Retaining SANEs

As I mentioned in yesterday's post, not all sustainability issues are about money. Some of them are about staffing. Keeping good people on your roster is one of the biggest challenges for many programs; staff turnover is high in this line of work. So how can we effectively maintain our numbers and stave off the burnout that so frequently contributes to this problem? Here are some suggestions to consider:

  1. Identify the job: A frequent complaint we hear from SANE-trained nurses who don't stay in the field is that they thought the job would be something different. Help set realistic expectations from the get-go by providing a written job description for the position of SANE in your agency. Lay out clear expectations of the role including information like the number of shifts expected each month; attendance at a certain percentage of staff meetings; requirements for continuing education or national certification.
  2. Orient new staff: Trial by fire is not an effective orientation strategy; neither is handing people a packet of information and telling them to call you if they have any questions. Take the time to schedule an hour or two with your new SANE to review the aforementioned job description and role expectations; orient her/him to the equipment, the paperwork and the pager; take some time to talk about the philosophy of your program and answer questions. Is the new staff person someone you've worked with forever in your other job in the ED or on L&D? Remember that this is a totally different gig with a practice much more autonomous than many nursing roles. An orientation is still important. It also allows you the opportunity to discuss the expectations your new SANE has.
  3. Evaluate regularly: This may be a secondary or volunteer position for many people, but they still need to be evaluated as a SANE. Consider evaluation following a probationary period and annual evaluations thereafter. Don't wait to have a conversation about problems until they pile up and overwhelm you--they will overwhelm your SANE, as well and make it challenging to remedy the issues. Likewise, don't take a no-news-is-good-news approach to feedback, either--this can be a very solitary role and it's nice to hear that you're meeting or exceeding expectations. Besides, regular evaluations bolster the professionalism and importance of the role; think about how easy it could be to dismiss a position that isn't even worthy of evaluation.
  4. Reward your staff: We would love to be able to provide regular pay raises and reimbursement for everything from call time to mileage to educational expenses. Realistically, though, most programs don't have that luxury. But you probably do have the luxury to do some small things that can still be meaningful. A gas card or gift certificate for a local restaurant for the nurse that saw the most cases last (month, quarter, year); movie passes for the staff member who recruits the most new SANEs; cupcakes at a staff meeting to celebrate successful completion of certification (or even of clinicals, because you can't tell me that a new SANE on the schedule isn't worthy of celebration). You can probably even get local businesses to donate some of these items. And don't just look to material goods--does your agency have a newsletter? Highlight team members' accomplishments there. Or ask your community paper to write a story about founding staff members in honor of the program's anniversary or Sexual Assault Awareness Month. There's room for creativity.
  5. Provide opportunities for leadership development: There are a lot of ways you can make this possible. Give staff a chance to do some of the community outreach you've been doing yourself. Allow experienced staff to provide the professional education you're asked to provide to law enforcement, EMS or other clinicians. Being asked to write a grant? Ask for volunteers to review the proposal before it goes out. Form a small committee from your team to brainstorm ideas for fundraising opportunities and outline a plan for the coming year's activitities. There are an endless number of ways we can help our team members develop leadership skills, and most of them are free. It helps people feel more invested in the role and in the program, and it has the added bonus of relieving you of some of the time consuming tasks on your plate. Plus it can be a great asset in starting the succession planning you've been putting off...

Do you have some creative suggestions for retaining good SANEs? Please let us know about them in the Comments!


Submitted by LindaRossman on

One approach we have taken toward retention of nurses in our program is pay increases related to experience. While they are "shadowing" they are paid X amount/case, when they are independent they receive X amount/case, after they complete their first independent year they receive X amount/case, after 100 cases they receive X amount/case. Each pay raise is $25/case . It's not a huge incentive but it helps retain some of our most experienced nurses (300+ exams) even if they want to cut back on the on-call schedule for awhile.

If your program only has a certain amount of money to pay for exams, perhaps establishing a similar scale with that money could be a way of rewarding and retaining experienced nurses in addition to the small things Jen talked about that are invaluable to retention.