Overcoming Obstacles: Addressing Common Challenges of Securing Nurse Leadership in the Cardiovascular Setting

Is your organization currently seeking a cardiovascular nurse manager? If so, you are not alone! Over the past few years, Corazon has found that the cardiovascular nurse manager role, both in the cath lab and the cardiovascular ICU setting, is a position that organizations commonly have difficulty securing. In fact, while Corazon’s recruitment team places service line administrators, physicians, and nurse leaders across three different service lines, cardiovascular nurse managers represent almost 25% of the inquiries/requests we have recently received. Often we receive a request for assistance with recruitment after an organization has exhausted all of their “usual” internal recruitment resources with no success.  The cardiovascular nurse manager role has proven to be quite challenging to fill, and we believe this is a result of several combined factors related to the economy, relocation, and the nursing shortage. 

In searching for “cath lab manager” jobs within a common Internet job board (SimplyHired.com,) 7,845 jobs were produced, and according to SimplyHired’s tracking of job trends, there was an 8% increase in “cath lab manager” jobs between October 2011 and September 2012 (Figure 1).¹ 

With the increase in demand, these roles have become more and more challenging to fill. Recruitment efforts can frequently go on for 6-12 months, sometimes even longer, before the role is filled. In communicating with potential cardiovascular nurse manager candidates while seeking to fill these positions, we have identified some common obstacles in recruiting for these roles. Recognizing the significant impact these obstacles can have on a successful recruitment effort, we will suggest some approaches that may be helpful in securing and developing the cardiovascular nursing leadership you need at your organization.

Relocation. One obstacle our recruitment team often encounters is a lack of candidate willingness to relocate. The U.S. Census Bureau conducts the Current Population Survey (CPS), an annual survey of about 50,000 households, for the Bureau of Labor Statistics.² The migration data based on that survey indicate that the nation’s 2010-2011 overall “mover rate” was 11.6%, the lowest ever since first collected by CPS in 1948. In 2012, this number slightly increased, going up to 12%. (Figure 2).  

Not only is the total number of movers low, but of those who are moving, most don’t go very far. In 2012, the majority of people who lived at a different residence one year ago moved within the same county (64.4%).

Among these 11.8 million inter-county movers — defined as “people who moved to another county, either within the same state or to a different state” — the most common distance moved was less than 50 miles (40.2%). Therefore, even though people moved to a different county, the largest percentage did not move far from their previous place of residence.³ 

Consider the actual number of cardiovascular nurse managers currently working within your county or within 50 miles of your organization… That number is likely rather low. If we apply the survey’s statistics to your recruitment, that number represents, at best, over 64% of your candidate pool.  

When the survey looked at the reasons why people move, only 9.7% of the total number of movers moved because of a new job or transfer. Noticeably, very few of those households relocated due to a change of job within healthcare, as only 1.5% of the total number of movers belongs to the industry category of “Education and Health Services” and moved for “new job or transfer.”⁴ Of the 50,000 surveyed households, the actual NUMBER of movers within the combined category of Education and Health Services who moved for a new job or transfer was only 408.  

The nursing shortage. Another possible factor to consider when looking at the challenges to recruiting nurse managers is the oft-discussed, though not always agreed upon, nursing shortage. While some suggest that there is now actually an abundance of nurses, the experts still state that there is a shortage.  According to the American Association of Colleges of Nursing (AACN), nursing is the top occupation in terms of job growth through at least 2020. The AACN believes there is a nursing shortage, especially in the South and West.

The Bureau of Labor Statistics concurs with AACN, with a 2012 jobs report noting, “Employment of registered nurses is expected to grow 26 percent from 2010 to 2020, faster than the average for all occupations.”⁵ Senior Human Resources Representative Ellen McCarthy from Saint Luke’s Hospital in Kansas City, Mo., was quoted in a mid-2012 article from HealthCallings.com, saying, “[W]hat appears to be a nursing glut is a glitch caused by the recession. When the economy turned sour in 2007, in most parts of the country, demand for healthcare services of all types started dropping because those who lost their jobs also lost their health insurance. With less demand, many hospitals were forced to cut staff and increase the patient-to-RN ratio. And, finally, experienced nurses who would have retired didn’t, and/or those who were working part-time went to full-time (often because of a spouse’s job loss).”⁵ 

So, how can your organization secure a qualified candidate for your current or upcoming cardiovascular nurse manager role? While there is no surefire way, there are certainly some approaches that may better the chances of successful recruitment…and retention!

