coordination and integration mechanisms are in place. Another key aspect is to ensure that teams have the necessary range of skills and attributes for success.

6 – Uphold work-life balance

Many organizations strive for work-life balance, but opinions vary as to what it looks like and how to achieve it. In a cross-sectional study, researchers found that healthcare workers’ definitions differ significantly depending on position and time in their specialty. However, they found some consistent correlations.

Researchers analyzed specific indicators of a lack of work-life balance, such as the frequency of workers skipping or eating poorly balanced meals, missing breaks, working late, getting insufficient sleep, being unable to attend to non-work needs, or having to change personal plans to accommodate work demands.

Pinpointing the occurrence of these specific harmful behaviors can help objectively assess whether work-life integration is less than ideal at your organization and provide tangible ways to correct it. Adding benefits related to work-life balance may not make a difference unless they are directly related to giving employees more personal freedom, such as family leave, flexible scheduling, and childcare.

7 – Communicate frequently

The saying, “no news is good news” does not necessarily hold true within a professional setting. For your nurses to understand your organization’s mission and goals, leaders need to establish a consistent communication cadence. SHRM discussed the positive impact of effective communication and underscored the importance of developing a comprehensive communication strategy.

A solid strategy helps build morale, satisfaction, and engagement. It also drives commitment and loyalty, educates employees, gives them a voice, improves efficiency, reduces costs, and can help lessen misunderstandings, grievances, and lawsuits.

8 – Provide education and training

An employee initiative that combines resources, benefits, and support — all of which boost engagement — is education. During a career that will ideally span decades, nurses expect to learn and grow. In addition to continuing education, compliance, and certifications, nurses may also have personal or professional educational goals, especially as they begin to achieve mastery within their areas.

Education, perhaps more than most nurse engagement strategies, brings a huge payoff for your organization by improving competencies, creating versatility, and developing leaders. These qualities help your bottom line, but above all, they improve the quality of care you provide and elevate your organization.

Nurse engagement affects patient outcomes

Research has shown that when patients receive care from a highly-engaged, high-performing team of clinicians, outcomes improve. Nurse engagement affects perception, productivity, safety, and overall quality. The interdependent connection between all these characteristics and patient experience is undeniable. Are you doing all you can to promote the engagement of your nurses?


Support Clinicians’ Career Growth Opportunities

Relias partnered with the American Hospital Association on its 2023 Health Care Workforce Scan, which examined the current state of the healthcare workforce. Watch our webinar to learn how acquiring new skills can engage clinicians and enable them to provide more effective patient care.

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