Category: Nursing Articles

Charge Nurses Are Also “Chief Retention Officers”

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Organizational loyalty is cemented through relationships with supervisors and managers, but don’t overlook the importance of the Charge RN role to nurse loyalty and retention.  Turnover studies show that more often than leaving an employer, staff leave their first-level supervisor.

Charge Nurses play a role in onboarding, coaching, patient experience and safety, and nurse retention.  Develop your Charge RNs to be unit leaders, by teaching critical thinking, delegation, effective communication, conflict management, leading through change, and other qualities for successful leadership.

How can a Charge Nurse help your organization with nurse retention?

Being a Leader Who Fills In Gaps

It’s obvious that nurses on the team are busy, overworked, and possibly stressed. Your team may be understaffed at times, or during this Covid/Delta-era, understaffed most of the time. This means nurses on the team or unit could be behind on charting, procedures, assessments, or administering medicines. This may slow down throughput, and it could impact patient satisfaction or even outcomes.

A Charge RN can be the first line of defense to keep the unit productive and nurses happy. She may need to fill in in placing IVs, triage patients, get EKGs, or order medications. The Charge is a leader who fills in gaps of care or administration, quarterbacking and motivating the team, whether it’s normal times or Covid-times. This type of leader keeps team morale on an even-keel which helps with nurse retention. On the flip side, an unprepared Charge Nurse can have the opposite effect.

Helping Nurses Manage Stress and Keep Calm

Of course you want all nurses to be calm in emergency situations, but in the Charge role this is especially important. Charge Nurses put out fires during the shift and oversee that other nurses handle stressful situations properly. A Charge Nurse who knows her stuff and understands key policies can take the air out of a stressful situation.

The Charge Nurse can also help alleviate nurse stress by keeping the shift organized. Charge RNs should make prioritized lists and help chart in real-time to avoid backlog which can also cause stress.

Being a Communication Line Between Management and Nurses; Identifying Problems Early and Intervene

Charge Nurses should foster nurse communication and gather input for the organization. They may have the best intel on how the team is perceiving and reacting to what is going on.  Help your Charge RNs understand how to use “chain of command” when escalation is needed (and not needed).

Continuous, open communication, however, makes nurses and all of us feel valued.  Charge RNs can help identify workplace incivility early. These incidents can lead to low team morale, low productivity, and increase absenteeism. Conflict is unavoidable and problematic, so nurses with strong conflict resolution skills are better able to deal with challenges quickly and reduce potential errors stemming from it. A Charge RN can also identify staff who are struggling and help with early interventions.

Be a Model of Positivity and Professionalism

Encourage Charge Nurses to lead by example, and always look for ways to help the team succeed. Encourage your team to practice positivity and professionalism by showing initiative and by thriving under direction. Let Charge RNs know that serving as a good example and demonstrating a strong work ethic, flexibility, and positive attitude will help pave the way to future leadership positions. It isn’t just about “soft skills” of leadership either, because these are skills which will impact issues like organizational financial goals, patient outcomes, and patient experience.

You may not be thinking about how Charge RNs can be a key part of your nurse retention efforts. Nurse Managers can’t do it all alone.  Reward Charge Nurses with professional development and watch the change in team dynamics! 

To assist health systems who would like to sample the power of charge nurse development, or are strapped for instructors in these staffing-challenged times, Catalyst Learning is teaching public NCharge® “Nurses Learning to Lead” classes in Oct-Dec. Learn more about our upcoming virtual, instructor-led course. Courses carry 3.5 ANCC contact hours.

“Be the Boss No One Wants to Leave,” Webinar by Rose O. Sherman, 9/28/21, sponsored by Catalyst Learning Company

“Letters: Embracing retention at all levels,” Lippincott Nursing Center/Nursing Management magazine, Kathy G. Newton RN, Florence Stewart RN/BSN, Sabra Henry RN/BSN

“Strategies for Nurse Retention,” Elite Learning, Lorraine Mercado

“Recognizing and Overcoming Toxic Nurse Leadership,” RN Journal, George A. Zangaro PhD/RN, Kelly Yager MS/RN, Joseph Proulx, EdD/RN  

“Improving the Charge Nurse ‘s Leadership Role: A Collaborative Learning Forum,” Walden Education, Felicia Katherine Pryby, 2016

How Can I Be The Boss No Nurse Wants To Leave

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This article is a summary of a digital workshop given by Rose O. Sherman and Catalyst Learning Company on 9/1/2021. Ms. Sherman’s presentation was titled “Become the Boss No One Wants to Leave: Nurse Recruitment in Turbulent Times.” Catalyst Learning sponsored the event in recognition of the heroic role that nurses played in the U.S. in 2020 and 2021.

