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How nurses may be impeding recruitment and retention

  
https://www.infirmiere-canadienne.com/blogs/ic-contenu/2024/10/01/infirmier-entraver-recrutement-maintien-poste

If you help spread the ‘hidden curriculum,’ you’re part of the problem

By Kathy Arseneau
October 1, 2024
istockphoto.com/LeoPatrizi
Discouraging others from entering a profession that is in dire need of people has brought forth new challenges for health-care organizations and the nursing occupation itself.

“Whenever someone tells me that they are going into nursing I just look at them and say, ‘Are you crazy?’ I’d never tell anyone to do that.”

Courtesy of Kathy Arseneau
“Nurses themselves have the power to influence the future of nursing,” Kathy Arseneau says.

I have heard this reaction many times from nurses on the front lines who have endured the strains of an ongoing nursing shortage, a global pandemic, and extremely high workloads. Can we blame nurses for feeling this way?

Absolutely not. While many people were able to pivot to a virtual work world within the comforts of their home during the pandemic (“Another morning latte from my new cappuccino maker I ordered off Amazon, anyone?”), nurses were stepping into the unknown armed with limited resources, dwindling staff, and policies that changed daily — sometimes hourly.

Fast-forward to the pandemic stabilizing, and we are still enduring a significant nursing shortage. When asked what can improve our current nursing landscape, undoubtedly nurses respond with, “More nurses.” Agreed; but how do we recruit and retain nurses when the profession itself seemingly tells people to run the other way? Discouraging others from entering a profession that is in dire need of people has brought forth new challenges for health-care organizations and the nursing occupation itself.

This phenomenon can be linked to a concept known as the “hidden curriculum” that exists within all professions. Hidden curriculum is defined as the unintentional teachings that are portrayed to others through attitudes, values, and actions in the workplace. It exists in every discipline, and its effects can be either beneficial or detrimental to work environments and professions.

Often, hidden curriculum is referenced by educators to describe the contrasting differences between the formal education that students receive from institutions (university and college curriculums) as opposed to the informal education that students/nurses receive by way of interactions that take place at the nurses’ station, in the cafeteria, or in hallways.

However, hidden curriculum also manifests in the workplace: it can tarnish the professional image of nursing, deterring people from the profession or causing them to leave it altogether. The image of nurses becomes negative by way of those currently employed in the field who discourage others from entering it. It can be revealed through such statements as:

  • “If I were young and unattached, I’d be doing travel nursing, not wasting my time here.”
  • “Why did you ever decide to go into nursing? If I were you, I’d switch to something else.”
  • “If I had to do it all over again, I’d never have gone into nursing. Get out while you can.”

Why should we care about this?

Nurses form the majority of staff within health-care organizations. This means that not only do nurses play a pivotal role in the provision of care, but they are also instrumental in influencing and shaping the future of nursing.

When nurses display professionalism and pride in their career, it raises the standards of nursing as a profession; this, in turn, can encourage others to enter the field, or stay in it. We desperately need such encouragement right now.

Hidden curriculum is more powerful and memorable than any flashy recruiting ad. No advertising campaign can effectively encourage people to join a profession when its members are telling them to stay away.

Nurses themselves have the power to influence the future of nursing. They can exert this power positively by encouraging others entering the field to improve working conditions and the image of nursing as a profession. No one can promote nursing better than nurses themselves.

Research tells us that hidden curriculum is what most strongly influences professionalism, the very thing that is critical for creating a positive image and attracting others to a profession. When hidden curriculum is negative, it can lead to the abandonment of professionalism, deteriorate workplace culture, and create undesirable images of the profession. All this makes the recruitment and retention of nurses more difficult.

Although hidden curriculum runs subtly below the surface, its impact can be far reaching and devastating: “Iceberg, dead ahead!”

We cannot deny that working conditions for nurses are difficult and challenging, nor can we dismiss how nurses feel. Their feelings are valid, and they deserve better. However, if we agree that the solution to improving working conditions is having more nurses, then why do we so vehemently discourage others from coming aboard?

Much of nursing education is obtained through observational learning, whether learning to insert an IV or packing a wound — we “watch, then do” as we gain our professional competencies. Observational learning is also one of the best tools we have to amplify the recruitment and retention of nurses — it is what others observe and hear from those already in the profession that will have the biggest impact on prospective applicants. If you tell them not to enter, they will listen.

Nursing is one of the most respected and trusted professions in the world. By the very nature of our work, we are always teaching, whether formally or informally, through a hidden curriculum.

Will what you teach be helpful or detrimental to the profession?


Kathy Arseneau, LPN, BA, M.Ed., is a regional model of care coordinator living and working in Fredericton, N.B. She promotes care models that are rooted in strong collaboration and scope optimization to ensure optimal patient outcomes.

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#career-stage
#covid-19
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#nursing-practice
#professionalism
#recruitment-and-retention