At the beginning of my recruitment career we were retained by a Top 10 Medical Center to recruit for PICU, NICU and CICU Registered Nurses (RN’s). The recruitment effort was in a large part due to adding beds and a mandate from the medical staff to recruit, “the best and the brightest RN’s.” The result, was an epic failure.
Whether recruiting for highly qualified Staff RN’s or CEO’s- Stakeholders and Boards gravitate towards the most qualified candidates and for good reason. The problem arises when the organization gets exactly what it asked for.
A hospital in turnaround mode or just bleeding cash may hire the former CFO turned CEO who turns nonprofit hospitals into money making machines going from 30 days cash on hand to 182 days in a single fiscal year or builds the new hospital by finally passing the controversial bond measure. Or well-intended HR departments may hire the RN with a plethora of certifications and critical thinking skills feeling optimistic at future feedback from an appreciative medical staff.
The problem arises when the candidate, the smart and highly capable candidate, starts doing his or her respective job. Rarely do we see around the bend of hiring ‘best in class’ and ask ourselves the question, “What happens when we get what we want?”
What happens when the intelligent and experienced RN questions a physician’s orders? What happens when the capable CEO starts to renegotiate physician contracts or suggests a RIF to the Board of Directors?
So often we want the “Best in Class” Candidate and so often we’re ill prepared to manage the relationship post hire.
Involving the stakeholders most likely to find conflict when the candidate starts doing his job is essential to ensuring a successful hire.
Medical staff should be involved in hiring RN’s – From creating the screening questions to utilize in the HR vetting process or in the video interview process allowing physicians to create a pivot point for the interview conversation. For example; share the last time you called a physician after hours to clarify or question his orders for patient. What was the situation, how did the physician respond and what was the outcome?
Senior leadership and Boards can ensure they’re prepared for the C-Suite candidate they hire by giving pause to the interview process during the onsite. In-person conversations (not regulated to the standard 45-minute block) regarding past experiences and hypotheticals based on the current challenges the new C-Suite executive will encounter lay the groundwork for understanding how the candidate will do his job.f And how he will handle the consequences of raising the bar or just carrying out the expectations of the leadership.
For the hospital with an aging medical staff or the organization with a dysfunctional, yet beloved finance department; discussion regarding the EI /Emotional Intelligence, likely outcomes, and pushbacks from staff and community alike are an essential part of the interview conversation.
As for the Top 10 Medical Center? After the first round of hiring, firings and resignations- All hiring at the medical center ceased for 30 days. The medical staff was given two choices- Continue the current recruitment path or continue the path while allowing HR to create a college recruitment program. The medical staff chose the latter assuming working with RN’s earlier in their careers could create better working relationships. In short, they became invested in the hiring and retention process.
The result? The majority of the Best in Class RN’s were quickly promoted to management and knowing the temperament of the medical staff created a successful preceptorship program with retention exceeding the previous norms.
Hiring the Best in Class Candidate is an easy win for any healthcare organization when the stakeholders ask the right questions before hire.