Volume 13│Issue 1│Spring 2022
Conduct at the Core: Engaging Contract Nurses
Brooke Hickman, MBA, BSN, RN - CRMH 11 West Unit Director The evolution of healthcare will never cease. Many who came into the world of medicine have spoken to its everchanging platforms. Change can be seen as forward progress if those in leadership can adapt to the momentum. Since the start of the COVID pandemic, unit-level nursing leaders have seen fluctuations in staffing. Leaders may have thought their areas were immune to the “Great Resignation,” only to see it hit later. 11 West went from a functional vacancy of 31% in October 2020 to 56.19% in December 2021. There continues to be limited applicants to backfill needs. Nurse leaders must adapt to the current market. Leaders must explore strategies of how to best manage contract staff. Seasonally, we have found it harder to obtain contract staff, leaving our hospitals without resources to care for the community. Our overreaching goal needs to be the provision of necessary resources for the community the organization serves. The organization must switch from seeing contract staff as short-term support and resolve to retain them as long as possible. This may involve determining how to include contract staff and engage them on their assigned unit. Contract staff can be a valuable resource due to their experiences within various organizations.
On 11 West, unit-level leadership has identified several strategies to better engage contract staff that may be useful to leaders of other units. For instance, nurse leaders meet one-on-one with core staff to discuss growth, expectations on both sides, and to obtain suggestions toward forward progress. This can be expanded to include leadership one-on-one meetings with contract staff. Some questions for contract staff that could be included are: • • • • •
How long have you been traveling? Why do you travel? What do you look for when you are deciding on an assignment? What makes you re-sign on this or any assignment? What are things you have seen in the workflow or on the unit, in general, that could be improved based on your previous experiences?
During one-on-one sessions, contract staff on 11 West have been open and honest with their suggestions and feedback. Their feedback can help the personal growth of leaders and the critical thinking skills of core staff, in addition to improving unit functionality. Setting unit expectations should occur just as one would when onboarding permanent core staff. The culture of the unit is an essential driver of contract staff satisfaction. Including contract staff in one-onone sessions, unit activities, and recognition is paramount. They want to be on a unit that is welcoming and inclusive. They want a comparable acuity assignment with available resources. Unit culture can and will determine the length of time a contract nurse is retained. Of the eleven nurses that 11 West has contracted, 72% (8 out of 11) renewed their contract, some several times. Currently, seven of those eight remain working on the unit. Consistency of unit staff can ensure maintenance and improvement in quality scores. The first contract nurse was added to the unit approximately July of 2021. Since that time the unit has maintained zero CLASBIs and zero HAPIs. *Continuation of this article on page 3 Carilion Clinic Roanoke Campus
