Relationships and retention: The staff nurse perspective
Maintaining adequate numbers of competently trained registered nurses at the bedside is a critical imperative for nursing leaders given the scope of the anticipated nursing shortage. New retention strategies will be needed to effectively respond in a manner that protects the health and safety of the American public. The purpose of this study was to examine the experiences of staff nurses (SNs) with their nurse managers (NMs) using hermeneutic phenomenology as the philosophical framework. Semi-structured interviews with 19 SNs employed at a large academic medical facility specializing in cancer care were conducted to identify major relational themes.
A wide range of experiences were found to exist and were best depicted in a framework described as The Dance. The Tango typified the Engaged nurse interacting with an Exceptional or Competent NM. This pair was tightly connected and all respondents believed their relationship challenged them to be a better nurse and influenced their decision to stay in their current position. Nurses in a Connected relationship worked with a manager they respected; however, the relationship worked because the NM provided something the nurse needed and valued. This relationship was best described as a Waltz and a helpful rather than influential theme characterized the interactions. Parallel participants viewed their relationship from a position of neutrality and the Twist was used to describe this virtually non-existent relationship. Retention decisions were guided principally by factors external to the NM/SN relationship. Mismatched participants danced a Solo dance and struggled to maintain a relationship based on unresolved issues and stayed despite significant personal and professional distress.
The findings suggest the significance of the NM/SN relationship has a degree of variability and regardless of the relational association all the respondents viewed a positive relationship with their NM as important. However, for the majority of the participants retention decisions were attributed to a variety of personal and professional development factors and not the relationship with their NM. Leadership behaviors, management style, and the quality of nursing leadership were found to have an impact but ultimately, The Dance continued because the needs of the nurse were being met.