Retention remedy: Building a sense of community through appreciative inquiry

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Retaining qualified nurses can sometimes be as challenging as it's important. As the pool of available nurses gets younger and less experienced, finding creative ways to keep current staff employed becomes more meaningful. Nurses with even a few years of experience on a unit become the leaders and mentors for new hires.
The literature reports that an environment providing self-scheduling, career development opportunities, participation in decision making, and Magnet® recognition can bolster staff retention.1-3 However, sometimes even these tactics aren't enough. This was the case in the clinical float pool of one hospital. Despite having an environment that embraced the critical elements listed above, the clinical float pool was experiencing a 27% nursing turnover rate. Leadership opted to approach engagement and retention by creating a sense of community within the department.
Sense of community is a term often used in relation to a geographic area, such as a town or city, but this concept encompasses much more than location and can be extended to include the work environment and relationships one builds with coworkers. Evidence shows that feeling connected to a work “community” may lead to improved organizational outcomes.4 Feeling a sense of community at work can provide the context for innovation, acceptance, and forward motion during times of change.5 In healthcare organizations, this may easily translate into greater nursing satisfaction and improved staff retention.
Sense of community on a nursing unit can be a reflection of the interpersonal relationships formed between staff members. On some nursing units, such as the clinical float pool, robust workplace relationships may be difficult to achieve. A clinical float pool encourages nurses to develop self-motivation, independence, and an extreme flexibility that may not be required, or even desired, on other types of nursing units. Float pool nurses often work alongside staff members with whom they've had no other relationship. Because a sense of community leads to greater innovation, a more positive environment, and better coping behaviors, it's an important concept to consider in any work environment, but may be of particular benefit in a transient environment such as the float pool.6
Appreciative inquiry (AI) is an organizational development tool that encourages evolution toward a better work environment by capitalizing on the innovation and positive energy already present.7 AI provides a structured approach to evaluating the current circumstances, identifying the positive that already exists, and utilizing the positive-present to build a desirable future.
A project was undertaken in the clinical float pool to determine if AI could provide a framework for improving sense of community and, if so, whether a heightened sense of community would lead to improved intent to stay employed.
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