There’s no quick fix or simple long-term solution, but many senior living executives have successfully slowed turnover and maintained full-strength nursing staffs by using similar strategies.
Focus on Empowerment
As the clinical and often primary providers of care for residents, nurses are critical to the success of an assisted living operation, says Budgie Amparo, senior vice president, quality and risk management for Seattle-based Emeritus Senior Living.
“Skilled nurses are essential to increased levels of care and quality,” says Amparo, who also is an RN and a certified legal nurse consultant. “Your company can have millions of dollars in revenue, but all it takes is one bad lawsuit and all that fades away— and your image goes with it.”
Several years ago, when Amparo joined Summerville Senior Living (which has since been acquired by Emeritus), a nurse would leave the company about every six months. At that time, the company implemented programs that empowered nurses. Today, attrition is waning at Emeritus communities.
“Empowering nurses means acknowledging their skills,” says Amparo. It may seem like a subtle thing, but by recognizing nurses as the highly skilled people that they are, assisted living executives can greatly improve the work environment—which goes a long way to improve retention rates. Amparo says nurses feel valued and empowered by participating in the process for hiring new nurses, even at other communities. He says managers also keeps close tabs on exemplary nurses so that they can swiftly be promoted to management positions.
The empowerment strategy has also been effective for Silverado Senior Living, based in San Juan Capistrano, California. Because it specializes in dementia care, Silverado’s operational model requires licensed nursing services at its sites 24 hours a day.
“Because we’ve built it into our model, we’re pretty sophisticated in our recruiting and retention efforts,” says Anne Ellett, Silverado’s vice president of health services. “We empower our nurses to be managers. They are so significant in the lives of residents and the lives of their families.”
Ellett points out that often nurses are the first person family members will go to when they have concerns about a loved one at a community, so it is important for nurses to feel supported in their work and confident in their abilities to be a representative of the company. The director of nursing at each residence holds monthly meetings where nurses discuss anything that will help them continue raising the quality of care at the residence and improve their own working conditions.
Show Recognition
Of course money is important, Amparo says, but it’s certainly not everything. Senior living executives and middle management must show sensitivity for nurses’ needs and show appreciation for exemplary work.
“When people leave a job it’s not just because of money, it’s how they’re being treated,” he says. “You might not even be saying it directly, but it shows in everything you do for them.” ALFA also provides a way for senior living companies to recognize exemplary nurses through its annual national awards program. In 2009, Curtis Bond, LPN, of Southerland Place Midlothian (a Brookdale Senior Living community) received the ALFA Hero Award in the nurses category.
During National Nurses Week, each Silverado community recognizes its nurses with catered lunch events and even spa days. They’ve also received recognition pins and thermal lunch boxes, in addition to flowers and other gifts. Organized by the American Nurses Association, Nurses Week each year begins on National Nurses Day, May 6, and ends on May 12, the birthday of Florence Nightingale, widely known as the founder of modern nursing. Ellett says Silverado communities also invite residents and family members to special events during Nurses Week. Getting a personal and heart-felt thank you from the residents and their family members is among the best rewards a nurse can receive, she says.
Offer Perks
Competitive pay and benefits still play a major role in recruiting and maintaining a skilled nursing staff. Silverado conducts salary surveys each year to ensure the company is paying competitively. The operational goal is to be in the upper 25 percent in terms of pay across the industry.
Flexible work schedules, professional development opportunities, and an overall sense of corporate wellness also top the job satisfaction list for nurses. And while many senior living companies are moving in the right direction in terms of hiring and retention, many still face a challenge of numbers. According to the U.S. Bureau of Labor Statistics, the demand for skilled nurses will continue to grow at a rapid rate.
“Nurses have a lot of choices out there,” Ellett says. “Put yourself out there as a good place to work and really transmit a passion for caring for residents and making a difference—because that is why people go into nursing.”
This article was adapted from an Executive Insights issue originally published in May 2005. The Wall Street Journal.
