Applications pouring in at innovative hospital

PR, walking rounds help fill nurse positions

Higher salaries, better hours, bonuses, incentives, education programs. You name it, rehab directors have tried it to recruit and retain nurses. But St. Francis Health Center in Topeka, KS, has spent a lot of time thinking outside the nursing shortage box. Their efforts are starting to pay off: Within six months of implementing a number of innovative strategies, rehab nursing applications began rolling in the door.

Rebekah Evans, RN, MBA, director of rehabilitation services for St. Francis, says the rehab department used to have three to four nursing positions that stayed open for more than a year. "We just could not fill them, and we could never figure out why," Evans says. "Then we started targeting the schools, our nurse recruiter, started making our own nurses happier, and it has really helped a lot."

Evans says she hit the jackpot by educating the hospital’s nurse recruiter about rehab. "In rehab, it’s difficult sometimes to interest nurses because they don’t do a clinical rotation through here and they misunderstand the skill set we need," she says. "They think it’s a nursing home."

Realizing that this misunderstanding was hurting the recruiting process, Evans explained the benefits of working in rehab to the recruiter. "We work with a team, we have a special certification, our nurses are involved in team conferences," Evans says. "Once she understood, she realized how fun this place could be. We have seen a huge increase of applicants sent to us because of her understanding of rehab. She can talk it up."

To enhance nurses’ understanding of rehab, St. Francis also has worked to improve its relationships with local nursing schools and has provided a clinical rotation for student nurses.

Evans regularly meets with representatives
of the hospital’s public relations department to make sure they have ideas for getting stories about rehab out to the community. They work together on such topics as school safety, diving safety, senior programs, and fall prevention. "We’re probably the No. 1 department they use now for promoting stories in the community," she says.

Another big draw for community interest is the rehab program’s Easy Street program, where part of the unit is designed to look like parts of the community. Patients can practice using a pay phone, getting in and out of a car, shopping at the grocery store, or going to the bank. The hospital has partnered with a local preschool to involve children in decorating Easy Street for holidays. Last year’s Halloween haunted house drew 300 visitors, giving the hospital a great chance to promote its rehab work.

Another innovative idea the hospital came up with is making presentations to eighth-graders
at local schools. "Through research we’ve found that oftentimes right around eighth grade they’re starting to think about careers and to build perceptions about careers," Evans says. "We do activities with the students to make it enjoyable and increase their understanding. We let them pretend they’re a stroke victim, and they have to sit in a wheelchair and not move one side of their body. We show how nursing would help this type of individual."

But the rehab department doesn’t stop at promoting itself in the community. The staff also has looked at PR within the hospital. "Sometimes rehab departments are not seen as glamorous to other departments, so we’ve also had to check on bonuses that are given in other departments to recruit nurses," Evans says. "We’ve gone back to human resources to make sure we’re not losing nurses to other departments due to other bonus and pay structures. We did find that was happening."

Walking rounds

Perhaps a more concrete measure that has helped the nursing shortage is the new concept of walking rounds in which the whole team meets with patients. "It makes the nurses feel very much part of the whole rehab team and makes them highly accountable for understanding what’s going on with those patients," Evans says.

The rounds are split between the day and evening shifts so more nurses can be involved. "Originally, our day shift did all the team conferences on patients. We now have two shifts fully involved in all aspects of patient care," she says. "There’s almost always conflict between the shifts, so we’ve done a lot of teamwork between day nursing vs. evening nursing vs. night nursing. We’re using an evaluation tool to identify their individual personalities and how they can best work with each other. From there, we’ll help the team move forward and come up with a strategic plan that’s specific to nursing."

A nurse runs the rehab council that includes representatives from throughout the rehab department. "They help identify issues and problem-solve different ways to resolve those issues. It’s not a top-down type of resolving problems," Evans says. "An example of what has come out of that is we have started having the patients go as teams into our big gym for therapies together. It gets nursing more involved in the whole program because nurses help the therapists bring the patients in, they help with scheduling, and it also allows the nurses to spend a little more time with the patients that aren’t in the gym."

St. Francis has successfully educated nurses about the benefits of rehab. "Other nurses seem to think rehab is one of the prime places to work," Evans says. "That’s a form of educating our own internal nurses so they’re choosing to work in rehab."

Need More Information?
  • Rebekah Evans, RN, MBA, Director of Rehabilitation Services, St. Francis Hospital, 1700 SW Seventh St., Topeka, KS 66606. Telephone: (785) 295-8346.