Picked by peers: Put the hiring process in staff nurses' hands

CLICK to Email E-mail
CLICK for Print Version Print

Work environment

Picked by peers: Put the hiring process in staff nurses’ hands

After reading this article, you will be able to:

  • Discuss why staff nurses became involved with interviewing employment candidates
  • Describe benefits of staff nurse involvement in the interview process


Interviewing for a nursing job can be daunting. Your body stiffens, your mouth goes dry, and your palms sweat as you meet the gaze of the unit manager. But candidates applying to the ED at St. Elizabeth Medical Center in Edgewood, KY, are more at ease because of the interviewers—staff nurses.

“It’s been very helpful for staff nurses to conduct the interviews because we tell [the interviewees] real-life stories of what it’s like to be in the trenches, so to speak,” says Stephanie Alford, RN, BSN, CEN, FNE, SANE, staff nurse in the ED. “Then they can envision for themselves if the job is a place they can see themselves working.”

The decision to put the hiring process into staff nurses’ hands came when Alford had to identify a needed improvement in the ED for one of her undergraduate courses. What started out as a process improvement at St. Elizabeth has enhanced nursing autonomy and increased retention in the ED from 61% to 84% in two years.

Move toward a behavioral-based interview

When Alford approached the ED director regarding her project, the director pointed to the interview process. The director wanted to make some changes and move toward a behavioral-based model, which involves asking a candidate about experiences in his or her employment history that can help predict future performance.

For example, a traditional interview question is, “How do you deal with change?” Using a behavioral-based model, this question might be phrased as, “Give a -specific -example of a time when you had to change your routine suddenly and unexpectedly.”

Alford surveyed St. Elizabeth’s ED staff members by asking what qualities and characteristics they looked for in coworkers. Staff members came up with a list of characteristics (e.g., flexibility, critical thinking, self-motivation, and leadership), and Alford created -behavioral-based questions to assess each characteristic. (See a sample list of questions on p. 10.)

Initially, Alford was doing the research with the expectation that managers would be conducting the interviews. But the nurse manager in the ED, Terri Vietor, MSN, RN, CEN, wanted to take the hiring process one step further.

“I wanted the staff to conduct the interviews because they are the ones who know if a candidate can successfully work in the ED and if they can work alongside that person,” says Vietor.

Create a hiring committee

Vietor gave Alford the autonomy to develop a staff hiring committee that would conduct the interviews, and Alford then recruited members for the committee. She asked those who expressed interest to attend a presentation during which she explained the new hiring process and how behavior-based interviewing works and provided tips on good interviewing techniques.

Prior to the presentation, Alford met with HR to learn about the legalities of interviewing. Her presentation also covered what questions can and cannot be asked of a candidate during an interview. For example, the hiring team is not allowed to ask about a candidate’s age, marital status, religion, or ethnicity. She also worked with HR to create an assessment document, which all hiring committee members fill out with their thoughts on a candidate.

Currently, 14 ED staff members, including staff nurses, technicians, and clerical coordinators, sit on the committee. “The hiring committee is a lot of work,” Alford says. ‘“You really have to have the staff buy in to make it successful, and you have to have a strong chair of the committee. [As the chair], I spend a lot of time scheduling the interviews and keeping track of our hires and getting staff lined up to come into the interviews.”

Interview the candidate

St. Elizabeth’s HR department is the first to receive all new-hire applications. After HR conducts reference and background checks on possible applicants for the ED, it sends the candidates’ applications to Alford.

Once Alford receives the applications, she calls selected applicants to schedule interviews, explaining that they will be conducted by staff members. She then sends an -e-mail to the hiring committee members to inform them of the scheduled time and to recruit interviewers.

“We always have staff nurses sit in on the interviews, but if we are specifically interviewing for a tech or clerical position, we make sure we have one of those members on the interview,” says Alford.

Although staff members were conducting the interviews, Vietor initially sat in with the hiring committee. But when Vietor left toward the end of an interview, “you could just see the candidate relax and be more at ease because now it was just their peers interviewing them,” says Alford. “And it’s very appealing to candidates that our nurse manager gives us the autonomy to do the hiring.”

Vietor realized the committee was getting a good assessment of the candidates and turned the entire interviewing process over to staff members.

“The hiring committee has been an extraordinarily successful initiative,” says Vietor. “They came into this committee with talent, enthusiasm, and goals because they were given the power to participate in a decision-making process.”

Once the interview is complete, the hiring committee regroups to discuss the candidate and fill out the assessment document.

“Even if we are interviewing new graduates who may not have any medical experience, the behavioral-based questions still work because we ask them to use any life experience to answer the questions,” says Alford.

Once each assessment is complete, the committee decides as a team whether the candidate is a good fit for the department. During the past two years, the committee has conducted more than 150 hour-long interviews, consuming more than 150 hours of staff members’ time.

“It has been a financial investment for our department because most interviews are done during our days off, so we get paid to come in to do the interviews,” says Alford. “But it has been worth it because we save money in management time and turnover.”

See proof in the numbers

Alford says the main reasons for the success of the ED hiring committee is that staff nurses have the ability to make big decisions and the committee’s name is behind the candidates hired.

“We get to choose the new hires, so we want them to succeed,” says Alford. “Once a new candidate has been hired and is out on the floor, we make sure they know where supplies are, introduce them to physicians and coworkers, and we take them under our wing, because our name is behind them.”

In 2007, of the 28 nurses hired before the staff hiring committee was formed, 11 left. Since then, 55 candidates have been hired but only eight have left—and seven of those left to pursue higher education or take other positions within the organization.

The new process has also set a solid foundation for the future. Alford says it’s vital to start growing and mentoring the next generation to become leaders in their department.

“It’s important that managers give staff the resources and empowerment to grow,” she says. “Empowered nurses give better patient care because they are more satisfied, and it’s going to improve retention because staff are going to want to stay in that environment where they grow.”


Adapted from HCPro’s Advisor to the ANCC Magnet Recognition Program®, May 2009, HCPro, Inc.