Workforce shortages, burnout, and soaring costs are pressing issues for nurse leaders. In an effort to address workforce issues, the American Organization for Nursing Leadership (AONL) led a nationwide strategic initiative over 6 months in 2022 to cull best practices and strategies for nurse leaders. AONL and the AONL Workforce Committee, a volunteer group of national experts, accomplished 2 key objectives during this time. First, they gained keen insights from nurse leaders through 2 nationwide surveys. Second, they collected practice-led initiatives, which often are not included in searchable peer-reviewed literature. These practices were gathered in a compendium, organized into 7 sections. This article summarizes topics from the compendium, which was designed to assist nurse leaders as they seek to create the best environments for nursing professionals. The compendium is available on the AONL website at http://aonl.org/compendium.
Talent Attraction and Acquisition
With fluctuations and shortages in the nursing workforce, organizations need to use the right innovative strategies to attract and acquire desirable candidates. This begins with nurse leaders collaborating with talent acquisition professionals to ensure that nursing professionals with the right skill sets apply. Working together, they should clearly define the scope of experience and education, job responsibilities and work area, and culture. Effective preboarding and onboarding processes need to be in place. Talent can be more effectively attracted and acquired if the process is done quickly and intentionally. These conclusions were supported by findings from AONL research indicating streamlined processes for recruiting, hiring, and onboarding that shortened the time between application and offer supported effectual and meaningful interactions with candidates.
Recruitment and Retention
Fluctuations in staffing, patient volumes, and reimbursement have challenged the well-being of staff and leaders. Findings from AONL research indicates that with the limited time that nurse managers have, they need productive meetings, support to do the "right work," flexible schedules, and support for work-life balance. Job satisfaction and emotional health are adversely affected by inadequate compensation, staffing shortages, increases in span of control, bullying and incivility, and the amount of time spent on administrative work, such as scheduling and payroll tasks. Practice-based solutions to improve recruitment and retention include team-based leadership; recruitment and retention initiatives sensitive to geography, facility size, clinical area, and organizational culture; centralized staffing and scheduling when possible; effective delegation; and team-based leadership.
Leadership
Relationship building with individuals and teams predicates the nurse leader's effectiveness in influencing individuals to work together to achieve common goals. AONL research indicates that nurse leaders who feel comfortable sharing ideas with their leaders are motivated to influence and drive change, take risks to improve patient care, and advocate for their teams. To inspire and motivate the nurse workforce, leaders need to be present, willing to listen, open to new ideas, and be honest and transparent. Given the complex demands on nurse leaders, particularly nurse managers, it is critical that they receive support from peers, team members, supervisees, and the organization. It is also important that nurse leaders are well-prepared and given the opportunity for professional growth and development. Nurse leaders need to be accountable for boundary setting, using staffing and scheduling best practices, and developing and redefining professional identity within their leadership role, and facilitating a culture for everyone to do their best work. Exemplars in the compendium show both how to develop relational capabilities and ways to ensure nurse leaders have time to practice them.
Positive Practice Environment
A healthy workplace environment fosters growth, safety, and health of nurse leaders. Nurse leaders can thrive when they are empowered and engaged and have effective interpersonal relationships. Creating and nurturing positive practice environments can occur only when healthcare leaders put forth ongoing effort and emphasis. AONL research indicates that organization culture is the most essential component in creating a positive practice environment. These best practices presented in this section focus on areas that nurture a healthy, positive practice environment for nurse leaders including building the culture and environment; creating opportunities for engagement, recognition and appreciation; fostering wellness and well-being; and introducing innovative care models.
Academic-Practice Partnerships
The educational, practice, and research processes in nursing involve academic-practice or academic-service partnerships. Although these partnerships vary in their depth and breadth, they have provided solutions to meet both patient and student needs. These partnerships also can provide opportunities for students, improve staff retention, and promote clinical inquiry. However, AONL research indicates that these partnerships can be further developed to ensure a talent pipeline and improve the quality and practice readiness of graduates. Most importantly, current collaborations can learn from partnerships that have grown and strengthened over time. These strong partnerships have provided collaborative opportunities to augment available resources and have improved both graduating nurse and clinical outcomes.
Culture of Inquiry
Organizations that encourage inquisitiveness, support learning and innovation, and expect evidence-based practice value nurse leaders and the nursing workforce. AONL research indicates that nurse leaders challenge current practices and take risks to enable change when there is leadership support and trust, data and evidence use, and a culture that supports innovation. Working within a culture of inquiry enables leaders to create psychological safety by motivating staff to use design thinking and build connections. This, in turn, enhances nursing leaders' ability to measure organizational impact and facilitate behavior changes within the organization. Promoting a culture of inquiry necessitates implementing best practices for changing organizational culture, leadership abilities, shared/professional governance, and design thinking. Transforming the work environment brings meaning and insight into professional growth and commitment and into practice and patient care.
Total Rewards
Having the right combination of financial compensation, career development/advancement opportunities, meaningful recognition, and self-care/wellness opportunities has proven to both attract and retain nurse leaders. AONL research indicates that nurse leaders also are experiencing burnout and are more likely to remain in their positions when they are offered retention bonuses, flexible scheduling, paid time off, and retirement plans with matching funds. Particularly for nurse managers, it is important to implement best practices including effective communication of the total value of compensation, provide nontraditional incentives (eg, incentive-based bonus plans, hybrid work schedules, opportunities to work from home), and provide administrative support for nurse managers to remove burdensome administrative tasks.