Boost morale of ED nurses with these novel incentives

Looking for ways to boost morale? You may be surprised at how simple and inexpensive the solutions are.

"Many of the best ideas are not high-cost items," says Sandy Fox, RN, ED nurse manager at Avera McKennan Hospital in Sioux Falls, SD. Nurses may accept a position based on hours or dollars, but they stay because they enjoy the work environment, she says.

"The best return on your investment is to create an environment that employees enjoy working in," says Fox.

To boost morale of ED nurses, offer these incentives that work:

Award an ED employee of the month.

There is a hospital employee of the month program, but recently the ED began a separate program to honor its staff, says Fox. Candidates are nominated by ED staff, and the winner is selected from the nominees at staff meetings, she says.

"Photos and an interview with the winner are posted on a bulletin board, so that others will get to know more about them," she says.

The winner will receive a month of parking in an area where only senior employees and management are allowed to park, she says. "There also are gifts such as T-shirts and gift certificates for the coffee shop or gift shop," says Fox.

Pay for the certification for emergency nurses (CEN) exam.

If ED nurses choose to take the CEN exam, the hospital pays for the exam, which costs $180 for nurses who are members of the Emergency Nurses Association, and $320 for nonmembers, says Fox. The facility also offers nurses a review course at no charge, which is periodically provided at the hospital by an outside agency at a cost of $4,500 per class, she says.

Paying for the test is important because more nurses are likely to take the exam, says Fox. "Most of the nurses have children, and paying the total amount would probably keep many staff members from taking the exam," she says.

The review ensures that nurses are well prepared when they take the exam, says Fox. All nurses who pass the exam are given a $60 watch with the hospital logo, she adds.

Give nurses a free vacation.

To reward seniority, a program was started to give ED nurses with 15 years experience an all-expense-paid group trip, including a spouse, says Fox. Previous trips have included Disney World, Lake of the Ozarks, and a golf resort in Northern Minnesota, she says.

"Currently, we have about eight nurses who are eligible for the trip," she says. "It is offered to them every five years after they hit the 15-year mark."

Give nurses with seniority more flexible shifts.

Currently, senior ED nurses are being surveyed as to whether they would like an eight-hour shift instead of a 12-hour shift, says Fox.

"At this point we are not sure of what staff would prefer, and [an eight-hour shift] may end up being offered to more than just the senior staff," she says.

At Christiana Care Health Services in Newark, DE, ED nurses with the most seniority are being offered a Monday through Friday position and/or a position with no off-shift rotation, says Karen Toulson, RN, ED nurse manager.

Ask nurses to plan major changes.

A recent triage redesign project was successful largely due to input from ED nurses, says Toulson. A new private area was added for patients to talk to the triage nurse, with seven triage assessment bays, she explains.

"We will be starting another project to add more patient care rooms, and a staff nurse is actively involved in the planning and design phases of this project," she reports. Nurses were encouraged to give input on workflow and placement of essentials such as ice machines, telephones, computers, and sinks, she adds.

ED nurses are encouraged to become involved in ongoing projects, Toulson says. "We currently have nurses that are leading unit-based committees on retention and recruitment and performance improvement," she says.

Have a zero-tolerance of negativity policy.

Negativity toward staff members, physicians, and ancillary service staff is not tolerated, says Toulson. "This has made a positive impact on the morale of our department," she says.

All ED staff are expected to communicate professionally, emphasizes Toulson. "This also entails gossip that is negative and detrimental to the team and includes staff talking about others in the break room where the comments would not be considered private," she adds.

Ask staff what they would like to change in the ED.

Ask nurses what they perceive as barriers to patient care, what equipment problems they may have, and what suggestions they have for making the ED a better place to work, suggests Toulson.

At Christiana, ED nurses were surveyed about the top three things they would change in the ED if they could. "We received roughly a 30% return rate," says Toulson.

Toulson divided the list into short-term and long-term solutions, she says. "The short-term fixes were implemented, and we keep the staff updated about the progress of those items in the long-term category," she says.

Short-term solutions included developing a policy for a code of conduct during trauma resuscitations, and long-term solutions include the problem of taking verbal orders over the phone for admitted patients, says Toulson.

"One of the ED staff members and myself devised an interim order sheet that will give the inpatient unit basic orders until the patient is seen by the attending physician," she says.