A guide to how homecare agencies can leverage mentor & transition programs to retain nurses
The burdens and burnout within the nursing profession have led to the current state of staffing shortages across a variety of settings in which nurses work. Home care nurses often have unique circumstances in which they are very independent, performing complex case management and problem solving with less “at hand” resources than other healthcare environments. In addition, nurses are caring for sicker, more complex patients in all environments. Being proactive to support the specific needs of homecare nurses through mentor or transition programs can promote retention and provide an excellent return on investment when targeted at the foundational reasons nurses leave their roles.
Leaving Homecare
Though becoming cliché, “work life balance” is only one reason some nurses leave their positions. Reasons ranging from low compensation to dissatisfaction with agency tools (ie home health software, patient care equipment, or transportation challenges) or practices have all been reported by nurses and caregivers in the aftermath of an exit. These realities lend themselves to acknowledgment of the desire for nurses to have flexibility and respect for their personal lives and mental health. Equally as important, however, are the need for a sense of belonging within the organization, a positive work environment, mentorship, and the ability to communicate concerns easily and without fear of negative criticism.
In home health care, nurses are often isolated from other team members and communication occurs mostly through email or messaging. In contrast to settings where one can walk down the hall to “ask another nurse” for a second opinion, home care nurses do not have this luxury and questions can go unanswered for extended periods of time. Compounding this issue is the lack of experienced nurses available to adequately mentor. Home care nurses also carry the burden of having less overall resources at hand, often carrying supplies with them to visits in an oversized bag. Home care nurses have a unique need to be resourceful with what they have while also coordinating care. These tasks can easily become overwhelming if the nurse is not given clear instruction, adequate training, and mentorship.
Nurse Mentor Programs
A mentor can be defined as a tutor or coach. Nurse mentor programs, sometimes called transition or preceptor programs, have been well established to not only improve patient safety but can contribute to promoting retention. Additional benefits of nurse mentor programs include career satisfaction, stress reduction when changing nursing specialties, increased recruitment and retention of mentees, stronger developed leadership skills within the organization, and conveying a sense of trust. A program can be as short or extensive as the home care organization desires, but one fact remains; a lack of ongoing mentorship to nurses leads to the loss of potential talent, satisfied patients, and revenue.
Individualized to the Home Care Environment
Starting from scratch to implement a nurse mentor or transition program is not necessary, however, modifying an existing program or outline to the specifics of the home care agency is essential. The program should be organized to meet specific organizational goals in combination with proactively addressing well-known areas of concern in nursing. For example:
By the end of the mentor program, the nurse will:
- Be able to identify and correctly utilize information technology tools needed to comply with organizational policy and thrive in the home care environment.
- Be able to independently assess and prioritize care for clients with complex needs in home care.
- Identify support tools and/or staff for real-time questions or concerns.
- Understand how to identify and address gaps in patient care(s) without fear of retaliation.
- Feel valued by the organization, know how to advocate for themselves, their patients and advance their career knowledge.
- Gain a sense of belonging and ownership to the organization.
Nurse mentor programs are often structured programs in a classroom or online setting occurring over 6-12 months upon hire but could be longer if using a competency based transition model. Each month, a new topic is introduced focusing on the desired outcome. Site coordinators ensure updated material is prepared and organize speakers as appropriate. Members of the interdisciplinary team are often welcome to speak to topics of specialization within home care, such as physical therapists, occupational therapists, social workers, wound care/ostomy nurses or dietitians. When nurses understand the big picture and how they and others fit into the home care environment, a sense of belonging and ownership is often built. Building the program into the nurse’s current workload vs. adding workload is also key to creating an exciting opportunity to enjoy home health nurses vs. burdensome, required training.
Community in Transition
Mentor or transition sessions often do not build upon each other so new hires can jump into the current session. This helps build a sense of community between the new nurses in the organization. New graduate nurses as well as nurses transitioning to home care should be placed in the transition program and partnered with at least one nurse mentor for the entire duration of the program for additional one-on-one support. Preceptors are most effective when they volunteer and are trained on how to mentor new nurses using positive feedback. Essential to the success of any new program is the support and buy-in from administrators. All mentor sessions should also allow for designated discussion time. This could include addressing nurse questions and reflecting on the current practice environment.
Check in Before Nurses Check out
Annual reviews may be too long of a time period for nurses to wait to check in on their current satisfaction in homecare. Implementing a nurse mentor program is a proven and proactive approach to support the retention of nurses in all settings. Not sure where to start? Start small, focus on a few of your agency’s identified areas of improvement, exit interview feedback or commonly cited reasons why nurses leave their positions. Mentor programs are most effective when developed in collaboration with nurse mentors, as they often have the insight into topics that may be most impactful for the organization.
Author’s Note: Views, information, and guidance in this resource are intended for information only. We are not rendering legal, financial, accounting, medical, or other professional advice. Alora disclaims any liability to any third party and cannot make any guarantee related to the content.
Reference links
https://www.nursingworld.org/content-hub/resources/nursing-leadership/motivating-nurses/
https://onlinelibrary.wiley.com/doi/epdf/10.1111/jan.15696
https://www.ncsbn.org/nursing-regulation/practice/transition-to-practice.page
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