Across the U.S., nurse leadership is struggling with unprecedented staffing shortages and high turnover. COVID-19 has been a ‘Quake Experience,’ a massive life change with aftershocks that will likely last for years. Nurses have experienced an impact both personally and professionally, leading to stress, burnout, exhaustion, hopelessness, and some disengagement. Nurses and other health staff may be reconsidering their professional lives, asking questions like “am I really supposed to go back to work like nothing happened?” “What is my economic worth, and am I respected?”  “Is acute care the right setting for me? Have I found the right work-life balance?”

In the midst of this nursing workforce landscape, nurses are leaving the hospitals and systems they work for. While burnout, stress, inadequate staffing and better pay may get more attention and headlines, a major reason that nurses leave organizations is lack of good leadership. A lack of leadership doesn’t just mean the nursing VP. All levels of leadership, including the Charge Nurse, play a key role in retention. Nurses look for stability, trust, compassion and hope from their leaders. Younger nurses especially have different work demands than their more experienced peers, with needs evolving from paycheck to purpose, from wanting a boss to wanting a coach, and they look more for frequent feedback than annual reviews.

So given this new reality, how can I be the boss that no one wants to leave?

Focus on a Healthy Work Environment, plus Focus on Unit and Team Culture

Unit culture is an invisible architecture that new staff sense quickly. To have a healthy work environment, Nurse Managers and Charge Nurses set the tone. Make sure these frontline leaders encourage nurses to ask questions, make nurses feel appreciated, and listen to staff concerns. Nurse leaders who inspire staff generally have a strong bias toward taking action to correct situations, are vulnerable and compassionate toward staff, and manage conflict and diversity of ideas well.

Teach frontline nurse leaders to have zero tolerance for disrespect and abuse. A Charge Nurse who sees and ignores incivility or bullying has just normalized the behavior. Staff then either become part of the hostile workplace or leave entirely.

What is something nurse leaders can do quickly to help with culture issues? Consider bringing back an old ritual, or even start a new one. During COVID madness, many teams lost the rituals that connected nurses to the team and created a psychological safety net for the unit.

One last thought to help with work environment is to create a culture of recognition. Give symbolic gestures to show that leaders appreciate nurses. Begin shifts with “thank you for being here,” nominate your staff for awards, write thank you notes, and attend events where staff are being recognized. If your managers and Charge RNs see you doing this, they will likely follow your lead.

Do what you can do to encourage group cohesion and stronger work teams, remember that a toxic culture will destroy the best plans. Focus on work culture will help make leaders that staff do not want to leave.

Develop Charge Nurses to be Unit Cohesion Leaders

Organizational loyalty is cemented through relationships with supervisors, managers, Charge Nurses and team members. Many nurses don’t leave a health system, they leave their first-level supervisor. Develop your Charge RNs to be unit leaders, by teaching critical thinking, delegation, effective communication, conflict management, leading through change, and other qualities for successful leadership. Charge Nurses are the first-level supervisors who play a role in retention, onboarding, coaching, plus of course patient experience and safety.

Be Flexible to Meet the Needs of Your Staff – Be a Coach for Younger Nurses

Older nurses are retiring fast, and even Gen X makes up barely a quarter of the nursing workforce. Gen Y and Gen Z make up 60% of the nursing workforce now. As a leader, don’t wait for these Millennials to grow up and become Baby Boom or Gen X nurses. It is not going to happen. Be flexible in your leadership style to meet needs of younger staff. Be as accommodating as possible with work schedules for example. Also be flexible in your leadership style by trying to think more like a coach than a boss. Younger nurses think more about purpose than prior generations, so show young staff how their role contributes to the mission of the organization.

Lifetime employment is not the goal of most nurse staff today. Staff are more likely to see their jobs as “tours of duty” on a professional career ladder. To show support for Millennial and Gen Z nurses, support nurses’ career goals and do not give any perception that you may hold associates back from moving to the next level. Ask your nurse staff questions to aid their career development with questions like: “what goals do you have,” “what types of professional roles have you considered,” “what obstacles are you encountering,”  and “what new skills do you want to achieve.” Consider using a Career Development GROW® Model Coaching Template with nurses to show you value their career trajectory.

