RED2022 brought together nursing, finance, and HR executives from leading healthcare systems, representatives of state-level clinical workforce organizations, and leading voices in nursing education to discuss the future of the clinical workforce. Action-packed sessions identified key issues and challenges impacting clinicians, and all participants shared ideas and best practices for addressing them. Following are the “Top 10 Takeaways” from the conference:
#10 – We’re not just losing nurses to retirement
The biggest drops in the nursing workforce are those in their 20s AND their 60s. Nurse leaders are investigating ways to keep early-career nurses engaged in their roles, looking closely at improving culture and providing the best preceptors/coaches available (see #2 below). Stories of early burnout and departures may be overwhelming to some who are newer in their careers. One executive noted the importance of sharing the positive stories of clinical care to reinforce the purpose of the profession and remind staff of their essential role in improving patient outcomes.
#9 – Nursing schools turn away one-third of applicants because of capacity constraints
Nursing school applications picked up in 2021, following a slowdown in 2019 and 2020. But a higher application rate does not equate to higher enrollment. We need stronger partnerships between healthcare systems and academia to ensure that all who are interested in nursing have the opportunity to pursue their studies and start their careers. Removing barriers to entry is critical if we are to make meaningful change in creating pipelines of new talent and reducing nursing vacancies.
#8 – Retention bonuses only go so far – healthcare leaders are investing in alternatives
Many organizations gave retention bonuses to clinical staff during COVID-19 surges. Leaders now give greater attention to paying down nurses’ student loans, offering incentive pay for hitting benchmarks, and bringing top nurses into executive savings and incentive plans.
#7 – Executive perceptions of nurses must shift
One healthcare leader noted that “nurses are on the wrong side of the ledger,” creating a pervasive, negative impact of clinical staff. Too many executives view nurses as a cost, which in turn creates the perception of nurses as a commodity. Views must shift so that nurses are viewed as trusted professionals. Additionally, nurses need a seat at the executive table. Currently, only 5% of hospitals have a nurse on their board.
#6 – Travel nursing has provided a model for internal innovation in health systems
While travel nurses remain a necessary part of health systems’ staffing plans at this stage, executives are carrying some of the attractive parts of the travel model over to their “internal agency” staffing initiatives. Many health systems have set up internal travel programs in which a nurse with experience and flexibility can complete 13-week travel assignments within the health system for pay commensurate with traveling through an external agency. These programs are largely in their first 12 months of existence, and none has fully displaced the need to use external travel resources. However, the model is providing health systems with a vehicle to re-engage and retain experienced staff.
#5 – You can’t retain nurses at the bedside without focusing on nurse leaders
Executives are meeting with nurse leaders regularly to stay informed. Weekly sessions enable them to identify and address issues immediately before they impact morale. When workload and technology matters are fixed promptly, nurses feel more valued and culture improves. Executives note that culture drives retention more than bonuses or other perks, and believe strongly in creating an environment nurses won’t want to leave. If organizations fail to engage nursing leaders, they often depart, with good nurses often following them out the door.
#4 – Relieve nurses of non-clinical tasks to boost job satisfaction
Why is it that when other departments are short-staffed, the overflow workload is directed toward nurses? Healthcare leaders are investigating this question, and redesigning workflow to enable nurses to focus solely on patient care. Adding more to their plates does not result in efficiency, but rather burnout and diminished focus on clinical duties. Some organizations are adding a clinical administrative staff member to assist teams with routine clerical work. Others tap students and unlicensed assistants to handle tasks like walking patients, changing beds, and restocking carts.
#3 – Virtual nursing models are gaining traction
Healthcare leaders are pursuing options to support onsite staff with virtual nurses, which gives them an “eye in the sky” to monitor patients 24/7, among other benefits. One healthcare organization piloted this collaborative model to do the following: Make rounding more efficient by partnering a virtual nurse with one on-site. Second, assign bedside documentation and admission history tasks to the virtual nurse. This proved to be a game-changer: Onsite nurses were freed from time-consuming computer tasks to focus more fully on hands-on care. Seasoned virtual nurses practiced at the top of their license, offering guidance and support to less experienced staff working onsite. The pilot was deemed a success and implemented systemwide, serving as a case study for other organizations to consider.
#2 – The right preceptors and coaches make all the difference in retention
Two factors are essential in retaining nursing graduates: Providing a safe learning environment and a consistent and prepared preceptor. Given the difficulty in recruiting new graduates, executives are focusing heavily on preceptor and coaching programs to assist individuals as they transition from nursing school to bedside roles. One organization utilized a 1:2 preceptor to the NGRN model and noted a 300% increase in new nurses’ confidence levels, resulting in a 90% retention rate. Savvy leaders understand that a great nurse is not necessarily a great preceptor, and take the time to ensure they have the right people coaching new staff.
#1 – There’s no silver bullet
There’s no single strategy that will solve the challenges facing the nursing profession. Healthcare leaders who implement multiple strategies, involve their nursing workforce in decisions, and exchange best practices with others are best positioned to succeed.
To experience the conference for yourself, request access to RED2022 On-Demand to watch the live discussions and let the conversations guide your strategy.