Our minds seek simplicity. We require clarity. We emotionally need the either-or; black or white; name the bad guy. Blaming is the most common and easiest (non-)answer to all our problems.
Checkbook out of balance? Find the error, fix it, and everything is solved. Even better, find the person who added wrong: throw a stone at him or her, and everything will be fine. But what if: the bank made an error; and you forgot to put in two checks; and your husband added wrong?
Healthcare out of balance? Same answer: just find and fix the (singular) problem. Get everyone covered: universal health insurance solves everything. Make our demands known: The Patient’s Bill of Rights is the fix. The problem is bad apples: just kick out the incompetent nurses and drunken doctors, and we will all have quality medicine. Give nurses signing bonuses and presto, no more nursing shortage.
Complex, long-standing multi-billion dollar problems that affect absolutely every person in our country cannot be explained by one simple answer. Anyone who claims it can either does not understand, or is telling you a falsehood for personal gain: to get elected; to become the next nationally known talking head on TV; or to sell a book or DVD.
It is never just one thing.
Before our technical glitch, Landon Johnes had left a comment about nursing shortages and I answered with the below:
Landon Johnes’ comment on nursing shortages is right on target. Signing bonuses get people to sign up. They do not assure a motivated worker, at least not motivated toward the patients. Money does not engender or even encourage such a drive or instill “discretionary energy” (Jeffrey Pfeffer’s phrase).
Research we did showed the following. (A) Nurses leave because of an unsatisfying work environment, not because of money. (B) Those who stay or hire on because of the money do the minimum necessary to avoid getting fired. When the contract is up, they leave the unpleasant workplace, looking for some place where management will respect them and actually help them care for patients. For further proof, consider the Mayo Clinic, which has a lower pay scale than many comparable institutions. Mayo management works very hard to create a satisfying work environment for all care providers. Result? Mayo has a turnover rate less than 7%, while the national average is around 14%.
But wait! There’s more! Watch for a forthcoming Post, titled Retain Our Nurses, showing that turnover is not what really matters. We need to track the outcome we want: retention.
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