Staff selection is one of the most important functions of a nurse manager. In his book Good to Great: Why Some Companies Make the Leap…and Others Don’t, author Jim Collins says, “get the right people on the bus, the right people in the right seats, and the wrong people off the bus.” He goes on to explain that “…if you have the wrong people, it doesn’t matter whether you discover the right direction; you still won’t have a great company.”
While applicants must have the minimum level of education, licensing, certification, and clinical and technical skills necessary for a given position—selecting the “right” individual often depends on identifying the right characteristics, attitudes, and values that drive the “right behavior.”
Some skills and individual characteristics are essential to success and managers should seek to identify them in nursing candidates when filling a seat on the bus:
1. Excellent Communicator
Nurses communicate with those who are ill, suffering, anxious and afraid to provide comfort and support. They educate patients and their family members about diagnoses, medications, and procedures. They care for those with auditory and visual impairments, and language barriers for whom communication is challenging. They advocate for patients as members of interdisciplinary teams when others may have conflicting ideas and priorities for care. Nurses write care instructions, proposals, and research reports. They interact with administrators and co-workers to find solutions for organizational issues. No matter what their role, nurses must have well-developed verbal and written communication skills.
- Team Communication: Poor team communication has been linked to preventable medical errors, high nurse turnover rates and low morale (Brinkert, 2010). In both personal and professional settings, the use of effective interpersonal communication strategies by nurses may reduce stress, promote wellness, and therefore, improve overall quality of life (Vertino, 2014).
- Patient Communication: Results of a 2013 Press Ganey study showed that “performance on the Communication with Nurses dimension of HCAHPS surveys strongly influences four other Patient Experience of Care dimensions within the value-based purchasing framework. Further, there is a growing body of evidence that HCAHPS performance in general—and performance on the Communication with Nurses dimension in particular—is strongly associated with hospital performance on other CMS payment programs.” (Press Ganey, 2013)
2. Compassionate / Empathetic
Compassion comes from Latin words meaning to “suffer with.” It is understood as empathy for someone experiencing physical, mental, emotional, and/or spiritual suffering. Many consider compassion and empathy to be the essence of nursing practice as values that anchor and orient day-to-day work (Jones, Strube, Mitchell, & Henderson, 2017).
Interviews with CEOs and senior leaders at 35 U.S. hospitals known for their commitment to compassionate care revealed that:
- Organizations that place a high priority on delivering compassionate care benefit from lower staff turnover, higher retention, recruitment of more highly qualified staff, greater patient loyalty and reduced costs from shorter lengths of stay, lower rates of re-hospitalization, and better health outcomes, and fewer costly procedures.
- Caregivers who can express compassion for patients, families and each other experience higher job satisfaction, less stress, and a greater sense of teamwork.
- Patients who are treated compassionately benefit from improved quality of care, better health, fewer medical errors, and a deeper human connection with their caregivers. (The Schwartz Center for Compassionate Healthcare, 2015)
3. Critical Thinker / Problem Solver
As the delivery of healthcare becomes increasingly more complex, it is important for nurses to have well-developed critical-thinking and problem-solving skills. When a patient’s condition rapidly changes, critical thinking enables a nurse to recognize important cues, respond quickly, and select interventions to best address the needs of the situation. In other instances, nurses must sift through an abundance of data and information to assimilate and adapt knowledge for problem clarification to find effective solutions.
In a survey of 117 nurse educators, 82 nurse administrators, 23 recent BSN graduates, 96 experienced BSN graduates and 11 deans or directors of nursing programs, critical thinking was consistently listed as one of the most important entry-level competencies (King, Smith, & Glenn, 2013).
The nursing profession, by nature is stressful—emotionally, mentally, and physically. The day-to-day demands can be exhausting for many, leading to high rates of burnout and turnover. Resilience is the ability to “bounce back” or cope successfully despite adverse circumstances. Studies have shown that those who have high levels of resilience are less likely to develop stress disorders and more likely to remain in the profession as healthy nurses (Turner, 2014).
Some characteristics of resilient people are:
- A playful sense of humor
- The ability to adapt to new circumstances quickly and thrive during change
- An ability to manage emotions in a healthy way
- An avoidance of victim mentality and staying detached from victim reactions in others
- Good friendships and loving relationships
- An ability to honestly express feelings
- Optimism, or an outlook of expecting things to work out well
- A talent for converting misfortune into good fortune (Siebert, 2005).
5. Patient Safety Advocate
A climate of safety is a type of organizational culture and is the result of effective interactions of structures and processes, and the attitude, perception, and behavior of staff related to safety. A greater number of errors are found in organizations and units with a poor safety culture. In fact, some researchers found that the safety climate predicted the occurrence of medication errors, that the level of safety was associated with the unit-specific and hospital-wide climates, and that a positive safety climate in a unit could compensate for the detrimental effects of a low-hospital-wide climate (Hughes, 2008).
Preventing patient harm due to medical errors requires effective systems to be in place and all members of the healthcare delivery team to be patient safety-minded. “A professional who provides direct care needs to have a kind of wariness or patient safety vigilance. This quality is most often informed by a rich knowledge about adverse events and how to help avert them or minimize their damage. This kind of practical wisdom or ‘safety savvy’ grows continuously from the experience and an ability to recognize when something is not right. Often an adverse event that is about to unfold can be averted or its impact minimized if it is caught in action… They understand that health care systems are full of ‘error traps,’ and that they are vigilant in foreseeing and preempting, mitigating, and rescuing patients from them” (Henriksen, et al., 2008).
In addition to identifying these five characteristics essential for success, managers also need to take into consideration, the organization’s goals, culture, and values. Clinical specialty and team dynamics specific to a unit or department for which a position is being filled, may guide decisions about the attributes that are most important for hiring.
For example, if an organization is working toward a patient satisfaction goal, clinicians with excellent patient communication skills may be a priority. If a position is being filled in an emergency department, a manager may seek out candidates who are decisive and calm under pressure. If a department is facing significant change, individuals who are adaptable and resilient may be good hires. It is important to establish a list of goals and priorities, and then identify the characteristics that are most important for success.
As members of the largest professional practice within the healthcare industry, nurses play a crucial role in helping organizations meet a growing list of new demands and pressures. Ensure that your organization is setting up nurses for success by hiring best-fit candidates for the right roles.