by Chad Harrington
17 June 2015


Few people could say more about retaining nurses in Nashville than senior corporate healthcare recruiter Mitchell Bush. The need to retain nurses comes from a shortage of experienced nurses: “When people say, ‘There’s a nursing shortage,’ I agree with that, but there’s an experienced nursing shortage.”

Bush has a solution, and if implemented, it could change the industry as a whole—here and across the country—because great nurses are a key component of a flourishing healthcare industry.

Bush’s career over the last 11 years has focused on placing nursing candidates at hospitals throughout the Greater Nashville Area. Quick stat: Ninety percent of the candidates he sets up for interviews get hired, so he’s doing something right.

Bush is a humble man who cares about making solid hires. His reputation depends on it. If he makes a bad recommendation, his name is on the line, because he works in one location as an on-site, internal or “corporate” recruiter. This is the reason reputation and quality are a huge deal.

More than a decade of doing the same thing in the same place gives one a reputation, no doubt. Aspire Health recently brought Bush on, where he’ll be implementing his solutions to the nursing shortage.

He said Nashville is “just now at the pain point where this needs to happen.” Change needs to happen, and HR managers, recruiters, and nurses can be the change.

The Problem: Not Enough Experienced Nurses

Bush said the U.S. is struggling as a whole: “Nashville is a healthcare mecca, so it’s more concentrated here. We feel it more.”

Bush gave five reasons for the nursing shortage:

  1. Retiring nurses.
  2. Inexperienced, new nurses. Bush says their cost to train is easily equal to their annual salary, causing a financial strain and time barrier.
  3. The exodus of experienced nurses into teaching or other non-bedside roles.
  4. The inherent difficulties of nursing, including the physicality required in the role that often causes nurses to prematurely exit direct patient care.
  5. Night shifts.

The nursing shortage spreads far beyond Nashville, though; it is nation-wide, as Vignesh Ramachandran reports for USA Today: “Between now and 2022, not only will there be an expected half-million nursing jobs from growing demand — but also another half-million nurses will retire and need to be replaced.”

A Key Solution: Career Planning

Many solutions exist out there, but Mitchell Bush has one idea that lies at the very heart of the issue: a career path. The “career path” Bush has created provides a simple, cost-effective method for retention. The goal, Bush says, is retention and career path planning is a key solution:

Truth is that after nurses have paid their dues in night shifting and get through their first few months, they are a hot commodity and ready to relocate for bigger and better opportunities. At that point, Bush says to nurses, “Everybody in the country will want you.”

How To Retain New Nurses

Bush says a great solution is career planning from day one. He doesn’t pretend to innovate a brand new idea: “Retaining people is not new and having concern for your employees is not new; this is just making it very, very real and concrete, and that’s what these new grads want. They want concrete; they want to know that there’s a plan, and they want to be able to look at it.”

What Is The “Career Path”?

Bush describes his career path idea: “It asks them several simple questions about their goals, what they want to do, what they really think at that point they want to do in nursing, what certifications they want to get, what specialty they want to get in and that kind of thing.”

They start the career path document while onboarding, then pass it along to HR, and finally give it to their floor manager who can stay with them until their next step.

How Does The “Career Path” Retain Nurses?

“This is one of the things. I mean, it’s not the end-all, be-all, and it’s not going to work all the time, but by and large when these inexperienced people know that the hospital has their best interest in mind and their career in mind and lays out a path for them, then they at least know there’s a plan. You know, what we tend to do all the time is, Hey, congratulations on your job! Get in there; work hard; learn it; have fun. Then eighteen months down the road they start getting calls from other people with other options, and a lot of them take those options.

“Let’s say their manager said, ‘You need to stay in this floor for twenty-four months and then I will introduce you to somebody in step-down, if you wanted to get to a more acute area.’ They’re going to get to that eighteen-month point and get that call and hopefully say, ‘No, we have a plan. And I’m going to be able to do this, and I’m going to be able to do it the right way within the same company (not have to leave the company), and keep my benefits and keep my tenure and not have to jump jobs.’

“That’s the hope.”

“You have to continue to reevaluate it and talk about it as a manager with the employee to make it happen. So that’s really my next thing… the manager has to buy into that and they have to practice it.”

That’s where healthcare HR professionals come in. An individualized career plan for each nurse is great for hospitals, for nurses, and for health care HR: “[The career plan] stabilizes, doesn’t fix, the highest need area in hospitals today and that’s night shift, medical surgical nursing. That area all over the country has the highest turnover and it is our biggest need.”

Final Question

I asked Bush what’s the one thing you would tell every health care HR professional in Nashville.

He said, “I would say to them, ‘What you’re doing right now is not working. You need to work with people in the know and people who have ideas outside what clinical minds would think.’”

Bush has a solution for the nursing shortage, and Aspire Health is letting him run with it.

What’s keeping you from retaining new nurses? Leave your comments below.

You can contact Mitchell Bush by email (mbush@aspirehealthcare.com) and through LinkedIn.

Chad Harrington writes for Relode, a software startup that offers a modern way to find and organize job candidates. 

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