Recruiting And Retention: Bridging the Gap, Part 2

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.

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

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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 retain tenured nurses, and how CNOs can help transition the knowledge of tenured nurses to new graduate nurses.

Connecting the Generations

There are major differences in expectations between Traditionalists, baby boomers, Gen X, millennials, and Gen Z in the workforce. Life circumstances and work-life balance needs are different, some nurses might have children or elderly adults they need to care for, while others are younger and able to work at varying times during the week.

Due to the stressful nature of nursing and current workforce challenges, there are tenured nurses who are leaving the profession entirely and taking their knowledge with them.

CNOs need to strategize ways to keep the knowledge within industry, so that new graduate nurses can learn from them.

“Our environments are really physically and mentally demanding,” Vozzella said, “so what options can we give to somebody who’s at the end of their career?”


One strategy that CNOs should use is to sit down with tenured nurses before they decide to leave the workforce and ask them where they want their career to be in the next three to five years, Vozzella explained. Providing individualized flexibility is key and will keep tenured nurses working at the bedside longer.

“If a more tenured nurse wants to be off all summer, it would be better for us if we allowed that,” Vozzella said, “in order to keep that person working in an intensive care unit or an operating room for five more years.”

CNOs also need to make sure that tenured nurses feel valued. Lewis recommended taking a look at what offerings are being given to incoming nurses, and how that can be balanced with offerings for tenured nurses.

“When you go online, sign on bonuses are exponentially large in some areas, the compression factor is real,” Lewis said. “[We need to ensure] our tenured nurses feel the same value because we don’t want them to feel left behind.”

Compensation is not the only factor, the position of a tenured nurse could become hybrid, where half of their work is at the bedside and half is in a faculty position, Lewis suggested.

“There’s benefit to saying it’s not just monetary compensation,” Lewis said, “but we’re willing to work with you to create some level of flexibility that meets you where you’re at.”

Virtual Nursing

One of the best options for keeping tenured nurses in the workforce longer is virtual nursing, according to Vozzella. Virtual nursing would retain the knowledge of tenured nurses and provide new nurses with support so that they feel less isolated.

“[The tenured nurses wouldn’t be] walking as much, but they could continue to speak to patients or…mentor new nurses that are starting out [while] not having to do such a structured 12-hour shift,” Vozzella said. “They could do it for four hours, [or] they could do it from home.”

Lewis agreed, adding that generally having more creative positions in nursing is how to keep tenured nurses from leaving the workforce. Virtual nursing creates opportunities for nurses to do virtual admissions and remote patient monitoring, which would keep tenured nurses from exclusively having to work at the bedside.

Mentorship Opportunities

Another way to keep knowledge within the industry is to provide tenured nurses with opportunities to mentor incoming nurses. According to Lewis, one way to do this is to keep an expert or a tenured nurse on call, so that newer nurses can reach out if they need help with something.

“We’re starting to see [this] as a strategy [for] when we can’t get [tenured nurses] at the bedside,” Lewis said, “[and] how [we can] take that knowledge and really use it to help that novice nurse become safer in their practice and feel more confident.”

Lewis also recommended a nurse emeritus program, where seasoned nurses who are close to retirement can mentor newer nurses or even nurse leaders. Volunteer programs or nurse faculty positions are also helpful options since many nurses who leave want to stay connected to their patients.

“Our nurses really do feel connection and callings to do the things that we do every day,” Lewis said, “and so the more we can meet them where they’re at to share that collective knowledge, they’re willing to do it.”

This is part two of a two-part piece, click here for part one.

G Hatfield is the nursing editor for HealthLeaders.

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