Nursing performance evaluations

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					Nursing performance evaluations

The subject of nurse retention and turnover came up during a recent conversation I was
having with the HR director of a regional hospital system here in Florida. We were
discussing the Florida Center for Nursing report that identified the median turnover rate
for RN's was 20% in 2007. The HR director responded that prior to the recession they
were running in the low to mid twenties, but it had dropped to just below twenty percent
in the past two years. As he said this, a look of trepidation came upon his face, as if he
was waiting for the other shoe to drop.

The director added, "I hate to think what's about to happen once hospitals begin hiring
again. The nursing shortage didn't go away simply because the economy faded." Curious,
I asked him to confirm if the American Hospital Association estimate that it costs an
average of $64,000 to replace a single RN was realistic at his institution. "Easily, and that
doesn't account for the increased stress an open position places on the remainder of the

A little short math reveals that a hospital with 200 nurses experiencing a 20% annual
turnover rate is very likely expending $2.5 million a year in hard dollar costs associated
with this phenomenon. Extrapolated across the nation, this endemic turnover challenge
may, in fact, be costing American hospitals more than $10 billion annually. This doesn't
take into account the additional costs associated with patient length of stay, the risk for
adverse events, cost at discharge, and patient-perceived quality of care, all of which are
negatively effected by nursing staff shortages and exacerbated by nursing staff turnover.

A quick search of the peer-reviewed, published research on the subject reveals many of
the underlying causes of endemic turnover in hospital nursing are rooted in the "soft
skills" of nursing, leadership, and organizational culture. Digging a bit deeper into the
literature identifies some innovative, evidence-based suggestions and approaches to
lowering costs and improving patient care as it relates to this front-line challenge. More
than two dozen studies document the positive role emotional intelligence and the
cultivation of emotional resiliency can deliver in nursing and clinical leadership.
Fortunately, these are learned skills and competencies that can be developed over one's
lifetime. The research clearly reveals that emotional intelligence in nursing:

-Has a positive impact on nursing team cohesiveness and patient/client outcomes.
-Minimizes the negative stress consequences of nursing.
-Reduces nurse burnout.
-Contributes to performance, career longevity, and job retention.
-Builds successful nursing leadership.
-Leads to more positive attitudes, greater adaptability, improved relationships, and
increased orientation towards positive values.
-Enables the expression of empathy through healthy, professional boundaries.
Nurses capable of a self-reflective process become aware of their own emotions. When
nurses recognize their own feelings they are more likely to manage them and
communicate in appropriate ways.

The nursing profession exemplifies positive intention, a spirit of service, and
compassionate behavior. The daily interaction of nurses with their patients has a distinct
impact on patient satisfaction, especially the emotional needs of patients and their
families. Yet constantly evolving technologies, severe economic constraints, and the
chronic nursing shortage combine to challenge the ability of nurses to focus on patient
care. The very people that are in the position to have the most positive impact on critical
patient perceptions also bear the brunt of many of today's challenges.

The fact is, healthcare is entering a phase of unprecedented change, experiencing
pressures from many sides simultaneously. Like so many industries today, healthcare
must adapt to a rapidly shifting economics, demographics, and expectations. Investments
in technology will undoubtably help contain costs and improve efficiencies, but
technology can only go so far. Of all industries and endeavors, healthcare is simply the
most human. Investing in the human aspects of care, in developing emotional
intelligence, adaptability, engagement, and techniques in self-care should be a key
consideration as administrators seek innovative ways to successfully lead their
institutions through this period of uncertainty and change. : Over 200 ebooks, templates, forms for
performance appraisal.

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