Recruiting and Retention: Bridging the Gap, Part One

The biggest challenge facing CNOs these days is the workforce shortage. Not only are there not enough nurses entering the industry, but there are also many tenured nurses who are leaving the profession or retiring, and taking their knowledge with them.

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Nursing leaders must implement creative solutions to recruit and retain nurses of all generations who will continue providing the best standard of care to patients.

During the recent HealthLeaders’ Nurse Labor and Compensation NOW Summit, Cassie Lewis, Chief Nursing Officer at Bon Secours Mercy Health, and Gail Vozzella, Senior Vice President and Chief Nurse Executive at Houston Methodist, spoke about strategies to improve nurse recruitment and retention, and how CNOs can help create and strengthen the next generation of nurses. 


Recruiting and retention challenges have always existed, but were greatly exacerbated by the COVID-19 pandemic. The nursing shortage became more evident as large numbers of nurses left the industry or went to agencies, and academic pipelines were disrupted, Vozzella said.

“Rebuilding our workforces certainly led to looking closely at recruitment strategies … nationally across hospitals,” Vozzella said, “and I think it gave us the opportunity to look and see where we had clunkiness in the recruitment process.”

Lewis agreed, emphasizing how the pandemic affected the different generations of nurses in the workforce.

“We obviously are needing to recruit different skill mixes of nurses because we have the need for expert nurses or nurses with experience,” Lewis said. “But also we are seeing a lot of new graduate nurses coming into the profession.”

This, however, creates a lack of experienced nurses at the bedside.

“Trying to ensure that we are adequately training our newer graduate nurses and giving them that experience that they’re looking for…is very challenging,” Lewis said.

Additionally, nurses now hold more power over where and when they work, since there is a higher demand for them.

“The ball is in their court,” Lewis said. “They have many competing offers, [and] they have many health systems where they can go.”

“I think as chief nurses what we have to balance [alongside directors and managers] as they hire and onboard is doing it with speed,” Vozzella said, “because certainly people are getting multiple offers.”

Another challenge facing CNOs during the recruitment process is that there are five generations in the workforce, according to Vozzella. A graduating class of nurses can now include people from several age brackets, and people who are second-career nurses, and their needs are all going to be different.

“Communication is key when you’re communicating with [different] generations of nurses,” Vozzella said. “We have to be more intentional as nursing leaders and as we implement new strategies to hopefully unburden the bedside nurse of tasks that they don’t need to be doing.”

The perception of nursing on social media also plays a big role in the modern recruitment process.

“I think one of the things that has been very eye-opening is with the presence of social media,” Lewis said. “[Nurses] do talk and there are platforms now for them to talk about organizations.”

“I think we have to make sure that we have the right environment [so] that our culture speaks for who we are,” Vozzella said. “[And we must be] attentive to what is being said on social media.”

Strategies for CNOs

The solution to these challenges involves creating an environment where nurses want to work and where they feel valued and supported, both personally and professionally. This includes providing individualized experiences and the flexibility to have a work-life balance.

“One of the things that we’re seeing with these different generations of nurses is work-life balance means something different to every generation,” Lewis said.

“Even benefits packages for employees, one size no longer fits all,” Vozzella said. “At different phases of life, you need different things.”

“What could be the game changer between one organization and another is that individualized experience,” Lewis continued, “where someone really cares about you as a person and has the ability to have some level of flexibility.”

Both Vozzella and Lewis emphasized the need to strengthen academic partnerships to create strong pipelines into the industry, and the necessity of creating robust transition to practice programs.

“Having a nurse residency program has been … beneficial, because people coming out of school are [just] getting the basics in training,” Lewis said. “When [graduate nurses] are actually starting to take care of patients, they’re mind-blown at some of the things they’re encountering.”

CNOs need to make sure their nurses can come into the industry to practice nursing, rather than getting caught up in administrative tasks. According to Vozzella, this will also help with retention.

“Being called to be a nurse is very special,” Vozzella said. “We have to create an environment [where nurses] can use their calling and can help people. So that’s not typing in a medical record for 60% of your shift, that’s not hunting and gathering for supplies, or trying to find other things.”

Nursing leaders also need to be supported so that they have time to interview, recruit, and select candidates while fulfilling the rest of their responsibilities.

“[CNOs must] make sure that our recruitment teams have those strong partnerships with frontline leaders to make those selections,” Vozzella said, “and [that] we use as much technology as we can to make that a streamlined process, not just for the candidate, but also for the leader whose time is precious.”

G Hatfield is the nursing editor for HealthLeaders.

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