In the midst of a severe nursing shortage, one Veterans Affairs Medical Center has taken a series of steps in overhauling its interview process, and with it has cut nurse turnover rates by more than half.

The new system, which was first implemented more than a year ago at the VA Medical Center in Tomah, WI, is called the Nursing Stay Interview process. Nurses are interviewed by their nurse managers after being on the job for 30 days, and then again after 90 days. They’re asked questions such as “What, if anything, would you change about your job?” and “What things demoralize you and make you long for your days off?”

“The questions led to free-flowing conversations that helped staff discuss concerns and ideas with top leaders, and helped those leaders fix problems that kept these nurses at their jobs, serving Veterans,” says Natalie Hackbarth, MSN, RN, acting associate chief of staff-mental health and associate chief nurse-mental health at the Tomah VA Medical Center. The questions also have helped with nurse retention: In the first year of implementation, nurse turnover dropped by 52%. 

Hackbarth says they’ve now broadened the process to include LPNs and CNAs, as well as any staff who provide mental health services, such as social workers and psychologists. Similar processes have been implemented at VA centers in Oklahoma and Texas.