What's the best way to retain excellent nurses and other staff?

As emergency medicine is a team sport where everyone's contribution is important, assembling the best group of nurses and office staff is key to providing quality patient care. As an ED physician, what methods do you employ in your daily practice to motivate and retain the best staff?

Yes, money works but can only go so far. So to shed some light on the issue, we can start with the results of a Public Agenda Foundation study that elucidated the characteristics of an ideal work environment by surveying employees. The top ten results were:

1. Work with people who treat them w/ respect

2. Do interesting work

3. Be recognized for doing a good job

4. Have opportunity to develop skills

5. Work for people who listen to ideas about how to improve things

6. Have opportunities to think for themselves

7. See results of their work

8. Work for efficient managers

9. Have a job that is challenging

10. Be well informed about the goings on of the office

The good news is that emergency medicine work inherently fulfills several of these characteristics of an ideal work environment such as doing interesting and challenging work. Many of the others can be inoculated into the staffs' work environment by the physician's actions.

1. Respect the staff. Gone are he days of the hell raising surgeon that would throw a tantrum every time he did get his way.

2. Recognize the staff when they do a good job. In public, if they will take well to this. Always criticize in private.

3. Staff want to develop their skills and knowledge. Teach the techs and nurses about what you're seeing on the x-ray or ECG. If your super motivated, start a teaching conference for ancillary staff q month.

4. Listen to staff when they want to vent (or give accolades) about their work environment. Make appropriate changes when possible. If not, be the mouth piece for your staff, bringing their issues (and by association yours too) to administration. While it shouldn't be so, physicians often have more political clout to help bring about change.

5. Encourage staff to think for themselves. Don't tell them the nitty gritty details of how you want the job done. Tell them what you want as the end result and allow them to get their however they see fit. This may not apply to less experienced staff but for the gray haired ... let them fly.

6. Show staff the result of their work. For instance, if the tech gets an EKG quickly on a chest pain patient that helps expidite his transfer to the cath lab, tell him that his work help save the patient's life.

7. Be efficient. Just as we don't like running around in circles. Neither does you staff. Think twice before giving orders.

8. Keep the staff abreast of department goals and progress towards achieving them.

Alright, If I can incorporate a couple of these actions into my next shift, I think my staff and I will be better off for it. Any other suggestions .... ?