Communication is Key, Especially During Turbulent Times

In complicated times, transparent communication and visibility is key. When leaders don’t communicate, staff will fill in gaps with misinformation. Nurse leaders should practice effective communication during practice and policy changes, consider diverse communication styles among different staff, and choose the right words and tone for communication. If leaders do not communicate effectively it can lead to gossip, mistrust, perceptions of staff favoritism, and staff can become defensive.

The correct communication tone and style can be difficult even during ‘normal’ times, but it is even more critical when staffing is short. When there are staffing issues, make sure leaders are transparent about the challenges the team is facing. Make sure leaders are transparent about recruiting tactics that have been tried, ask for staffing ideas from the team, and acknowledge that nurse leaders do not have all the answers. It may be a difficult message, but staff will appreciate honesty, and may even be able to help.

STAY Interviews and Strategic Off-Boarding

STAY Interviews are a way to help with avoidable turnover. Aim to do at least 2 each year per nurse, the first one within 90 days of hiring. After this interview, note the actions that you will take and the actions the nurse/staff member will take. After this interview, use a stoplight method to assess risk of turnover, with green being likely to stay 1+ years, yellow to likely stay 6-12 months, and red a high risk for immediate loss. Ask questions like “what do you look forward to each day,” “what are you learning or do you want to learn,” or “how can I make your job better or want to stay?” Even if you are likely to lose an employee in their current role, you may find other internal roles that may be better professional fits. STAY interviews can help with internal mobility which reduces recruitment costs, and keeps high-potential staff in the organization.

If and when nurses do leave, stay upbeat and positive. Thank them for their contributions, and remember that other staff will watch how you manage resignations. When valued staff resign, think about how to create loyal alumni who will recommend your organization, and leave the door open for boomerang employees.

Catalyst Learning produces the curriculum NCharge™: “Nurses Learning to Lead” for Charge Nurses, which is available for on-site or virtual instruction.

Nurse Managers and ANM’s: Key Players in Saving the Country. Pandemic Reflections

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Nurse Managers and Assistant Nurse Managers in U.S. health systems have many things demanding their attention each day. And that is during “normal” times! The 2020-2021 pandemic created more challenges for managers in care delivery organizations. Nurse Managers were tasked with securing medical equipment, turning units into COVID-19 care areas, short staffing, and providing emotional support for nurses who were seeing traumatic events daily.

This was an event that no one could have prepared for, but now looking back, how can we put plan and prepare to put Nurse Managers in the best position to succeed?

Encourage Constructive Relationships with other Leaders

Make sure Nurse Directors have a relationship with your Nurse Managers that is based on mutual respect and accountability. Provide constructive performance feedback, which helps the manager grow and develop. Avoid micromanaging the manager though, as this could be interpreted as a lack of trust. In a constructive Director-Manager relationship, there is clear communication on expectations, a trust on judgment on operational decisions, and a mentor relationship being built.

Do your Nurse Manager have collegial physician relationships? Nurse Managers and physicians partner to achieve quality patient outcomes. Talk with your managers about this and see if they have a physician partner who looks out for them, and wants to help them to improve patient outcomes in the manager role.

Encourage Nurse Managers to be Transparent about Rocky Times

Nurses do not expect their managers to have all the answers to problems, but they do want the truth. If there is transparency about instability, and a manager acknowledges that the team is going through rocky times, it can be a building block for trust. It can also help solve the issues. When staff members have all the information on a topic, they may devise reasonable suggestions or alternatives to solve or improve a problem. Through transparency, nurse teams can mature more quickly.  A lack of transparency however can have long-term detrimental effects and lead to less trust, or even turnover.

Teach Nurse Managers to Think about Retention of their Team

At Catalyst Learning, one of the biggest issues we’re hearing from our customers and advisors is that short staffing of nurses is everywhere. We keep hearing that many nurses on teams are very young and inexperienced. Besides just natural cyclical employment, the pandemic pushed some early retirements of Boomer nurses, and a lot of experience has left the building. Unfortunately, there is little we can do about this.

For your Nurse Managers to be successful, they need an experienced team. So make sure they are thinking about retention, especially of younger nurses who may shuffle out quickly. Encourage managers to offer role clarity when nurses first start and communicate on critical issues. Teach managers to offer recognition to make their team feel valued, intervene when disengaged nurses become disruptive, and offer opportunities for growth for high-performing young nurses. If your Nurse Manager plans on how to keep nurses engaged in the role and in the job, it will pay off.

