Avoiding registered nurse layoffs: how it's done Three hospitals share

D esp i t e t he t r end of d e c r e a s e d hosp i ta l s t ays 1 and d o w n s i z i n g and layoffs in hospi ta ls , 2, 3 s o m e hosp i ta l s p roac t ive ly and agg re s s ive ly resist the r e s p o n s e of l ay ing off r eg i s t e r ed nurses . Ins tead, t h e y p i e c e t o g e t h e r a s e l e c t e d use of the famil iar l ongrange m e a n s tha t i nc ludes futur is t ic "rightsizing," at t r i t ion, work hour manipu la t ion , c rosst ra ining, and re t ra in ing. 4 A few hosp i ta l s go even further: t h e y t ake a def in i t ive s tand . The following ins t i tut ions are e x a m p l e s of w h a t is poss ib le wi th a s t rong phi losophy, a d m i n i s t r a t i v e suppor t and vision, and h u m a n i s t i c p lanning .