Engaging Clinical Nurses in Recruitment and Retention

Pennsylvania Hospital, a 500-bed urban teaching hospital in Philadelphia, one of 5 Magnet ® designated hospitals within the Penn Medicine Health System, is committed to providing the highest quality patient care. Pennsylvania Hospital recognizes the value of the clinical nursing staff and prioritizes meaningful participation in organizational decisions. One example is the clinical nurse involvement in the hiring and selection process for nurses at all levels, which was developed during Pennsylvania Hospital’s journey to the American Nurses Credentialing Center’s Magnet® designation. In 2013, the department of nursing conducted a gap analysis which revealed an opportunity to elevate the practice of clinical nurses by involving them in the hiring process of potential peers. An interprofessional team consisting of nurse leaders throughout the organization partnered with human resource talent acquisition specialists and developed the Recruitment and Retention Leadership Team (R & R Team). This team led a hospital wide initiative to develop and align practices around peer interviewing and candidate selection.

The R & R Team utilized Pennsylvania Hospital’s professional practice model, Relationship Based Care (RBC), to guide their work. RBC provides the framework for meaningful, authentic human connection and caring. The RBC model places the patient and family in the center, surrounded by the fundamental tenets of the model- leadership, teamwork, professional practice, care delivery, resources and outcomes¹. It was imperative to the R & R Team that these core value were elevated during the recruitment and interviewing process to ensure that applicants who inherantly valued the priorities of RBC were hired. To do this, the R&R Team developed an interview tool and process that would be used consistently throughout the organization to aid clinical nurses in the peer interview and selection process.

Assessment of Knowledge and Tool Development
Nurse managers and clinical nurses reported variable practices for interviewing , thus the R& R Team was developed.  The R & R team developed a brief evidence based survey to identify inconsistent practices and quantify clinical nurse knowledge and comfort related to interviewing candidates. The survey was reviewed by a content expert to determine validity and generalizability throughout the organization. The survey was placed on the hospital’s intranet, was voluntary, and made available to all clinical nurses. Members of the R& R Team partnered with nurse leaders to further encourage participation.

Approximately 1/3 of all clinical nurses from varying shifts; 66% day shift and 34% night shift participated in the survey. The results of the survey aligned with feedback from nurses at all levels regarding the interview process and the following themes emerged: There were inconsistent practices throughout the interview process; there was opportunity to improve the structure of the interviews; and nurses who had not previously had the opportunity to participate in peer interviews were interested.

The R & R Team understood the importance of aligning with the professional practice model and utilizing evidence based practice to guide the tool development. Furthermore, Behavioral Interviewing (BI) techniques were utilized because this style of interviewing has demonstrated effectiveness in assessing the core values of the organization in a potential candidate². The purposeful combination of RBC and BI led to the creation of a clinical nurse interview tool. This tool guides clinical nurses to the selection of appropriate questions that demonstrate their abilities to practice within RBC and to align with Pennsylvania Hospital’s core values. 

Implementation
Clinical nurse engagement and feedback were essential to ensure practicality, usablity and success of the tool and interview process. Clinical nurses from various practice areas were asked to pilot the tool and provide feedback regarding ease of use, and sustainability.  Feedback from nurses who piloted the tool was favorable, therefore the R& R Team expanded the use of the tool and interview process to all practice settings.  The tool provided a structure so that clinical nurses could easily ascertain an applicant’s potential to excel if hired. To ensure use and sustainability, the R & Team partnered with nurse managers on how to operationalize the unit based interview process. Additionally, the R & R Team utilized the information provided by the tool to formalize communications between the nurse managers and the talent acquisition department.   

Results
Upon completion of the interview tool and process for implementation, the R & R Team re-surveyed clinical nursing staff using the same survey to establish if the interview tool led to increased comfort and staff engagement with the recruitment and interview process. The post survey demonstrated that 68% of the respondents felt as though their input was essential in the hiring process, 77% felt that by using the interview tool, they were able to get a “good sense” of a candidate’s organizational fit and 90% of the respondents felt comfortable with participating in the interview process. (Figure 1) This validated that the tool was beneficial to clinical nurses when interviewing candidates.

Finally, the results identifying the impact of the interview and selection process in the interview process were most significant. After six months of utilizing the tool, 69% of the total number of applicants who were interviewed were interviewed with the new tool. Of the recommended candidates, 94% were offered positions. Those that were not recommended by the clinical nurses were not offered positions. This demonstrates the value of the clinical nurses’s feedback and evaluation of candidates, and that the use of a consistent interview tool and process provides a structure, and builds confidence among clinical staff.

Two years post implementation the interview tool and process is fully enculturated throughout the organization. Nurse managers and talent acquisition specialists confidently select candidates based on the clinical nurse feedback.  The partnership between the interprofessional R & R Team and the clinical nurses has not only improved the hiring process,but increased trust between clinical nurses and leadership. Additionally, The R & R Team, utilized the same framework to replicate the tool and process for the nursing support staff with equal successes.  Looking ahead, the R & R Team is planning to expand the use of the process and tool throughout the organization for non- nursing candidates.

References:

1. Koloroutis M. Relationship-Based Care: A Model for Transforming Practice. Minneaopolis MN. Creative Healthcare Management; 2004.
2. Anderson L. Using behavioral interviewing techniques to select the right employees. SHRM Resources. https://www.shrn.org/hrdisciplines/orgempdev/articles.