1. ACTIVELY search for qualified candidates. The nurse manager position isn’t one that you can just post on your hospital’s website and passively wait for the applications to start rolling in… You will have to actively seek out candidates. Consider reaching out to professional organizations, leveraging a professional network, advertising in professional publications, utilizing social media, and enlisting the assistance of an outside recruitment firm.  

2. Don’t narrow the candidate pool with overly stringent requirements. If you aren’t prevented from doing so by organizational by-laws or (for example) in order to maintain Magnet certification, don’t exclude candidates based solely on their degrees or specific credentials. While many employers require credentials such as a master’s degree, some of the best, brightest, and most experienced leaders don’t always have those degrees.  Don’t forget the value of experience gained through years of hands-on clinical work, involvement in daily operations and practice, and natural leadership ability. If you can look beyond specific credentials to place your focus on strong talent and leadership, you’ll stand a better chance at finding the ideal candidate to fit the role and hospital or program culture. 

3. Think about a succession plan while you DO have a manager. Identify and recognize the strengths of potential successors, and build a leadership talent pool from within to ensure continuity. Build on their skillsets. If you have a “superstar” staff nurse who hasn’t completed the hospital’s educational requirements for the role, the hospital can be proactive and help nurses acquire the additional education needed. Prepare yourselves for a possible future need before it happens.

4. Consider interim mentorship to develop promising individuals, whether internal or new to the organization. If you didn’t have a succession plan in place, but do have a candidate with the right knowledge and leadership potential, consider bringing in a qualified person to fulfill the role as an interim. The experienced interim can provide mentorship to your manager-in-training and stability to your program overall. An external interim may also be able to introduce your organization to a new or even better way of addressing operational issues, implementing new strategies, or reinvigorating program or team momentum.

With the growing demand for the cardiovascular nurse manager, many organizations are challenged with recruitment. The economy, lack of opportunity for professional or financial advancement, as well as the lack of desire to leave family and friends, are all factors limiting the pool of candidates willing to relocate for new career opportunities.  

Corazon recommends several approaches to address these challenges, including utilizing multiple tactics to source and reach the potential candidate pool; re-evaluating the requirements your organization establishes for the role; developing an internal leadership talent pool as a succession plan; or bringing an external mentor on board to nurture the skillset of either an internal or external candidate.  

With resourcefulness and dedication to either finding a ready candidate or developing the skillset of the right individual, organizations can fill the valuable role of the cardiovascular nurse manager.

Jennifer is a Recruiter at Corazon, Inc., offering consulting, recruitment, interim management, and physician practice & alignment services in the heart, vascular, neuro, and orthopedics specialties for clients across the country and in Canada.  To learn more, visit www.corazoninc.com or call (412) 364-8200. To reach Jennifer, email jwestford@corazoninc.com.   

References

1. Cath Lab Manager Job Trends. SimplyHired.com. Available online at https://www.simplyhired.com/a/jobtrends/trend/q-cath+lab+manager. Accessed May 17, 2013.
2. Current Population Survey. United States Census Bureau. Available online at https://www.census.gov/hhes/migration/data/cps/historical/Figure%20A-1.2.png. Accessed May 1, 2013.
3. Census Bureau Reports National Mover Rate Increases After a Record Low in 2011. United States Census Bureau. Available online at https://www.census.gov/newsroom/releases/archives/mobility_of_the_population/cb12-240.html. Accessed May 1, 2013.
4. Geographical Mobility/Migration. Table 24. Reason for Move of Movers 16 Years and Over, by Household Income in 2011, Labor Force Status, Major Occupation, Group, Major Industry Group, and Type of Move (All Categories): 2011 to 2012. United States Census Bureau. Available online at https://www.census.gov/hhes/migration/data/cps/cps2012.html. Accessed May 17, 2013.
5. Registered Nurses, from the Occupational Outlook Handbook. Bureau of Labor Statistics. Available online at https://www.bls.gov/ooh/healthcare/registered-nurses.htm. Accessed May 17, 2013.
6. Beal E. Is there really a nursing shortage? HealthCallings.com. Available online at https://career-news.healthcallings.com/2012/07/12/is-there-really-a-nursing-shortage. Accessed May 17, 2013.