Stay Interviews for PMHNP Teams: A Practical Guide

1. Set a purpose the clinician can understand

Explain what the conversation will cover, who will see the notes, and how decisions will be communicated. Give the clinician time to consider the questions. Choose a setting with enough privacy and time to discuss the work without competing appointment demands.

CDC/NIOSH’s Impact Wellbeing Guide emphasizes operational improvements and two-way communication with healthcare workers. Apply those principles by making the conversation about the conditions of work and the actions leaders can take. The guide was developed for hospital leaders; this article adapts its broad approach to a PMHNP team rather than claiming a validated retention intervention.

2. Start with what should be preserved

Ask which parts of the role help the clinician do good work and want to continue. Listen for specific resources, relationships, learning opportunities, or aspects of the patient population. Ask for a recent example. Positive details can be as useful as problems when leaders are considering changes.

Useful questions include: “What part of the week is working particularly well?” and “Which support would you want us to preserve as the team grows?” Record the condition and why it matters. A general statement such as “the team is great” becomes actionable when the clinician can describe dependable consultation or a scheduling partner who resolves recurring problems.

• Which part of your role feels most worthwhile?
• What resource helps you handle a demanding day?
• Which team practice should we preserve?
• What has improved since our last conversation?

3. Examine recurring friction in the work

Ask about tasks that repeatedly take more time or coordination than expected. Explore visits, documentation, messages, consultation, coverage, scheduling, and administrative handoffs. Let the clinician identify the issue before offering a solution. Ask how often it occurs and which part of the workflow contributes.

Separate a process problem from a request for a specific employment change. Both deserve a response, but they may have different decision-makers. For example, unclear inbox routing may require an operations repair, while a schedule or compensation request may require clinical leadership and HR review. Keep sensitive patient details out of the retention conversation’s general notes.

• What regularly interrupts work you need to complete?
• Where do responsibilities become unclear?
• When does the planned schedule differ from the actual day?
• What small change would remove repeated effort?

4. Discuss development in concrete terms

Ask what skills, responsibilities, or professional interests the clinician wants to develop. Explore the resources and time required, the clinical relevance, and the person who could support the plan. Make room for someone who wants to deepen clinical practice as well as someone considering leadership.

Turn a broad goal into a reviewable proposal. “More growth” might mean access to a specific learning opportunity, a defined mentoring relationship, or participation in an improvement project. Confirm which options are available now and which require approval. Avoid promising a promotion, schedule change, or resource before the appropriate owner has agreed.

5. Choose a small number of actions

Summarize what you heard and ask whether the summary is accurate. Choose the issues that can be acted on or investigated first. For each, record the responsible person, the next step, the decision needed, and a follow-up date. Explain plainly when a request is outside the manager’s authority.

An illustrative action record might say: “Operations will map the refill-request route with the clinical lead and return a proposed responsibility change by [date].” That is more useful than “improve communication.” If the organization cannot make a requested change, explain the current decision and consider whether another workable option addresses the underlying concern.

• Preserve: a condition that is working.
• Investigate: a concern needing more evidence or authority.
• Act: a change with an owner and next step.
• Explain: a request the organization cannot currently meet.

6. Return with evidence of follow-through

At the agreed date, report what changed, what remains pending, and what decision was made. Ask whether the action helped in practice. Track recurring themes across conversations in an appropriately limited summary, while keeping individual details within the organization’s established privacy and HR procedures.

Use the findings when planning future permanent roles. If several clinicians describe the same unclear coverage arrangement, repair the operating model and reflect the approved arrangement in recruiting. Candidates should hear about resources the organization can actually provide. Existing staff should also see how their feedback informs the work.

• Define inbox responsibilities before recruiting
• Clarify the care model for a permanent role