The Care of New
Nurses at Carroll County General Hospital: “Mother them; baby them;
nurture them . . . ”
How serious is Leslie Simmons about retaining new nurses at
Carroll County General Hospital? Very serious, judging by the vice president
for patient care’s instructions to the hospital’s mentors for new
hires: “Mother them; baby them; love them; make them feel nurtured and
looked after; and answer every question right away.”
There is a serious point behind the effusive language, says
Simmons. “New graduates haven’t worked anywhere else; they don’t
know any other environment. When an issue comes up and it is not dealt with
promptly, they may jump from hospital to hospital, looking for something they
may not find.”
Simmons’ approach to her own work reflects this belief
in the importance of open communications; she is constantly out on the nursing
units, staying in touch with current concerns. “Personnel at the
management level can sometimes get too disconnected,” she says. “Then
they aren’t able to fully represent the needs of their staff. My motto is,
‘Never forget from whence you came.’”
Simmons drew on her knowledge of current nursing concerns,
as well as her 15 years as a critical care nurse to defend her budget request
for a better-than-average ratio for hours of care at the bedside. Nurses at
Carroll County now have an average of five medical-surgical patients, compared
to six or seven statewide. According to Simmons, it’s a factor that has
drawn even experienced nurses working at higher pay—but also with higher
nurse-patient ratios—to Carroll County.
Mentoring is a full-time job
Simmons notes, however, that although the hospital has made
changes beyond mentoring to improve the work environment for nurses, “I
really think that the mentors have made the most difference.” Launched in
November 2001, experienced clinicians in all service lines were handpicked for
the positions, which serve as a primary contact point for a new hires’
first year. The mentor’s full-time job is to provide daily support through
coaching and answering questions.
In carrying out this and other nurse-retention changes,
Simmons has had the support of her executive management team and additional
financial resources provided by an $86,000 state Nursing Support Program grant
from the Health Services Cost Review Commission (HSCRC). The grant does not,
however, cover the costs of mentoring. “That is where other nurse
executives who want to make similar changes may have difficulty,” she
notes. “They may not be able to get permission for the up-front costs,
even if it would save their hospital money later.”
As an example she notes that recent orientation costs at
Carroll County General Hospital ran somewhat over budget, and that was hard on
her organization. “I feel, however, that orientation should not be rushed;
that it should be self-paced—some of our new hires took nearly seven
months before they were totally off orientation and into specialty areas.”
TLC yields tangible results
In the long run, says Simmons, a quality orientation also
saves the hospital money. “Providing a better ‘fit’ for the
nurse and the organization reduces turnover,” she notes. “And
turnover is more expensive than commonly recognized: replacing a
medical/surgical nurse typically runs $50,000 in hard costs.”
Simmons has solid evidence of a positive cost-benefit ratio
for her hospital’s careful nurturing of new hires: a nursing vacancy rate
that has fallen from 17 percent to just under 5 percent over the past year, and
a resulting significant drop in agency FTEs.
Contact:
Leslie Simmons, RN
Vice President, Patient Care Services
Carroll County General Hospital
200 Memorial Avenue
Westminster, MD
21157
410-871-6916
lsimmons@ccgh.com
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