Hospitals and staffing organizations across the country struggle with the retention of advanced practice providers for various reasons including job satisfaction, salary, mistreatment by physicians, and stress. The retention of advanced practice providers is one of the leading issues of importance among healthcare leaders, increase APP turnover negatively affects the organizations' ability to meet patient care needs, quality of the care delivered, and the control of staffing costs (Venegas, Benitez, Matthews, Brandt, Efron, Duckworth, & McGough, 2023). The first organization that I worked for after becoming a Nurse Practitioner was an emergency department staffing group, it was a high stress, high productivity, and high turnover position. Over the years I had watched nurse practitioners and physician assistants come and go, some to high stress levels, some were unable to meet the productivity needs of the positions, and some who left due to lack of respect for their position. There were multiple factors and all lead to increased turnover of APP's causing increased stress on the remaining providers and decreased our ability to meet departmental operating budgets. The costs associated with providing clinical education and training for specialized APP's such as those in critical care or emergency medicine specialties can be time consuming and expensive, it remains important to identify the intrinsic and extrinsic factors that contribute to job satisfaction promoted retainment of the APP (Venegas, Benitez, Matthews, Brandt, Efron, Duckworth, & McGough, 2023).

External Problems

A strategy can be thought of as a long-term plan that includes the organization's goals, values, objectives, type of products, and is created within an organization with the purpose of reaching a desired outcome (Reddy, 2018). An external problem that hospitals and staffing companies face is the wide range of training that APPs receive and their in-hospital experience prior to obtaining a job within the hospital. This causes the hiring organizations to provide a moderate amount of training to the APP so that they will be successful in the role and decrease provider turnover. There has been a lot of time and effort placed in developing onboarding programs that help prepare APPs for their role and specialty, then ongoing training and support to ensure their continued success.

Engaging stakeholders requires a comprehensive approach including ongoing communication, listening to the stakeholder, and working with them to solve problems, engaging a stakeholder is crucial for successful strategic planning and organization success (Sedmak, 2021). Promoting continued interactions between an organization and the employees increases positive communication, decreases stress, and promotes employee satisfaction. I worked as a nurse at the emergency department while completing school and then took a position as a nurse practitioner there when I finished, being a nurse there prior to becoming an NP allow be to have the support of the nurses and nursing leadership at the hospital. This kept me engaged and had great communication with hospital leadership, this is something that providers coming onboard from outside the hospital did not have to help support their success. I would encourage new providers to have continued communication and relationships with hospital leadership to communicate thoughts and needs.

QUESTIONS:

• Offer an insight you gained from the external problem of the company your colleague identified. Have you ever experienced a similar problem in the workplace?
• Ask a question about or provide an additional perspective regarding the strategy your colleague would recommend to the company to address the external problem.