RESULTS OF BRAINSTORMING RESULTS OF BRAINSTORMING SESSION –SESSION –

RECRUITMENT AND RETENTIONRECRUITMENT AND RETENTION

Chairs: Karen Stewart Chairs: Karen Stewart and Susan Pilbeamand Susan Pilbeam

Topic Areas AssignedTopic Areas Assigned

RecruitmentRecruitment RetentionRetention Teaching StudentsTeaching Students Credentialing IssuesCredentialing Issues CompensationCompensation ProtocolsProtocols

Recruitment or Retention Solutions?Recruitment or Retention Solutions?

It became evident after It became evident after reviewing the responses that reviewing the responses that – many of the solutions cited under many of the solutions cited under

retention were actually retention were actually recruitment solutions and vice recruitment solutions and vice versa.versa.

– There was repetition between There was repetition between the groupsthe groups

Recruitment - ProblemsRecruitment - ProblemsLack of visibility of the professionLack of visibility of the professionNegative Impact to students by Negative Impact to students by “burned out” therapists.“burned out” therapists.Difficulty in identifying potential Difficulty in identifying potential student pool.student pool.Lack of professionalism by current Lack of professionalism by current therapists.therapists.Resources for recruitmentResources for recruitmentGeneration gap.Generation gap.

Recruitment SolutionsRecruitment SolutionsWe (current generation of therapists and We (current generation of therapists and current leaders of the profession)…need to current leaders of the profession)…need to exhibit our pride in the profession – “I am exhibit our pride in the profession – “I am a respiratory therapist!”a respiratory therapist!”Recommend this profession to your Recommend this profession to your children.children.Johnson and Johnson does public Johnson and Johnson does public advertising on television for nursing, why advertising on television for nursing, why not the manufacturers of Advair or not the manufacturers of Advair or Serevent provide ads to promote RC.Serevent provide ads to promote RC.

Bumper StickersBumper StickersPublic Places – wearing your name Public Places – wearing your name badge! Banks, grocery line, restaurants, badge! Banks, grocery line, restaurants, rental car agenciesrental car agenciesWeb courses and other accommodations Web courses and other accommodations by the programs.by the programs.Closing plants and businesses. Talk to Closing plants and businesses. Talk to their recruiters to help place individuals their recruiters to help place individuals desiring retraining.desiring retraining.

Within HospitalsWithin HospitalsPromote staff membership and their active Promote staff membership and their active support to AARC and state society.support to AARC and state society.Managers must be members of the AARC Managers must be members of the AARC and serve as a model.and serve as a model.Talk it up. Encourage membership. Talk it up. Encourage membership. Reward staff members who join: Better Reward staff members who join: Better shifts, requested off days, etc.shifts, requested off days, etc. Promote research, abstracts and find a Promote research, abstracts and find a way to pay staff travel to conventions.way to pay staff travel to conventions.Personal contact and follow up with Personal contact and follow up with potential students or employeespotential students or employees

Solutions for RecruitmentSolutions for RecruitmentDiscuss the recruitment problem at the Discuss the recruitment problem at the advisory committee meeting.advisory committee meeting.Seek input from hospital directorsSeek input from hospital directorsForm an alliance with clinical sites for Form an alliance with clinical sites for recruitment efforts (combine resources, recruitment efforts (combine resources, both financial and personnel) both financial and personnel) Flyers in allergists’ and pulmonologists’ Flyers in allergists’ and pulmonologists’ officesofficesHospitals provide scholarships to students Hospitals provide scholarships to students with work agreement (George Gaebler, with work agreement (George Gaebler, Management Bulletin, Jan-March 2003)Management Bulletin, Jan-March 2003)Hospital giving opportunity for students to Hospital giving opportunity for students to work (based on state license) – but not work (based on state license) – but not mundane tasks.mundane tasks.

More Recruitment HeldMore Recruitment HeldHave students help with high school Have students help with high school presentations (especially their own H.S) presentations (especially their own H.S) and health fairs.and health fairs.Graduates to speak to high school Graduates to speak to high school guidance counselors about the guidance counselors about the profession.profession.Local media – someone did something Local media – someone did something special.special.Want ads help a lotWant ads help a lot

Recruitment StrategiesRecruitment StrategiesStrategies: Career fairs at hospitals;Strategies: Career fairs at hospitals;Finding student needs (Lynn Capran Finding student needs (Lynn Capran Central Florida Model)Central Florida Model)Change starting dates of programs to Change starting dates of programs to attract potential nursing, paramedic, attract potential nursing, paramedic, physical therapy applicants.physical therapy applicants.Change ending date to correspond to Change ending date to correspond to peak hospital employment season – peak hospital employment season – end of summer.end of summer.

Negative Impact to students by Negative Impact to students by “burned out” therapists.“burned out” therapists.

Negative Impact to students by Negative Impact to students by “burned out” therapists.“burned out” therapists.

