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National Association for Health Care Recruitment Annual Conference (NAHCR) and VA Nurse Recruiters Association Annual Conference (VANRA) : 1 National Association for Health Care Recruitment Annual Conference (NAHCR) and VA Nurse Recruiters Association Annual Conference (VANRA) Synopsis by Gerrylynn Foster RN,BSN July 14-20, 2003

Purpose : 2 Purpose The NAHCR conference is designed to provide health care recruiters, human resources professionals, and other interested individuals with an awareness of recruitment and human resources concepts, health care trends, legal issues, and technology currently impacting health care recruitment and human resources. The VANRA is a professional organization within the Department of Veterans Affairs, designed to promote the principles of professional nurse recruitment within the VA system and in collaboration with the community at large. Information sharing and networking is a primary component of this organization.

The Facts About Recruitment –What it is… : 3 The Facts About Recruitment –What it is… A search for the best qualified candidates, using a swift, thorough, outcome-oriented approach A judicious use of all available resources A matter of “perfect” timing

The Facts About Recruitment – What it is NOT… : 4 The Facts About Recruitment – What it is NOT… Glamour Shots, Hard Sales, “Promise Them Anything” (Totally about) what the organization needs, but rather what the organization can offer to the candidate

The Facts About Recruitment – What to Consider… : 5 The Facts About Recruitment – What to Consider… Developing a plan to “capture” that best candidate Budgeting, marketing and advertising that plan: Applicant sourcing options Screening and interviewing process to assess competency Decision making Tools to assist in data tracking and trending to evaluate that plan

Recruitment Problem Areas : 6 Recruitment Problem Areas Professional - Information Systems - Clinical Educators - Pharmacists - Senior Managers Technical - Radiology Techs - Nuclear Medicine Techs - Sleep Lab Techs Nursing - Critical Care, ER, OR - LTC - Home Health - LPN’s Entry Level - Nursing Assistants

Labor Force Projections for 2010 : 7 Labor Force Projections for 2010 The top five HC Occupations with the largest job growth projected (Source BLS) RN 451,000 (Increase by 21.7%) Nsg. Asst. 326,000 (Increase by 23.8%) Med. Asst 146,000 (Increase by 57.8%) LP/VN’s 136,000 (Increase by 19.7%) Info/Med Record Tech 41,000 (Increase by 19.7%) (Source – Bureau of Labor Statistics, 2002)

New Realities of the RN Shortage -Why Healthcare Professionals are Leaving : 8 New Realities of the RN Shortage -Why Healthcare Professionals are Leaving Aging RN Workforce (Avg. age 47.5 in 2001) College/University enrollment declining Working conditions Decline in relative earnings Negative press combined with alternative career choices Increased stress Lack of appreciation Acuity Less education funding

Why Healthcare Professionals are Leaving Con’t. : 9 Why Healthcare Professionals are Leaving Con’t. Gen X-er Values: Time over money Active personal role Greater autonomy/bureaucracy Desire for collaborative leadership

Facts in Nursing Today : 10 Facts in Nursing Today The future 1,754,00 Nurses will be needed in the U.S. by 2020, but only 635,000 will be available, based on current trends. (Source: U.S. Department of Health and Human Services. This equals a 1.1 million shortage.) In the next 15 years, nearly half the Registered Nurses in the country will be of retirement age. For every one nurse entering the profession, four are leaving. Lack of nurses contributed to nearly a quarter of the unanticipated problems that result in death or injury to hospital patients. (Source: Dr. Dennis O’Leary, President JCAHO)

Retention Is: : 11 Retention Is: A strong, collaborative culture Positive attitudes at all levels Enhancing loyalty to the organization Continuous communication including: Active listening Feedback Individual development Key initiative/strategy in a successful organization

Retention Is Not: : 12 Retention Is Not: Only the responsibility of one level of management Only the responsibility of HR Only based on monetary bonuses A short-term problem

Retention Facts : 13 Retention Facts One of the most important concerns of healthcare executives today because organizations are being threatened by the unavailability of experienced staff coupled with the severity of labor shortages Currently there is more burden on staff with leveling LOS & increasing patient demands resulting in decreasing morale & increasing turnover Declining job satisfaction

Retention Facts Con’t. : 14 Retention Facts Con’t. In relation to recruitment, keeping great employees requires a match between the employee, job & organizational culture Employees no longer have loyalty to organizations d/t past downsizing, more PT and more temporary employees and the needs/wants of different age groups Heavier reliance on new grads putting pressure on experienced staff increasing turnover Today’s employees are motivated by “self-interest,” not limited to pay

