How to Make Employees Want to Stay with You... Forever

A Conversation with Marianne Salerno, Director Recruitment and Retention

For our healthcare and hiring blog series, I interviewed Marianne Salerno, Director Recruitment and Retention at HealthAlliance of the Hudson Valley in Kingston, New York, and she shared how they cultivate relationships regionally to provide a long-term pipeline for keeping nurses over the long haul.

Chad Harrington
24 March 2016

She started out as a nurse, and stayed with HealthAlliance of the Hudson Valley for the last 35 years. Now Marianne Salerno specializes in recruitment and retention, so you could say that she’s invested in the community. Understandably, all she wanted to talk about for healthcare hiring was how to cultivate relationships, which is her key to keeping nurses from beginning to end. 

The end goal? Keeping great talent for community health.


Just like she grew her career from within HealthAlliance, she gives others a chance to do the same. She said that her primary goal is “to get nurses to come on board and to keep them here.”

Salerno mentioned how important new nursing grads are to overall strategy. Unlike many places, HealthAlliance readily accepts new grads into its workforce, so nurses can begin their careers with them.


Interested in working at HealthAlliance?


Retention: A major healthcare challenge

Just like many places in the country, Ulster County—where HealthAlliance finds its home—struggles to retain nurses because "the grass is always greener" to many employees.

Relode: What are your greatest pain points in relationship-building in community?


Marianne Salerno: “The thing I try to do is find areas in the hospital where nurses can develop themselves and have a commitment. I understand if people have to move out of the community, but if a nurse starts out on a regular medical surgery floor and eventually get restless, what other areas or opportunities or ways of enrichment can we offer to enhance their careers so they’ll gain experience and grow within our walls? 

“When they leave it’s really painful. We care about our people. We want them to stay. And, frankly, we don’t want to continually look for replacements.”

5 ways to build relationships for retention 

During our conversation, I learned that money doesn’t always do the trick for clinicians. Makes sense, really. So I asked Salerno, “When money isn’t the silver bullet for your area or your organization, how do you get them to stay?” Here’s what she said:

1. Create an orientation that makes them feel wanted.

MS: “The whole thing is trying to develop a preceptor or orientation program that really makes them feel wanted, makes them feel mentored, so they feel comfortable here as a new nurse.” 

2. Embrace your place.


MS: "Since HealthAlliance is not a large hospital, it has embraced its size to offer a warmer, hometown feel that is not readily available elsewhere. Because it’s a community hospital, people are likely to know many other staff members—and that’s a selling point for many clinicians.

"We’re really friendly. I’ve had nurses leave for another hospital and then come back because they missed the camaraderie.”

3. Assign an encouraging, knowledgeable person to be both a “preceptor” (or teacher) and a mentor to each new employee.

"The role of preceptor is to assess and encourage new nurses during orientation. They develop learning plans, assess needs and set goals. They continually evaluate the nurse’s clinical competence and talk through their strengths and abilities, especially if the nurse is entering the industry for the first time. The protege, in the mentor role, becomes more of a buddy than a teacher—but continues to be available for any constructive feedback and coaching. The mentor is someone the new person should feel comfortable with. It should be like a real relationship.”

4. Offer tuition-reimbursement program.

“We have a tuition-reimbursement program. A lot of the nurses need advanced degrees if they want to build their careers, so we offer a tuition-reimbursement program that’s really good.” If their employees pick a school that fits within the pricing cap, they can have their entire education paid for. “We’ve had nurses earn their Bachelor of Science in Nursing and even master’s degrees through this program.”

5. Encourage education from within the organization.

HealthAlliance offers educational courses within the organization so that clinicians can get certifications. For example, they can earn an advanced cardiovascular life support (ACLS) certification at HealthAlliance. With certifications like this one, or with certifications nurses receive on their own from credentialing boards, clinicians can earn more money. 

Salerno’s top three pieces of advice to other recruiters

R: What are your top pieces of advice for others in your position as the Director of Recruitment and Retention?

1. Maintain a commitment to staff

MS: “You have to have a commitment to the staff, and the focus must be on getting really good candidates as quickly possible. Everybody’s job is ultimately about serving patients. That’s not only true for RNs but for all departments.”

2. Post what’s great about the position and facility

“Second of all, when you are going to do the postings, you really have to focus on what you are showcasing about your position and facility, in order for the person to really want to chose you over everyone else.”

3. Advertise positions on social

“Number three is everyone is moving toward social media to advertise their positions, like Facebook or Twitter. The hospital has its own page, we have our own Twitter accounts, our own Facebook, we do some posting on LinkedIn. We do a lot of online advertising, such as with Indeed. We do some newspapers, but we go to social media most because that’s where everyone’s at these days.”


My reflections on building relationships for recruitment

One of my favorite lines from my interview with Marianne Salerno was how HealthAlliance provides a vital part of its community’s health in terms of employment and health care. As the largest employer of Ulster County, that’s a big deal. She said,

“It’s really important to us to try to get out into the community to see if we can find people to work with us here at HealthAlliance. It’s a twofer. It’s kind of like we’re trying to provide the best care to the patients and we’re also trying to provide—since we have positions available—for people in the community. So it’s a win-win!”

This reveals the heart of the issue—providing a win-win for people. That’s the essence of healthy relationships. It works on a micro-level (individual to individual) and on a macro-level between an organization and its community (group to group). That kind of mentality must have been part of what’s kept Salerno working for HealthAlliance for the last 35 years, and it will keep her going as she makes hiring great for the Hudson Valley.

HealthAlliance of the Hudson Valley Profile

  • 5 facilities
  • Largest employer in Ulster County, N.Y.
  • “HealthAlliance of the Hudson Valley is an integrated healthcare system committed to providing quality and compassionate medical care for our patients, their families and our community. We are dedicated to offering a full range of services and medical options, while strengthening the quality of your healthcare.”