Communicate with them about their Communicate with them about their attitude. attitude.

Ask the staff if they continue their Ask the staff if they continue their negative approach, how can we address negative approach, how can we address current staffing problems in RC current staffing problems in RC departments. departments.

Do not accept a bad attitude – one rotten Do not accept a bad attitude – one rotten apple spoils the who batch. apple spoils the who batch.

Avoid student placement with these staff Avoid student placement with these staff members.members.

Use the “gung ho” therapists to help the Use the “gung ho” therapists to help the burned-out with ideas.burned-out with ideas.

Negative Therapists (cont.)Negative Therapists (cont.) Ask staff how to improve the image of the Ask staff how to improve the image of the

profession.profession. Let the staff help solve problemsLet the staff help solve problems Schools can find “star” hospitals and use Schools can find “star” hospitals and use

them as an example. them as an example. Therapists who are assigned as preceptors Therapists who are assigned as preceptors

should be evaluated for their effectiveness should be evaluated for their effectiveness as preceptors (annual evaluation – using as preceptors (annual evaluation – using student input in the process)student input in the process)

RetentionRetention

Identity crisisIdentity crisisJob satisfactionJob satisfactionSelf representationSelf representationStudent caliberStudent caliberLow payLow payBad attitudes on the part of staffBad attitudes on the part of staffLack of managers networking and support Lack of managers networking and support Lack of excitement in the fieldLack of excitement in the field

Retention SolutionsRetention Solutions

Increase staff identity with uniform dress code Increase staff identity with uniform dress code and large print name tags.and large print name tags.Hand out cards to patients with RC department Hand out cards to patients with RC department and phone number.and phone number.One exam/one titleOne exam/one titleAdapt Disney “Guestology”Adapt Disney “Guestology”Hospitals promote the profession – directions to Hospitals promote the profession – directions to the RC department, employee of the year, the RC department, employee of the year, patient comment rewardspatient comment rewardsGive them a clinical ladder of promotion – more Give them a clinical ladder of promotion – more skills, more pay.skills, more pay.

Retention SolutionsRetention Solutions

Put clinical instruction as part of job Put clinical instruction as part of job descriptiondescriptionHand pick clinical mentorsHand pick clinical mentorsFaculty to walk the walk…clinical time Faculty to walk the walk…clinical time teaching or working; participate in teaching or working; participate in recredentialing examsrecredentialing examsStrong advisory boardsStrong advisory boardsRemove deadwood – faculty and hospital Remove deadwood – faculty and hospital staff.staff.

Retention SolutionsRetention Solutions

Financial incentivesFinancial incentivesCommunity involvement – communicationCommunity involvement – communicationCourtesyCourtesyManagement techniques and communication Management techniques and communication with employeeswith employeesHospital based scholarship programsHospital based scholarship programsState society scholarships (vendor support? State society scholarships (vendor support? State seminars just for students.State seminars just for students.

Credentialing - ProblemsCredentialing - Problems

Graduates from advanced level programs Graduates from advanced level programs are not taking the RRT and CS.are not taking the RRT and CS.CRT and RRT receive same pay in many CRT and RRT receive same pay in many institutions. Pay less and get the most.institutions. Pay less and get the most.Little or no differentiation in clinical role Little or no differentiation in clinical role between the two credentials.between the two credentials.Test preparation may be deficient.Test preparation may be deficient.Expense an issue for some. Expense an issue for some.

Issues in TeachingIssues in Teaching• Discrepancies between book way and the

hospital way.• Staff is torn between teaching and workload –

what is the priority. (The patient. Who is paying? Clearly define roles)

• Improper use of technology.• Student lack of professionalism and work ethics.• Communication is No. 1 problem—unclear

expectations.• Rewards for both students and staff?• 50-50 responsibility (school-hospitals) – or who

teaches and who pays. ($)

Issues/Problems in TeachingIssues/Problems in Teaching

• Using students as free labor.• Difficulty in accommodating students.• Lack of desire/time of hospital staff to be

instructors.

Teaching -- SolutionsTeaching -- Solutions• Books, in general, try to be well references and

evidence based – they represent the ideal. Hospital practice expedites delivery of health care requiring modification of the ideal.

• Students give incomplete information which results in communication conflicts between staff and program faculty, which may never be true or be verbalized. Nip it in the bud.

• Provide clinical staff lectures and bring them into labs? –CEUs, new techniques, etc. Also train preceptors using inter-rater reliability.

Teaching -- SolutionsTeaching -- Solutions

• Bring in vendors for lectures/labs – staff and students.

• Schools responsibility to give objectives (communication) and hospital to ask what else student’s need (communication). Improve contact between DCE and clinical instructors.

Solutions in TeachingSolutions in Teaching

• Role model preceptors.• Scholarships.• Creating a professional clinical

environment.• Adequate training for clinical instructors.

