May 21, 2007, 9:26 pm

Nurse Retention: Say It If It’s Worth Savin’ Me


“Mommy, where do nurses come from?”

“Why dearest, they are grown in cala lillies and when their caps are totally formed they are picked for hospitals.”

“But the caps are all different!”

“Yes, Davy. Each variety has a different cap. You know where they were grown by what their cap looks like.”

“But mommy, how can you tell a boy nurse from a girl nurse?”

“Go ask your father….”


Shameless self-promotion: my column on nursing history is up at Nursing Jobs. org. This is the link to the blog itself, so you can check out my writing colleagues, too!


How important is it to you to have positive feedback about your job?

I don’t mean the yearly evaluation that wants to know if you meet the “Mission Statement”, or evaluates how Joint Commission compliant you are. You know the kind. Check boxes. “Meets Standards.” “Exceeds Standards.”

(I’ve never “exceeded” a single standard. Oh, I “meet” them, but the only areas I’ve ever “exceeded” in are customer service and charting. Customer service is probably because I actually like my patients. The charting is only because I’m anal-retentive with my writing. Lord help those who mess with my charts…)

I’m talking about the “Great job!”, “Nice catch!”, “Good show!”, “You rock!”, “Have you lost weight?” sort of feedback.

Okay. I’m kidding about the losing weight.

But really.

Do you need to hear that you are doing a good job?

Does it matter who gives you the feedback?

Is it more important to hear it from your manager, as opposed to a doctor or a colleague?

And are you more likely to stay in a job if you receive external recognition?


I believe it has to do with the individual.

If someone has less experience in a position, they need more feedback on how they are doing. That feedback could be positive or negative, but it’s the only way to know if the requirements of the position are being met.

To someone with more experience, there is an intrinsic knowledge of a job well done. It has been my observation that someone with experience is more likely to hear when they aren’t performing up to par than to hear kudos when they perform as expected.

Then there are the “off” shifts. Many shifts don’t even see their manager, let alone get feedback on a regular basis.


That’s where our co-workers come in. It’s up to us to give each other feedback. That pat on the back for a difficult IV start. Recognition that the rapport with an angry patient diffused a potentially violent situation. A few high-fives in the break room after a particularly horrendous shift. Some time to recuperate after the death of a patient.

Managers certainly want to support their staff and if you need feedback you can always ask for a conference.

But for me personally, when all said and done it isn’t manager feedback that “retains” me.

What is important is the support of our colleagues, and the occasional “Good work!” from someone who understands the pressures of the job can mean more than any check mark on an evaluation six months hence.

It’s the support, camaraderie and respect that develops between colleagues on a unit that generates the positive feedback that “retains” nurses. We need to take care of each other. No one else knows the pressures we are under.

Foster that supportive environment and you will keep nurses forever.


  • Nursing A Headache

    May 22, 2007 at 8:22 am

    It’s not just on the floor — there are those of us out of the hospital environment facing the same thing. The only time I ever hear anything positive about my work is as a preface to what I’m doing wrong…

  • La Bellota, SN

    May 22, 2007 at 12:20 pm

    So right. Worth more that money. But you didn’t hear it from me ; )

    Seriously, it reminds you of how much you already love what you are doing when you get that little pat on the back.

    I begin a new set of clinicals tonight at 2 different hospitals. I am so excited nervous and scared that I am about to have a fluid volume deficit…. to put it nicely.

  • AlisonH

    May 22, 2007 at 1:00 pm

    Amazing, the power of a few words. When I was in critical condition, I had a conversation with a nurse that made all the difference to both of us in helping us cope with the situation–he in being able to open up about what was hard to him in his work, because of his empathy for his patients, me in seeing him being comforted as I reassured him it was okay. I went back later to that hospital, once I was well, to thank him for helping give meaning to the whole experience for me and for his thereby having made it worth having had to go through that Crohn’s flare.

    Amazing, the power of opening up just a bit.

  • NPs Save Lives

    May 22, 2007 at 7:52 pm

    The feedback I get from my co-workers is great, but what I live for is the “thanks for all you do” from my patients that I take care of. They are the reason I go to work everyday and put up with the backbreaking pace. I will miss the bedside stuff when I start at my new job in the office but I will still be able to make rounds at the hospital. Keep up the great work everyone! Without teamwork, it won’t work!

  • Mother Jones RN

    May 22, 2007 at 8:12 pm

    I don’t need praise from my boss to know that I’m doing a good job. It’s a good thing, too, because the nurses on our unit are never praised. I feel really good when I get positive feedback from coworkers that I respect. It can make all the difference in the world on a bad day.

  • TC

    May 23, 2007 at 8:00 am

    It really makes a difference when you work with great people. I hate those “meets” and “exceeds”, especially because I haven’t met anyone yet who gets “exceeds”, especially in my job, which has merit raises. Getting “exceeds” means you’ll get another 1% on your annual raise, and you bet they’re not giving out that kind of money.

    The best feedback I ever got was from a guy who walked into my ER one day with his son. “Remember me?” he said, “3 months ago I cam in in cardiac arrested and you were my nurse. Thanks for saving my life.” You know in the ER you code a lot of people and most of them don’t make it….I remember that guy every time I get down.

  • EMS Junky

    May 28, 2007 at 12:32 pm

    Wise words.

About Me

My name is Kim, and I'm a nurse in the San Francisco Bay area. I've been a nurse for 33 years; I graduated in 1978 with my ADN. My experience is predominately Emergency and Critical Care, and I have also worked in Psychiatry and Pediatrics. I made the decision to be a nurse back in 1966 at the age of nine...

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