As a teenager, I worked at a dry cleaner and thought college was impossible for a two-time high school dropout like me. The owners treated me like family, and I enjoyed working there. One evening, the owner, Madeline, told me she was happy I was working for her but wanted me to have more, and we began discussing my interests and future goals. She showed me how much she cared by taking time to have additional chats like this during walks or over lunch. This interaction shaped my future leadership style with supporting my employees.
During the pandemic, leaders took on a new role: We became firefighters! The chief nursing officer supported and mentored our leadership team to combat the fires together, but each was a new blaze that added to the daily challenges of watching patients die and seeing our staff burn out. The team fought psychologically and emotionally each shift. After watching nurse managers and staff relationships deteriorate due to mistrust and lack of answers, it became apparent that we needed to reconnect and rebuild trust once the fire settled. Despite the daily struggle with patient placement, staffing, shortage of supplies, and decreased funds, it was time to prioritize our focus and rebuild relationships.
A nurse manager myself, I worked with two hospital senior nursing leaders to implement “stay interviews” to build trusting nurse-manager relationships, increase retention, and decrease turnover. I was grateful that this organization encouraged innovation and collaboration for this to supplement the other efforts. I'm usually a "fly by the seat of my pants" kind of woman, but I realized quickly I had to teach myself and other organization leaders how to conduct a stay interview to be successful. Many leaders were not familiar with stay interviews or how to conduct them. Essentially, they are the opposite of exit interviews. Managers discuss why employees are staying rather than human resources inquiring why they are leaving. Three things were essential to set the tone for the stay interview.
1. Communication of the “why” to connect with the cause and get buy-in.
2. Dedicate uninterrupted time. Block your calendars and put your cell phones on silent.
3. Be ready to listen to the employee's concerns, ideas, and desires without interrupting them.
What questions should you ask in a stay interview and when should you do them? The interviews focus on what's essential to the employee, not performance or departmental needs. Four quarterly check-ins per year are reasonable to meet with a large team. Conducting two annual check-ins focusing on performance and two stay interviews allowed me to meet with the employee for at least 30 minutes on a quarterly basis. The initial stay interviews focused on low-performing areas identified by the hospital's employee engagement or pulse survey scores. Subsequent stay interview questions were different based on the recent engagement data.
The interviews were not a secret, and a lot of communication helped the employees and leaders get ready for check-ins. It was shared in huddles, emails, and meetings that they were coming and the why behind it. Leaders were educated on the "why," and how the data showed our employees were unhappy, and the stay interview allowed us time to ask our employees questions to figure out how to address their concerns and desires for growth instead of waiting for them to leave the organization.
I recommend starting with an engaged employee, as this process is new and unfamiliar. Engaged workers shared more ideas, and the flow of questions was easier. After the stay interviews with high achievers, I interviewed those who might leave, followed by the remaining staff. I interviewed in my office or outside, wherever I could find a quiet place without interruptions. I took a walk outside with some of my staff who were at risk of leaving, which allowed their energy to be focused on their concerns and helped remove the emotions associated with them. Many employees shared personal and family issues. Having a file folder with copies of resources (tuition assistance, employee assistance program, wellness support, etc.) was helpful and appreciated.
I began each interview with a question that promoted a positive reflection: "What do you like most about working here?" Most people said, "My team." I became comfortable probing deeper with the remaining four structured, open-ended questions. A great example from probing came from an employee who said she couldn't complete her work on time. Her frustration was assumed to be related to the department's increased volume, but probing deeper revealed that there were regular interruptions in workflow due to phone calls from other departments, and she had to stop what she was doing to answer the calls. After learning that the workload wasn't as overwhelming as expected, but a process was interrupting her workflow, we created a plan to standardize addressing phone calls and escalation of stat calls. This was shared with the nursing leaders and staff. She had considered resigning but is now thriving.
I'm not saying every interview was perfect, but I did learn a lot! Most employees were receptive, and I was able to focus on concerns I could control and escalate those beyond my control. The key for me was getting comfortable with hearing responses to questions that I maybe wanted to avoid hearing. A valuable takeaway was to learn to listen with my ears and not respond with my mouth.
Hearing what was essential to some was, at times, quite different from what was important to me or what I thought the unit needed. Most days I felt like a firefighter, but the staff said they felt supported. A realization came over me that some staff were on the way to recovery and getting back to normal. I was prepared to support them during the stay interview, but in reality, some of them supported me and provided a positive forecast on the status of our team.
To build trust, I closed the stay interview with a summary of an employee's concern and our conversation to ensure communication was clear, and we had a plan. Sharing strategies for addressing concerns, and growth and development opportunities (shadowing in other areas, shift change, etc.) with a follow-up date ensured closed-looped communication. Following up on tasks showed the employee I was listening. No silver bullet exists to address retention and satisfaction, so customized action plans were vital.
Overall, the stay interviews were effective, and I’m grateful for my evenings as a high school student with Madeline, as her leadership style has stayed with me long after her passing. I hope the stay interviews have the same impact on my staff.
Michelle Panock, DNP, RN, NEA-BC, CNL, is a nurse manager at Loyola University Medical Center and a member of Sigma’s Gamma Phi Chapter.