Staff may be interested, but not fundamentally prepared to teach.

Solutions in TeachingSolutions in Teaching

• Hospital director should take ownership of the process.

• Program faculty need to set clear expectations for students and make clinical instructors aware of them (communication).

• Consider liability issues – student gets workload, staff takes a coffee break, something goes wrong…

• Consider how the students are grouped: all at the same level or bright ones with slower ones.

Teaching SolutionsTeaching Solutions

• Send educators through clinical rotations with students or work PRN every month or so.

• School responsibility is didactic and hands on• Hospitals responsibility is to refine skills, train in

department and hospital organization, learn time management, etc.

• Management’s responsibility to welcome students, provides model for staff behavior.

Possible Solutions-Two CredentialsPossible Solutions-Two CredentialsReview the difference between the two Review the difference between the two credentials.credentials.Use self-assessment exam prior to actual Use self-assessment exam prior to actual computer exam.computer exam.Reduce the cost or ask for subsidy from hospital Reduce the cost or ask for subsidy from hospital or school (program expense?)or school (program expense?)RC Department to impose a time frame for RC Department to impose a time frame for passing or reduce pay or terminate.passing or reduce pay or terminate.Celebrate the RRT at the hospital level.Celebrate the RRT at the hospital level.Schools promote the advanced level.Schools promote the advanced level.Vary the job differences: CRT floor care and Vary the job differences: CRT floor care and RRT unit or specialty areas.RRT unit or specialty areas.

Compensation Compensation

Compensation for clinical instruction Compensation for clinical instruction (hospital provided).(hospital provided).Compensation for students.Compensation for students.Compensation for educators (school)Compensation for educators (school)

Compensation for clinical Compensation for clinical instruction.instruction.

Monetary compensationMonetary compensation– Paid by schoolPaid by school– Merit pay by employersMerit pay by employersProvide CEUs to staffProvide CEUs to staffInstructors gain CEUs for teachingInstructors gain CEUs for teachingTuition reimbursement or using school Tuition reimbursement or using school facilities, fitness facilities, libraries, as a way facilities, fitness facilities, libraries, as a way to repay hospital staff.to repay hospital staff.RecognitionRecognition– AwardsAwards– Job titlesJob titles

Compensation for StudentsCompensation for Students

Preview employment setting – specialty Preview employment setting – specialty areas.areas.Job offersJob offersScholarshipsScholarshipsEquipment donations from hospitals to Equipment donations from hospitals to school labsschool labsDistant sites provide some housing Distant sites provide some housing arrangements.arrangements.

Compensation for EducatorsCompensation for Educators

Get studentsGet studentsGet equipmentGet equipmentCEUs from hospital-based presentationsCEUs from hospital-based presentationsClinical Instructors may be groomed for future Clinical Instructors may be groomed for future teaching positions at schools.teaching positions at schools.

• Dangerous –“Should you be eating that?!”

• Safer –“You know, there are a lot of apples left.”

• Safest –“Can I get you a glass of wine with that?”

Guide for Husband-to-Wife Communication

Protocols - Problems• Problems related to differentiating

between protocols and procedures.• Differences between what protocols

hospitals implement and what students are learning.

• Lack of communication between managers and educators regarding protocols.

• Patient assessment skills and critical thinking skills are needed. Students need to be independent thinkers.• For that matter, so do staff.

Protocols - Definitions• Definition from Carl Mottram• Procedure

• One person• Defined start and stop time• One task without a long process

• Protocol• More than one person• Across a time span• Several activities• Flow chart

Protocols - Solutions• Differentiate between what protocols

hospitals implement and what students are learning.

• Hospitals need to implement protocols and staff need to follow them.

• Protocols must be reinforced in both settings.

• Clinical Instructors must be aware of protocols and how to use them.

Protocols - Solutions• Staff therapists must reinforce protocols

with students as being important.• Students (and staff) need to be

independent thinkers.• These skills must be taught from the

beginning of the program and reinforced throughout.

• Skills need to be reinforced in the clinical setting with both staff and students

Protocols• Developing/coaching critical thinking

and decision making in students. • Increased responsibilities and

independence• Reinforce correct decision making• Quality of students – raise the standards• Weave critical thinking into all didactic

courses • Leads to self confidence.

Protocols• Communication and team work

from preceptors and school faculty using the best individual resources.

• Teach and reinforce interdisciplinary team work and communication

Protocols• Combine book knowledge and real life

experience: combine strong didactics with time management/realistic workloads.

• Learning and developing individual styles and workflows

• Rotate students through multiple preceptors to show different styles and different workflows.

In Conclusions – Hang in thereIn Conclusions – Hang in there

Remember the lessons you learned in Remember the lessons you learned in kindergardenkindergardenBe nice to each otherBe nice to each otherShare your toysShare your toysAnd hang in thereAnd hang in there