Against the backdrop of nurse shortages, the key term “Recruitment and Retention” has been highly popular in congress meetings and heavily mentioned in reports which disclose the alarming decline of the nursing work force. However, it should be strongly enforced that Recruitment policy has no relevance without a Retention policy.
Immense global and European initiatives, with the efforts of highly motivated researchers, have ensured enough data collection to implement relevant and impactful long term policies. However, many important challenges remain.
In order to collect data for policy implementation, data collection systems need to be aligned, figures need to be shared, specific information needs to be provided and much more. Since all European nations have their own unique systems and scientifically cultural approach, this process becomes a highly complex one. For example, some nations operate from one national system and are therefore open and accessible, and on the other hand, there are nations with strong regional systems which make accessibility and communication much more difficult. These national and regional differences, added to the fact that changes in health systems are implicitly conservative and slow, makes it doubly difficult to adapt swiftly to urgent health threats, especially cross border health threats.
On the positive side, we currently see many young adults choosing to start a nursing career. All across social media platforms we are seeing images of enthusiastic young professionals at school, images with their diploma, bright and ready to step into the health environment. Nurses in advanced positions are applauding and encouraging these “new kids on the block”, but they also have their legitimate concerns. One must not forget that they are novices working their way towards professionalism. Novices in their first year who are training to work in a clinical setting, are often limited and inflexible and have a very limited ability to predict what might happen in any particular patient situation. They thus have a fragile contribution in an environment which demands high quality health care provision, especially where patients and citizens expect advanced, highly educated, competent professionals.
Too many of these young, graduated nurses drop out with a burnout, for which they could hardly have been prepared. These “burnouts’ are often cases where ‘successful’ nurses had done a great job in their novice stage, and progressed all the way to the professional stage, without having encountered the relevant problems and obstacles required to prepare them for the demands of the job in a clinical setting. This is further exacerbated by the advanced nurses who will often put “all hands on deck” in order to “protect” these novice nurses.
“Recruitment should be based on good Retention and not the other way around.”
These dynamics become highly problematic when the long-serving, expert nurses who have experienced the full spectrum of nursing with all its ups and downs, leave their jobs because the relevant institutions failed to invest in their well-being. These nurses with advanced experiences require recognition, continuing education, time to visit congresses and initiatives to explore the health horizons to widen their scope accordingly. In this way it facilitates a process whereby these long-serving nurses become valued specialists, mentors for the younger nurses and experts for the patients in their care.
Thus, in the case of Recruitment vs Retention, it is far better to invest in Retention first, keeping the best nurses on board and upgrading their skills, so they can become the best mentors for the next generation. “Recruitment should be based on good Retention and not the other way around. In other words, Retention first.”
December 2020, Ber Oomen