Promote Stress Management and Nurse Resiliency from the Top-Down

It’s obvious that fatigue sets in during stressful times, and nurse burnout happens even during “normal” times. Nurse resiliency is vital to our public health community, but how can we prepare Nurse Managers to help staff, and deal with it themselves? Our systems can promote resiliency from the top-down by encouraging nurses to take emotional breaks, like music, hobbies, exercise, or personal spiritual events. You can encourage Nurse Managers to huddle with their teams and teach nurses to recognize what they can and cannot control, and that other nurse teams are scared too. And you can encourage nurses to pursue emotional support and connectedness to peers, have work teams find a buddy who they can reach out to when workload is intense, and promote Employee Assistance Programs that your health system has for associate support.

Collaborate to Create a Great, Thriving Environment

OK, a Nurse Manager’s role is hard, the word “Fun” may not make sense. But you can help create an environment that focuses on positive attributes of the role. For example, encourage your Nurse Manager to recognize excellence in nursing practice when she sees it in her unit. That will be beneficial to her and the team. Also check on your managers to gauge if they have a manageable workload, adequate resources, and accessible professional development to equip these leaders with necessary knowledge and tools.

Are you creating a culture of meaning and excellence for your managers? Do they feel like their role is just churning out work, or do they see how their work is evident throughout the entire health organization? When constructing your leaders’ priorities, show them how these priorities are aligned with the organization’s mission. Show your manager how her work supports the standards and expectations of excellence your organization has, and that her work helps maintain a reputation for excellence. Assure there is an alignment of goals and desired outcomes in performance evaluations to assist the manager in getting the work done through others.

“The Journal of Nursing Administration” October 2017 issue, entitled “Magnet Supplement The Role of the Nurse Manager: Pivotal to Nursing Excellence” – articles written by Jeffrey N. Doucette DNP/RN/CENP; , Nora Warshawsky, PhD/RN; Sharon Lake, PhD/RN; Arica Brandford, MSN/JD/RN; Mary Kay Rayens, PhD; Donna Sullivan Havents, PhD/RN/FAAN

“A Phenomenological Study of Nurse Managers’ and Assistant Nurse Managers’ Experiences during the COVID-19 Pandemic in the U.S.” Wiley Online Library, Jane H. White PhD, RN, PMHCNS-BC, FAAN, March 10 2021

“Behind every RN is a nurse manager: 4 tips for these leaders during the pandemic,” Beckers Healthcare, Mackenzie Bean, June 11 2020

“Exploring nursing managers’ perceptions of nursing workforce management during the outbreak of COVID-19: a content analysis study,” BMC Nursing, Sarieh Poortaghi, Mehraban Shahmari, Akram Ghobadi, January 29 2021

“Nursing leadership during COVID-19 Enhancing patient, family and workforce experience,” Patient Experience Journal (PXJ), Anne Aquilia (Yale New Haven Health), Karen Grimley (UCLA Health), Barbara Jacobs (Anne Arundel Medical Center), Maryellen Kosturko (Yale New Haven Health), Jerry Mansfield (Mount Carmel Health System, Trinity Health)

“6 Healthcare leaders share the most difficult aspect of their job,” Kelly Gooch, Beckers Hospital Review

“How to Build – and lead- resilient health care teams during COVID-19,” Katherine J. Igoe, Harvard School of Public Health, September 20, 2020

Another resource was Rose O. Sherman, who offered guidance letting us know of issues managers are facing. (July 2021)

Are you interested in related articles? Feel free to enjoy these as well:

6 Traits of Nurse Managers Who Are Transformational Leaders

It’s Time to Be Deliberate About Nursing Leadership Succession

Encouraging Nurse Resiliency Techniques During COVID-19

Why are Many Young Nurses Not Applying for Manager Roles?

9 Ways to Transform the Nurse Manager Role – Lets Make it Fun Again!

Helping Charge Nurses to Lead During Unstable Times

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The role of the first-level supervisory nurse is critical for quality patient care and overall work quality for nursing staff. The role is also very complicated, especially given that nurses often assume the role based on clinical skills, with limited formal leadership development. Solving problems, understanding staff members scope of practice, and dealing with staff needs is a lot to take on, even when times are not turbulent. And in 2021 we know many nurse teams are dealing with staffing issues and turnover. Many teams are staffed with 50% new graduates, more temp travel nurses, burned out nurses, and high acuity patients. These factors, along with turnover of nurses and senior leadership plus new IT processes, add up to many nursing work teams dealing with a continued challenging time.

