Program keeps 55% staff around for 3 years and up
March 1, 1998 6 minutes read
Program keeps 55% staff around for 3 years and up
Agency’s turnover rate reduced
Private duty agencies face the challenge of staff retention daily. Not only must agencies focus on meeting patient needs, but also the needs of the private duty aides who provide care. With these issues in mind, private duty managers should consider implementing an innovative retention program to keep good staff.
At My Nurse, a private duty home health agency in Mount Marion, NY, the agency retains staff through education, schedule flexibility, and motivational programs. Retention is an important part of the agency’s philosophy, and its program works: More than half (55%) of the agency’s private duty aides have been employed for more than three years. Of the 55%, approximately 35% stay three or more years, and 14% stay five years.
Losing one staff member costs the agency approximately $300. "You have to care for your employees in the same way you care for your patients," says Sandy Cerul, RN, BSN, owner of My Nurse. "Our retention program gets our full attention. We treat all employees as equals and allow them some flexibility."
Retaining staff starts the day an aide is hired. During an eight-hour orientation, aides get an introduction to the philosophy of the organization and why the agency wants to keep them as employees. Because the agency wants to retain staff, they set high expectations for them during the orientation program: Competencies are assessed, needed skills are identified, and training is given on bloodborne pathogens.
"Our employees know what to expect from us from the very beginning," says Cerul. "They understand that we offer support and educational opportunities to help them reach a new level of professionalism." My Nurse makes retention one if its top priorities. In fact, retention is on the agenda for every monthly staff meeting, during which a brainstorming session takes place on new ways to recognize employees.
Increasing self-esteem
Cerul says that many aides need to increase their self-esteem and sense of belonging. She believes that fostering self-esteem in the workplace has been the essential ingredient in keeping good staff. The agency provides uniforms to all employees so they will look professional and feel good about their appearance. The uniforms, specially designed for the agency with its logo, include pants, two tops, and a jacket. The aides receive one uniform per year, costing the agency approximately $85 per employee.
Cerul encourages the development of "motivational projects" to help bolster self-esteem and recognize jobs well done. For example, some motivational projects My Nurse implements range from a sticker on an employee’s paycheck touting the extra effort an employee took with a patient or distributing "bonus bucks" one dollar bills given for good appearance or taking initiatives in patient care. Cerul explains that the bonus bucks are a fun way to show employees that their daily work performance gets noticed.
The agency’s bimonthly newsletter lets employees know that a certain week is designated as a bonus buck week. A staff committee determines which performances they want to highlight but do not disclose them. Employees who are observed in the home or who come into the office are awarded one dollar for every task that gets noticed by a supervisor. Topics are then published in the next issue of the newsletter so employees know what they were recognized for. Cerul says that she budgets about $100 for the biannual bonus buck week.
Even the newsletter plays a part in creating an atmosphere of support and fostering self-esteem. Cerul herself writes the bimonthly newsletter that focuses on recognizing employees who have done something special for patients; these employees are recognized as "gold stars." Publishing the names of employees who take pride in their work shows other employees that their efforts are taken seriously. The newsletter also has a "prayer list" that mentions any employee who may have a personal problem, a sick relative to care for, or is pregnant. "The aides really appreciate this," says Cerul. "They see it as another way that we care about them."
Included in the newsletter is a column that answers staff questions. "It’s important that staff know that we will answer any kind of question. We encourage them to ask because other employees may be encountering the same issue," says Cerul. My Nurse also offers a 24-hour on-call nurse so staff can contact someone if they have a problem with a patient or need reassurance on how to face a potential issue.
Education enhances work
Cerul says the biggest challenge her employees face is continuous learning about new topics in order to do their jobs better. Education has been an important element of My Nurse from its beginning five years ago. To keep staff current and comply with federal guidelines, the agency has developed an inservice program to address the many topics that aides and nurses inquire about. For example, Cerul’s schedule for inservices this year includes topics on alternative medicine.
"We’re located near Woodstock [NY], and we have patients who have acupuncture and massage therapy. Our aides want to know more about these treatments so they can be knowledgeable of them," says Cerul. In fact, the current inservice calendar includes inservices on acupuncture, massage and reflexology, and tai chi.
Cerul says that aides are encouraged, not obligated, to come to the inservice sessions. Typically, about 20 to 25 aides attend the monthly sessions. Since the agency does not pay the aides for their time, nor does it typically pay for a speaker, this is an inexpensive way to educate employees. The inservices are frequently given by nursing staff, but if the agency does pay for a speaker, such as experts on a particular topic, it is usually no more than $50.
Inservice topics cover important safety compliance issues, such as bloodborne pathogens and safety in home care. Specific clinical care issues are addressed, such as ostomy care, oxygen treatment, and AIDS. Cerul points out that employees are encouraged in the newsletter and through notices in paychecks to send in ideas for inservices.
Emphasizing the need to work
In the true spirit of working flexibility, My Nurse requires its private duty aides, who are often contract workers, to be registered with at least three agencies. "We recognize the need for our aides to work. Although we keep our aides assigned, and even try to get additional work for them, it’s important that they have other work available if we can’t provide it," says Cerul. She says this has given her company loyal employees who say that the agency treats them with fairness and respect.
Cerul says her agency also understands if a staff member has a sick child and cannot provide care that day. Even the weather is a consideration. The agency has an understanding with patients that no employee’s life will be put in jeopardy if the weather is dangerous. "We would rather have an aide miss one bad weather day than risk him or her losing control of a car on a snowy day," says Cerul.
Cerul says that she often acts as an advocate for her aides. "The best way I know how to provide the best possible care for my patients is to take care of my employees," she says. "All it takes is creating a different perspective on how to approach and treat staff. We take a very personal approach here, whether it be decorating the office for holidays or telling employees that they are doing a good job. We want them to know they count and are valued."
This philosophy has gone a long way in retaining good staff and even helps in the recruitment process. Cerul advises other private duty agencies to focus on their employees as much as they do their patients. "Employees are our most valuable resource. They should be revered more than referral services," emphasizes Cerul. "They are the essence of any agency, and employers need to put the time in to care about their staff."
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