Retention Facts Con’t. : 15 Retention Facts Con’t. More companies are adding to, not cutting back, strategies to retain valuable employees & to recruit the best in the market Emphasis on training & “growing their own” which will benefit the bottom line long term

Cost of Declining Retention : 16 Cost of Declining Retention Out of pocket or visible expense represents only 21% of the total turnover cost Cost of lost productivity during the entire turnover cycle (i.e. before, during & after a position has been filled is 79%) (Source Nurse Executive Center’s Advisory Board 2001)

Costs : 17 Costs Visible Costs Separation Vacancy Recruiting Hiring Orientation Invisible Costs Loss of productivity after termination Loss of productivity of other employees Loss of productivity during vacancy Orientation learning curve of new hire Loss of productivity of other employees during orientation

Worker Attitude / Values Research Profile : 18 2% Worker Attitude / Values Research Profile This diagram visually depicts overall worker attitude/values towards their employment/career. 3% “Grinners” attitude impacted by: Peers Supervisors Education Communication Involvement Culture

There is a Link Between Employee & Customer Satisfaction : 19 There is a Link Between Employee & Customer Satisfaction Source: Press Ganey

Employee Recognition : 20 Employee Recognition “What gets recognized and rewarded gets repeated.” -Michael La Boeuf

Principles of Recognition : 21 Principles of Recognition Emphasize success rather than failure Deliver recognition in public Recognition should be personal and honest Tailor to the unique needs of your employees Timing is crucial Connect accomplishments & rewards

“Worst Excuses for Not Giving Recognition” : 22 “Worst Excuses for Not Giving Recognition” “I don’t have time.” “I don’t believe in rewarding people for just doing their jobs.” People will think they’ve “made it” and will stop working hard, or putting in the extra effort

Recruitment and Retention Strategies Being Offered Throughout the Country : 23 Recruitment and Retention Strategies Being Offered Throughout the Country Mortgage payments for night shift to new graduates for 6 months, up $1000 and night differential Full time status for 24-32 hours a week, beginning with orientation Work 9 months get paid for 12 months Retention bonus- $40,000 over 5 years, $8,000 a year New graduates work a M-F schedule, weekend staff work at increase cost (up to $31 hr. if they have been there 10 yrs.)

Recruitment and Retention Strategies Con’t. : 24 Recruitment and Retention Strategies Con’t. Paying shift differential during vacation Re-entry program, offering the older worker 16 weeks of classroom clinical with pay for a 1 year commitment Mommy hours (9a-3p or 10a-4p) or 4hour shifts

VA Nursing Recruitment and Retention Initiatives : 25 VA Nursing Recruitment and Retention Initiatives

VA Placement Service : 26 VA Placement Service Goal of increasing service response to the medical center and facilitating hires Actions: RN applications automatically sent to the Nurse Recruiters who indicated they wanted them Email notification of the facility identified coordinator of the receipt of an online application for their facility

RN Referrals 2003 – From Online Applications : 27 RN Referrals 2003 – From Online Applications Number of Medical Centers sent referrals: 30 Number of RNs referred: 75 Number of LPNs referred: 3 Number of Hires: 3

Health Professionals Educational Assistance Program : 28 Health Professionals Educational Assistance Program Authorized by Public Law 105-368, The Veterans Programs Enhancement Act of 1998 (Amended in 2001). Employee Incentive Scholarship Program (EISP) National Nursing Education Initiative Education Debt Reduction Program

Nurse Recruiters - Conference and Liaison Group : 29 Nurse Recruiters - Conference and Liaison Group Nurse Recruiter Conference Call - Quarterly; Implemented January 2003 1-800-767-1750 Code: 45483 Purpose To serve as a forum for exchange of ideas, to provide evaluation and critique of current initiatives affecting recruitment and retention and to offer peer support and camaraderie

Nurse Recruiter Liaison GroupPurpose: To serve as a forum for information, feedback and development of recruitment/retention strategies. The members will serve as a conduit with the noted VISN and present recommendations that reflect the wishes and opinions of the nurse recruiters.Members : 30 Nurse Recruiter Liaison GroupPurpose: To serve as a forum for information, feedback and development of recruitment/retention strategies. The members will serve as a conduit with the noted VISN and present recommendations that reflect the wishes and opinions of the nurse recruiters.Members VISN 1,2,3 - Regina Bauzys VISN 4,5,6 Charlotte Foster VISN 7,8,9 Tom Badger VISN 10,11,12 Lynette Taylor VISN 23,15,16 Deana Gallegos VISN 17 Kris Davies VISN 18,19 Gail Smith VISN 20,21,22 Jane Edens

