Q: As DON, I spend much of my day fixing staffing issues or working the floor myself. How can I improve my current situation?  

A: Spending significant time on one issue can be overwhelming. You mentioned two: staffing and the need to work the floor to cover shifts. Addressing the former will alleviate the latter. 

First, tackle retention issues. Identify core problems making staff unhappy and develop a plan to fix them. For example, if nurse aides leave because they don’t like their schedule, provide self-scheduling options. If staff say they lack training or orientation, revamp orientation. When issues linger, turnover continues. Even if you find and hire new employees, they won’t stay if problems persist. 

Next, convene all nurse managers and the administrator to discuss how facility leadership will recruit staff. Consider innovative strategies. Rethink past approaches and explore new ideas. One idea could be shorter shifts to accommodate staff with school-age children who need to be home before and after school. This also can be attractive to nursing students doing clinical immersion rounds, as it allows them to pick up shorter shifts to work around school. While eight- or 12-hour shifts theoretically allows for continuity of care, if there is no staff available for them, nurse managers must fill gaps. 

Additionally, ask staff for their ideas. In one situation, staff reported friends couldn’t work at a particular facility because there was no public transportation. To address that barrier, leaders implemented rideshare opportunities. 

By stemming the tide of attrition, you can bolster your current team and position your facility for success with coming recruitment efforts — which lets you return to other leadership functions.