“This makes me feel so valued.” Scrolling through social media, my eyes were drawn into the post and the picture. What made the individual feel valued? Her employer sent pizza on her birthday while she was on vacation several states away. 

She made the comment that before becoming an employee with her current employer, she worked for a large health system that in the seven years she worked for them rarely or never acknowledged her birthday.

This nurse left the people she loved working with because she could not endure the environment she was working in any more. I interviewed her and asked what was the final moment that made you decide to leave? In reading her response, I felt my breath quicken and my heart elevate at her description of one shift, the one that was the pivotal shift.

“The specific shift that changed my course was a typical day shift during the peak of RSV. We had seen more pediatrics & neonates than I care to think about, afflicted with resp distress. We were flying babies out left & right, to different states because we as a hospital didn’t have a PICU or the support to take on the high O2 needs and intubated kids. My shift began with a 6-week old old preemie whose sister had already been flown out, intubated 2 days prior. She had RSV. High flow O2, resp rate almost 100, and difficulty maintaining spo2 above 90%. She needed transfer, and in my opinion needed to be intubated. The physician felt that she could be transferred on high flow O2 without being intubated. She was intubated immediately upon arrival at the receiving hospital.

“During this time, I was also assigned a stroke patient who was past the TPA window, but still needing Q15 NIH, CT scans, and eventually MRI. I had also been caring for a high-risk behavioral health patient, who I was needing to get RISK involved with as well as the patient liaison. My 4th patient rolled in, another stroke patient needing all the same as the other in a different room. There were 4 high-acuity patients in the ED at that time and I was given 3 of them. While I can say I think I’m happy they thought I could handle it, and I did, but at what cost? To their outcomes and to my mental health? I didn’t feel supported, and I don’t feel like if there had been a negative outcome, that I would be supported. I really began to feel like my nursing license was in jeopardy. I sat in the parking lot crying and then I made a decision.”

The nurse made the decision to leave and join a company that places nurses where they are needed. Traveler nurses is the label we give them. I cannot recount how many times a leader has said to me, we cannot compete with their salaries. 

In my interviewing of nurses who have left to become travelers, there is a theme:

1. Yes, there is an allure of the salary. #moneydoestalk

2. No, it is not just about the money, it was about the workplace environment and being valued, being acknowledged, and supported. Leaders who can listen and convey understanding of the environment, but then work to change it. #leadershipmatters

3. While salary is alluring, it is not the glue that binds them to the organization. It is how they are treated, celebrated and recognized. #HRdoesnotownretention

The nurse who received pizza was on vacation in another state on her birthday. It would have been easy for her employer to wait until she was home to send a birthday treat. But they didn’t.

In talking with a CEO of a large company that employs nurses as travelers, he shared that when they developed their business plan, they put retention as the number one key performance indicator for their company. Every leader has specific goals of retention and resources are allocated to their retention strategy.

Is retention of your employees aligned as not only a company goal, but also individual leadership goals? Do they have the tools they need to surprise and delight their employees? Yes, I said surprise and delight. Those were the words of the CEO: our number one goal is to surprise and delight our employees. One box of pizza delivered on a birthday, did just that, surprised and delighted.

It does not take an expensive people management system to surprise and delight. Early in my career, I had a manager who, when he hired me, asked what my favorite candy bar might be. My first day a welcome note was attached to the candy bar I had stated was my favorite. He then asked to meet with me. He asked how I was doing with my orientation and then he said, “I am a shy individual, but I believe in celebrating and recognizing individual and team contributions. When you see your favorite candy bar in your mailbox, or on your desk, it is my way of saying ‘I see your contributions, I value you as my team member and my deep appreciation for you!’” 

I remember those candy bars 30 years later and how they made me feel when I saw one on my desk.

What are you doing to retain your employees?

Are your actions predictable, automated?

Your competitors are working hard to surprise and delight those they have onboard already, and those who finally say it is time for a change. Do you want to be the loser in this competition for talent?

Martie L. Moore, MAOM, RN, CPHQ, is the President/CEO of M2WL Consulting. She has been an executive healthcare leader for more than 20 years. She has served on advisory boards for the National Pressure Injury Advisory Panel and the American Nurses Association, and she currently serves on the Dean’s Advisory Board at the University of Central Florida College of Nursing and Sigma, International Honor Society for Nursing. She was honored by Saint Martin’s University with an honorary doctorate degree for her service and accomplishments in advancing healthcare.

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.