The current nursing shortage has forced a growing number of healthcare leadership teams to take a long, hard look at their existing policies and procedures. Though each institution is unique in its own way, many similar areas of dissatisfaction exist and have been reported via national surveys and informal group discussions with nurses. Today, more than ever before, nursing leadership is challenged to be creative in order to increase satisfaction for staff RNs and to make nursing an attractive career for prospective students.

Several initiatives can be adopted to increase interest and applications from new graduates and experienced clinicians.

Adopt the characteristics of a Magnet Hospital. Magnet Designated Hospitals outperform their competitors in recruiting quality nursing staff. The Magnet Designation ensures high caliber professionals and the highest quality of patient care.

Develop partnerships with local schools. Educate students about the role of the RN through volunteer programs. Work with guidance counselors to set up seminars for those who are interested in healthcare within acute and non-acute settings. Become involved with hospital representatives who offer facility tours and internships, or attend career days at different schools. By advertising the benefits and rewards of nursing, with an emphasis toward younger audiences, managers can help lay the groundwork for future graduates and promote positive perceptions of our noble profession.

Recruit potential employees during clinical placements. Maintaining good relationships with local nursing schools is a key recruitment strategy. To ensure a positive clinical experience at their facilities, executives can invite students for tours and begin the networking process. Ongoing relationships with clinical instructors and students can be invaluable to future recruitment.

Work with Human Resources to ensure a fast track hiring process. Initiate the hiring process by telephone interviewing. Allow for walk-in interviews and complete pre-employment physicals in a timely fashion. Attending local job fairs and following up with potential employees is essential in these efforts.

Develop a new pool of nurses by recruiting from other professions. Many women and men are choosing nursing as a second career. Work with local businesses to support nursing scholarship programs and persons who may be looking for alternatives after such lifestyle changes as early retirement, divorce, or an empty nest. Consider younger individuals whose positions might have been restructured or downsized due to changes in the market and fluctuating economic conditions.

To ensure new nurses are satisfied with their jobs and remain loyal to the institution, executives must create a nurturing practice environment--from the top down.

Develop and maintain orientation programs. Devising appropriate orientation programs is a key retention strategy. Trained preceptors should provide the support necessary for the success of each new nurse. Weekly meetings--held with the nurse manager, education specialist, preceptor, and orientee--provide a forum for ongoing communication and a method for evaluating competency. They also reinforce nursing leadership's interest in orientees' progress.

Programs should be flexible and interactive. If possible, tailor orientation classes based on professionals' levels of experience. Providing observational opportunities for new nursing staff within other areas of the hospital is a great way to introduce them to core personnel. Observing surgery in the OR or a procedure in the cardiac cath lab exposes orientees to different settings and gives them the opportunity to view patients away from the bedside.

Develop recognition programs. Recognizing permanent and temporary staff for superior care creates a service excellence environment. Employee of the month programs and annual recognition awards also generate much excitement and are well received by all employees.

Offer opportunities for advancement within the facility. Clinical ladder programs and tuition reimbursement motivate nursing staff to work toward an advanced degree or to pursue a new position. This type of empowerment translates into good relationships between staff and administration.

Provide leadership training for nursing management. Ensuring that all managers have the tools to support the needs of staff is important to maintaining satisfaction on a particular unit. Many RNs cite a good relationship with their nurse managers as the reason for staying with a facility even though they are not satisfied with the institution in general. The role of the nurse manager may be the most vital to assuring a low turnover rate on a given unit.

Certainly, nursing administrators are challenged to provide the highest quality care at a time when cutbacks are plentiful and staffing issues are constant. In today's stressful settings, however, it is up to nursing leadership to facilitate supportive environments that encourage professional growth and, in turn, a sense of loyalty to their organizations. Only then can managers make a positive difference in the lives of new and seasoned nurses-- and, ultimately, their patients.