How to Retain Your Top NNP Talent

As a healthcare professional, you know that qualified neonatal nurses are in short supply. If you recruit NNPs, you may also know that the demand for these exceptional practitioners is predicted to continue to grow over the next few years.

Finding and hiring qualified NNPs is a daunting task. Once you succeed in recruiting competent nurses, you don’t want to lose them. According to the Journal of Nursing Administration, it costs roughly $82,000 to replace a nurse, let alone a nurse practitioner. That cost covers vacancy, orientation and training, the lowered productivity of a newly hired nurse, and advertising and recruiting.

And remember, if one of your top NNPs resigns, there’s no time left to make repairs. When a nurse has thrown in the towel, there’s usually no going back — he or she has hit a brick wall and is more than ready to say goodbye to both you and your facility.

So, how can you create an environment that attracts and retains top talent?

At ENSEARCH, we specialize strictly in the recruitment of neonatal nurse practitioners. For years, nurse managers and administrators have shared their secrets for maintaining and retaining high-performing NNPs. Here are some tips that may help you build and sustain a happy and dedicated team.

1. Develop a positive and supportive culture

Neonatal nurse practitioners want to practice in a culture where they can succeed, thrive and take pride in the work they do. Developing a caring and positive environment for your staff is the number one key to keeping them happy and fulfilled.

2. Listen and respond

Managers who listen to their nurses’ suggestions tend to have the happiest nurses and the best staff.

Encourage your staff to make suggestions for improvement, and act on them. Demonstrate that you actively listened and responded to their needs and that you will always have their backs.

Your NICU staff knows best what improvements are needed at your facility. So, ask for their input through both anonymous surveys and casual encounters; make sure that your nurses have everything they need to work effectively, especially when it comes to equipment and supplies.

“When we hire, we try to hire for life,” says Leah Carpenter RN, MPA, chief nursing officer at Memorial Hospital Miramar in Florida, “and we pay attention to what our nurses say.”

2. Be brave

It takes a lot of guts to ask your team members for honest feedback and constructive criticism. But if you have the courage, give your nurses a rating sheet and ask them to rank your managerial skills.

You might just be surprised by the results: you may rank higher in areas you thought were your Achilles heel and lower in areas you considered your strong suit. Regardless, now you’ve demonstrated to your team just how far you are willing to go to learn how to be a better manager. And that, as they say, is priceless.

3. Reward and recognize

“We spend a lot of resources on rewards and recognition,” explains Carpenter— who reports a waiting list of nurses hoping to work in her unit.

It’s true what they say: Money isn’t everything. Sure, it’s important. But most conscientious, value-oriented NNPs are interested in knowing that their hard work is being appreciated, every day.

As a manager, you’re responsible for focusing on your team’s achievements and for doling out positive reinforcement and praise whenever possible. By providing your best team members with a positive and caring culture, you ensure they remain enthusiastic about what they do and lack any compelling reason to go elsewhere.

4. Empower your staff

If you want to keep your top NNPs, you need to give them more independence and autonomy.

This means allowing your team to be part of the decision-making process, including both administrative tasks and hands-on healthcare strategies.

Alleviate workload problems: Why not start with the elephant in the room? Staffing, scheduling, and workload are among the top issues cited by nurses who decide to quit. “My schedule was never consistent. Sometimes we would work 12 days straight, without one day off”— many nurses feel frustrated and powerless when it comes to putting together the work schedule. You can nip this in the bud, easily, by allowing your team to be part of a self-scheduling process. Invite your staff to set up their own work shifts based on availability. Your best NNPs should own the scheduling process for their teams. For one thing, they know the needs and abilities of their teams better than you do and, for another, this allows your nurses to be in control and feel empowered— all of which leads to job satisfaction.
Level the playing field: When you provide your nurses with the opportunity to be heard, you’ll see an improvement in attitude, confidence and, ultimately, patient care. At the Methodist Hospital in Houston, Texas, nurses sit side-by-side with physicians and professionals where they participate, together, on clinical committees. Promoting this type of collaboration across a broad range of disciplines gives your NNPs a vote of confidence and a voice where it matters.
Encourage growth and mentoring: Once you make a hire, continue demonstrating your support by offering ongoing training and development opportunities. National nursing conferences like NANN, FANNP, ANN, and more are a perfect opportunity to network with peers and stay current with CEUs. Five years ago, Deb Wesley, senior vice president and chief operating officer at Phoenix Children’s Hospital began inviting nurses to attend a paid, 14-week Graduate Advancement Program in Pediatrics (GAPP). Today, Wesley enjoys a 30% increase in retention due, in large part, to this investment in her team’s growth and mentoring. Training and development opportunities should not be limited to workshops or online courses. Development can be part of the regular conversations you have with your staff: seek their feedback and ideas; offer validation and recognition.

5. Develop quality-of-life initiatives

Reduce overtime: A recent health study found that nurses who work more than 12 hours in a shift and 40 hours a week are more prone to turnover and job dissatisfaction. The same study concluded that nurses who work shifts longer than 12 hours are 1.45 times more likely to leave their jobs within a year. Currently, your nurses probably feel that overtime is the rule rather than the exception. You can change that mentality as you work to create a more supportive culture. By limiting and restricting overtime duties, you demonstrate your efforts to mitigate undue fatigue and burnout.
Enforce a healthy work/life balance: Just like you, nurses have responsibilities that extend beyond your hospital or facility— they have to make time to care for significant others, family members and, of course, themselves. Implementing quality-of-life initiatives for nursing staff can significantly improve morale and enhance loyalty.

Consider offering your staff varying shift lengths and staggered start times. This way, your nurses can customize their schedules to accommodate personal needs and obligations, such as soccer practice and school talent shows.

Also consider implementing on-site services for your NNPs, such as childcare centers and gyms. The results you see — increased energy, attitude and patient outcomes — will surely offset the costs of building and maintaining these extra perks.

Bottom line, neonatal nursing is a difficult job. The cost of turnover is quite high and, as a manager, you play an active role in preventing attrition. The key to retaining your top staff is to pay attention, develop a keen ability to sense when nurses are becoming mildly frustrated, and to act on these perceptions immediately with tactics guaranteed to keep your team content and loyal.