Emergency Department: Retention and Recruiting Strategies Matrix

Type of retention strategy Benefits of using this strategy Challenges of using this strategy Evidence-based Reference
Employee Recognition Available literature demonstrates that “when people are recognized for their contributions and feel valued by their organization, they tend to feel satisfied and engaged, increasing the odds they will stay in their current role” (Lefton, 2012, p. 332). This strategy not only makes nurses increase their engagement with the organization and its leadership but also enhances their motivation, job performance, self-esteem, commitment, and inspiration. It may be challenging to identify specific behavioral patterns that are associated with extraordinary nursing due to the lack of guiding principles and policies in healthcare contexts. Additionally, the strategy may occasion with feelings of frustration, anxiety, and despair among nurses who are not selected for the recognition awards, leading to poor working relationships. Lefton (2012)
Nurse Empowerment Healthcare organizations can empower their staff by “implementing organizational strategies that support shared team governance, open leadership communication, and supportive and empathetic nursing team relationships” (Linnen & Rowley, 2014, p. 45). Shared team governance and decision making is likely to reduce work overload in the specialty area by virtue of considering the needs and expectations of nurses, while open leadership communication has the capacity to address the issue of poor management leadership This strategy is dependent on the willingness of the nurse manager to effect changes and strategies that could be used to empower nurses in practice settings. Additionally, the strategy may be limited by factors such as nurse shortage, racial considerations, supervisor support, as well as hospital-based structural deficiencies. Chaudhuri, Yealts, and Cready (2013); Linnen and Rowley (2014)
Employee Rewards System Healthcare organizations that use extrinsic and intrinsic rewards to adequately compensate their employees based on factors such as merit and workload often record low incidences of turnover and absenteeism. A good employee rewards system not only enhances the performance and motivation of workers but also increases their loyalty and commitment to the organization. Additionally, research is consistent that non-monetary rewards have the capacity to attract and retain top-performing nurses. This strategy may be costly to implement due to monetary-based rewards. Additionally, it has the potential to strain interpersonal relationships and cause conflicts in the workplace if nurse managers do not take the initiative to explain the criteria for rewarding productivity or exemplary performance. Lastly, research shows that employees are motivated by different rewards. Hence it may be difficult to implement the strategy due to a lack of background knowledge on person-specific motivational factors. Rhodes, Bechtle, & McNett (2015); Tourangeau et al. (2014)
Training and Development This strategy attracts and retains high-performing employees due to its propensity to develop their potential through in-house training, public seminars, executive education seminars, and e-learning. This strategy not only increases group interaction and motivation but also provides employees with the opportunity to network with their peers and share ideas. Additionally, it enables nurses to develop critical skills that are, in turn, utilized in practice settings to improve organizational and patient outcomes. This strategy requires substantial administrative support and funding. Hence it may be difficult to implement in the absence of supportive work environments. Additionally, some forms of in-house training and public seminars are unable to impart relevant knowledge to nursing attendees due to their generalized nature. Lastly, strategies such as e-learning depend on self-motivation to succeed due to the absence of human interaction and direct instructor involvement, meaning that nurses with low motivation and self-efficacy beliefs are less likely to benefit. Cleary, Horsfall, Muthulakshmi, Happell, and Hunt (2013); Paplanus, Bartley-Daniele, and Mitra (2014)


Chaudhuri, T., Yealts, D.E., & Cready, A. (2013). Nurse aid decision making in nursing homes: Factors affecting empowerment. Journal of Clinical Nursing, 22(17-18), 2572-2585.

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Cleary, M., Horsfall, J., Muthulakshmi, P., Happell, B., & Hunt, G.E. (2013). Career development: Graduate nurse views. Journal of Clinical Nursing, 22(17/18), 2605-2613.

Lefton, C. (2012). Strengthening the workforce through meaningful recognition. Nursing Economic$, 30(6), 331-355.

Linnen, D., & Rowley, A. (2014). Encouraging clinical nurse empowerment. Nursing Management, 45(2), 44-47.

Paplanus, L.M., Bartley-Daniele, P., & Mistra, K.S. (2014). Knowledge translation: A nurse practitioner clinical ladder advancement program in a university-affiliated, integrated medical center. Journal of American Association of Nurse Practitioners, 26(8), 424-437.

Rhodes, C.A., Bechtle, M., & McNett, M. (2015). An incentive pay plan for advanced practice registered nurses: Impact on provider and organizational outcomes. Nursing Economic$, 33(3), 125-132.

Tourangeau, A., Patterson, E., Rowe, A., Saari, M., Thomson, H., McDonald, D.,…Squires, M. (2014). Factors influencing home care nurse intention to remain employed. Journal of Nursing Management, 22(8), 1015-1026.

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