Nursing Recruitment and Retention Initiative FY 2004 Medical Care Specific Purpose Budget Request -HCSDRO : 31 Nursing Recruitment and Retention Initiative FY 2004 Medical Care Specific Purpose Budget Request -HCSDRO Priority 1 - National Nursing Education Initiative (NNEI) and Education Debt Reduction (EDRP) for RNs. Provides funding for VA nurses to obtain bachelor degrees in nursing and advanced degrees. Provides funding for education debt reduction for newly employed registered nurses. $10 million, recurring $10 million, non-recurring

Slide 32 : 32 Priority 2 - Nursing Recruitment Advertising Initiative Provides funding for a coordinated approach to local, regional, and national recruitment. It establishes a clear VA Nursing organizational message based on assessment of today’s nursing and potential nursing community. Print materials, public service announcements and web based recruitment and application processes would reflect a consistent and comprehensive strategic approach. The proposed plan is designed in two phases over a two-year time frame. $2.245 million, recurring

Slide 33 : 33 Priority 3 - VA Nursing Education for Employees Program (VANEEP) – New Initiative Provides salary replacement dollars, FTE and funds to cover the cost of tuition, books and certain fees to allow employees enrolled in Licensed Practical (or Vocational) Nurse (LPN/LVN), Associate Degree in Nursing and Bachelor’s Degree in Nursing programs to pursue their studies on a full-time basis. $16.9 million, recurring 275 FTEE

Slide 34 : 34 Priority 4 - Student Educational Employment Program (SEEP) VA Cadet Nurse (VACAN) – New Initiative The VA Cadet Nurse (VACAN) Program is a proposed outreach program targeted at providing mentored work experience in the nursing environment for the high school and beginning college student. The ultimate goal is to increase the number of young people choosing a nursing career thus building the cohort of nurses available in 2010 and beyond. This initiative would provide a tiered program of volunteer work experience for 14-16 year olds and paid work experience beginning at age 16 and continuing through the college years. The SEEP Component of the VACAN Program funding request would have significant impact on attracting students from the middle to lower economic strata as it provides compensated work experience. expansion of staff to support the new programs is number 5. $2.29 million, recurring $0.4 million, non-recurring

Slide 35 : 35 Priority 5- HCSDRO - Additional Staff and resources to manage new and expanded programs. $171,451.00 recurring $14,780.00 non-recurring 3.0 FTEE (additional to existing FTEE) Priority 6 - VA Nursing Education Faculty (VANEF) – New Initiative Implements a nursing education faculty sharing program through partnerships with schools of nursing. The program would establish specific positions for nursing faculty for those schools who have students completing clinical experiences at VA Medical Centers.. It would combine VA employment with nursing education academic program faculty assignments. -$2.17 million, recurring 30 FTEE

Slide 36 : 36 Priority 7 - VA Learning Opportunity Residency This requests adds 110 additional student slots to VA Learning Opportunities Residency Scholarship (VALOR) Program. Initiated in the summer of 1990, this program provides opportunities for outstanding students (junior level in BSN programs) to develop competencies in clinical nursing while at an approved VA health care facility. Opportunities for learning include didactic or classroom experiences, competency-based clinical practice with a qualified RN (Registered Nurse) preceptor, and participation in nursing-focused clinical conferences. $0.68 million, recurring (additional to existing 1.7 for total of 2.4)

Nursing Recruitment and Retention Initiative : 37 Nursing Recruitment and Retention Initiative TOTAL REQUEST: Recurring funds = $49,975,000 Total Additional FY04 FTEE = 439 Non-recurring funds = $10,415,000 Total FY04 funds = $60,390,000. 22 FTEE (additional to existing 58 FTEE for a total of 80 FTEE

FY03 – Budget Request : 38 FY03 – Budget Request Nurse Recruiters Participation Obtained $100,000 to begin exploratory work on new marketing plan

Recommendations : 39 Recommendations Hire for permanent tours of duty Match preceptors to new hires Employee retention allowance Paid 40 hour/week salary while in nursing school fulltime with a 3 year commitment post graduation Monthly staff recognition on all units Incremental surveys Flexible scheduling (self-scheduling with policy and guidelines) Preceptor program with incentives

Summary : 40 Summary Maintaining stability around core values, while developing a strategy based on a strong sense of community which includes a high level of trust & respect in association with employee development and recognition of their continuing needs, will give this organization the credibility to be known as an employer of choice.