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Stop the brain drain

Laskowski-Jones, Linda MS, APRN, ACNS-BC, CEN, NEA-BC, FAWM, FAAN

doi: 10.1097/01.NURSE.0000559924.84567.9d
Department: GUEST EDITORIAL
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EDITOR-IN-CHIEF, NURSING2019

This month I'm delighted to have my nurse colleague, India Owens, MSN, RN, CEN, NE-BC, FAEN, contribute a guest editorial on a very important issue in nursing.

LINDA LASKOWSKI-JONES, MS, APRN, ACNS-BC, CEN, NEA-BC, FAWM, FAAN

EDITOR-IN-CHIEF, NURSING2019

“Brain drain” refers to the migration of intelligent, skilled, and capable experts leaving in search of better work circumstances. In recent years, I have observed such a brain drain in nursing. Not always by choice, but often by force.

A tenured nurse's practice comes under scrutiny, leading to forced retirement or resignation. Causes include the effects of physically and mentally demanding 12-hour shifts, adoption of electronic health records, and the higher wages of experienced nurses. New nurses may pursue alternative roles to escape the rigors of bedside nursing and a perceived toxic culture. Seasoned nurse leaders with valuable knowledge are dismissed by incoming executive leaders.

Although tenure in an organization can breed complacency, tenured leaders have valuable knowledge about departmental culture and the relationships necessary to effect change. Rather than being quick to dismiss, incoming executive leaders should initiate performance improvement plans with clear goals and invest in coaching existing leaders to meet them.

Besides reducing productivity, turnover creates disruption, which is a death knell for engagement. Cameron and colleagues found engagement predicted well-being above and beyond anything else.1 The source of well-being was unequivocally a positive work culture.

New leaders enjoy a period during which most ideas are accepted readily. What if the same courtesy were extended to established leaders? What if senior frontline nurses were offered transition paths to less physically taxing nursing schedules or roles? What if we harvested the ideas of new clinical nurses to improve the practice environment? Would the outcomes be better than those achieved by disruptive forced turnover?

Tenets from the research of Cameron and colleagues can be instrumental in bringing about positive organizational change:

  • caring for, and being responsible for, coworkers as friends
  • supporting one another and offering compassion for those who are struggling
  • avoiding blame and forgiving mistakes
  • inspiring one another
  • emphasizing meaningfulness of work
  • treating colleagues with respect, gratitude, trust, and integrity.

As we face a nursing shortage, we must create a positive work space to promote retention, from the front line to the C-Suite. Nursing experience, including institutional knowledge and organizational relationships, should be considered valuable and worthy of retaining. For the sake of our patients and the future of nursing, let's stop the practice of inciting chaos and focus on growing and improving current workforce assets.

INDIA OWENS, MSN, RN, CEN, NE-BC, FAEN

NURSE CONSULTANT, FAIRLAND, IN

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REFERENCE

1. Cameron K, Mora C, Leutscher T, Calarco M. Effects of positive practices on organizational effectiveness. J Appl Behav Sci. 2011;47(3):266–308.
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