Talent and Fit: How to Hire the Best Nursing Candidates In a Competitive Job Market

Talent and Fit: How to Hire the Best Nursing Candidates In a Competitive Job Market

Hiring nurses who best fit your organization is more important than ever. That’s because a nationwide nursing shortage and high turnover rates have combined to make it difficult for hospitals and health systems to maintain the staffing levels they need.

Consider this:

  • The five-year employee turnover rate at the average US hospital is 105%. The RN workforce fell by about 100,000 nurses during 2021.
  • More than 31% of RNs intend to leave their direct care positions within the next year, according to a recent survey by McKinsey.

About a third of the nurses who said they intend to leave their jobs said they would continue in a direct care role at another institution. But the rest said they intended to work in a role that did not involve patient care.

Better Hiring Practices Can Help

With such a demand for nurses, healthcare organizations should carefully review their hiring practices and look for opportunities to improve recruiting, said John Muir Health nursing leaders Michelle Lopes, senior vice president and system chief nursing officer, and Joni Palacios, talent acquisition manager. Lopes and Palacios shared their insights on nurse recruiting during a recent Tipton Health nursing leadership webinar hosted by Pam Power, Tipton Health’s associate chief nursing officer.

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Think Like a Candidate

One of the most important things recruiters can do is think like a job candidate, explained Power. “If we fail to get into that headset, we will miss a great opportunity,” she said, adding that organizational culture greatly impacts hiring and retention.

“They [candidates] might look at whether they can get the unit they want or the shift they want, but they are also looking at your organizational culture. They place that high on their list of considerations,” Power said.

Nursing students can be an important source of new hires, Power continued. “Remember that every student in your organization is a potential candidate. So, how you interact with students makes an impression on them. You want to make that great impression.”

Though new graduate positions make up a small percentage of hires at John Muir Health, Lopes said their residency program has been successful in attracting applicants. “About 3% of our total RN staff come through our RN resident residency program right now because our turnover is low,” Lopes said. “Being a community hospital, nurses who grew up here often want to work for John Muir Health.”

When nurses join John Muir Health, the onboarding process is an opportunity for the organization to quickly build relationships with new hires and introduce them to the organization’s culture.

“The onboarding experience in their first year of practice helps tie new hires to the organization in a personal way,” explains Lopes.

To help create a better onboarding process at John Muir Health, Palacios and her team used existing systems, such as Workday, to automate recruitment and onboarding as much as possible.

“We automated our entire onboarding process and became more accurate with less manual work,” Palacios said, adding that integrating recruiting and onboarding provided better reporting and integration and a better experience for candidates.

“We surveyed employees after their onboarding, and we got very positive results,” Palacios said.

Time Is of The Essence

Speeding up the interview process and reducing the amount of time it takes to extend a job offer can prove to be an advantage in attracting the best candidates for open positions, Power said.

“Think about eliminating as many steps as possible,” she said. “Can we be getting folks in front of managers more quickly? Can we expedite things like background checks and drug screens? Anything that puts multiple steps in one day makes the candidate experience so much better.”

John Muir Health made several changes to its hiring process to decrease the time it takes to interview candidates and make an offer. “We brought in screeners to look at all the incoming applicants within 24 to 72 hours,” Palacious said. The screeners can quickly schedule candidate interviews with the hiring manager and staff members.

While candidates are being interviewed, the screeners collect and verify required credentials and references. “This allows the recruiter to make an offer on the spot and eliminates the need for multiple interviews,” she said. “It has been super successful in keeping our time to fill positions low.”

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Other Key Elements

Other key elements for success that Power discussed, include:

  • Make your job offer more appealing by explicitly listing all aspects, including salary, benefits, time off and other perks. “Make your offer as appealing as possible compared to others in your region,” she said.
  • Including peers in the hiring process increases the likelihood of a good fit. “We think about making this process as quick as we can, but if there is any way to get peers into the process, they are a great voice," Power explained.
  • Make sure that the recruitment team has a good understanding of the role and what it requires. “It helps them [recruitment team] to do their job well, and it helps make sure that the right candidate is put in front of the right teams,” she explained.
  • Don't leave any nurse behind. “If a nurse is not the right fit for a specific team, perhaps there are other places you could employ their talents,” Power suggested.
  • Apply for a position at your own organization. “See what happens. How quickly do you get a phone call? How does that phone call go?” Power suggested. “It’s a good thing to consider if you want to gain understanding about your organization.”
  • John Muir Health also started looking at social media—specifically LinkedIn— to attract and identify potential candidates.

After noticing that a staffing agency they worked with was using LinkedIn, several managers at John Muir Health started posting open positions on LinkedIn saying “Hey, come join my team,” and listing the position they were looking to fill.

“We started using modalities that we had not used before,” Lopes said. “It was very personalized versus generic advertising.”

The system also revamped its website to put more emphasis on careers and hiring. “We updated the John Muir Health career site to attract new talent,” Palacios said. “That led to a significant increase in applicants.”

“We also launched a referral bonus program that increased our number of referrals and hires,” she continued.

“We did many things to make the candidate experience better,” Palacios said. “We made our processes more accurate to help save time with the lean staff we have.”

Lopes said one of the biggest factors in the system's success was the partnership between nursing and human resources.

“What I saw so clearly is how much they [HR] wanted to support us. They wanted to be part of the solution,” she said. “If we had tried to do that siloed, I think we'd be solving two different problems. The power of coming together with human resources was vital,” Lopes concluded.


John Muir Health includes two of the largest medical centers in Contra Costa County in the San Francisco Bay area. They are John Muir Health Walnut Creek Medical Center, a 554-bed medical center that is the county's only designated trauma center, and John Muir Health Concord Medical Center, a 244-bed medical center in Concord.


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