So how can nurse directors and leadership help charge nurses, as they lead through a turbulent time?

Be transparent about the key issues

Charge nurses do not expect their managers or directors to have all the answers to problems that arise, but they do want the truth. If you are transparent that there is instability and that the team is going through rocky times, that transparency can be a building block for trust. It can also help solve the issues. When staff members have all the information on a topic, they may devise reasonable suggestions or alternatives to solve or improve a problem. Through transparency, nurse teams can mature more quickly.  A lack of transparency can have long-term detrimental effects and lead to less trust or more turnover.

Offer support from more experienced nurses

Young nurses are not looking for authoritarian leadership; they want coaching to help them learn and grow as professionals. Retaining nurses requires adapting to this generation, so make sure the right experienced nurse is providing the coaching. The right coach/mentor can help a young nurse see how their contributions are valued. Mentors can encourage continuous learning, help young nurses to build networks/join professional organizations, and even help teach young nurses about emotional intelligence. For example, University Medical Center (Texas Tech University) offers senior nurse mentors to new nurse leaders. This helps nurses to think about professional development, clarify skills needed for the new role, and understand the goals of the health system. There is nothing in a textbook that can replace real-life experience of a seasoned nurse who has navigated a full career.

Identify struggling staff and plan for early intervention

Be on the lookout for nurses who are struggling with exhaustion, anxiety, or just the reality of how difficult the nursing profession can be. Help show them time management tricks or talk about where the nurse is struggling. If a nurse has a hard time speaking with physicians for example, help them practice those scenarios.

But if a nurse isn’t pulling his or her weight, or causes unnecessary team stress, find a plan to fix the issue. A charge nurse has enough on their plate, so especially during turbulent times, take as much of the team conflict or struggling staff issues off the table as possible.

Remove common leadership barriers charge nurses face

Even when not enduring turbulent times, there are personal and organizational barriers that can hinder success of frontline nurse leaders. Removing as many of these barriers as possible will setup your charge nurses for success. Personal barriers a new leader could face are an inability to see the big picture, a lack of self-confidence, or not delegating work. Remember that your charge nurses may have never led a team before, so talk through these personal barriers.

Leadership barriers could be organizational. These barriers could include staffing issues, a lack of ancillary or clerical support, or a lack of standard operating procedure. It’s impossible for a charge nurse to effectively complete tasks if he or she doesn’t know what the expectations are. If possible, it would be beneficial for charge nurses to meet with administrative leadership to quickly draft a common list of responsibilities. See our related article, 9 Leadership Barriers that a Charge Nurse Faces.

Offer leadership development to prepare nurses for the charge nurse role

Many nurses in a charge RN role have never led a team before and are serving in it because they have the clinical skills. Going from a nurse peer to a nurse leader can cause stress, as it is hard to delegate work to a friend.  So prepare your new nurse leaders with training that can give the insights, interpersonal skills and business knowledge they need to manage a team. Charge nurse leadership development can help a nurse transition from peer to leader, lead quality initiatives, be confident in communications, and help with conflict management.

HCA, the largest private health system in the U.S., made a strategic decision to systematically prepare future nursing leaders for success.  It developed its Charge Nurse Leadership Certificate program and saw that effective development of frontline leaders can improve retention and the delivery of patient care.

Being a charge nurse during turbulent times is very hard. Whether it is staffing, high acuity patients, or employee stress, the role is harder than ever. And we know that the charge nurse role is a first step into nursing leadership, so it is essential that we encourage these new leaders.  It is a win-win-win for leaders to provide stability, transparency, and inspiration.

https://www.emergingrnleader.com/helping-charge-nurses-create-stability-when-staffing-is-turbulent/

“3 Common New Nurse Struggles,” RegisteredNurse.com

“Transparency in Nursing Leadership and Healthcare,” Duquesne University School of Nursing, Rose Sherman, April 14, 2020

“Tips on How to Effectively Communicate to Doctors for New Nurses,” RegisteredNurse.com

“Mentoring Nurses Toward Success,” Minority Nurse Magazine

“For Nurses – Mentoring,” University Medical Center – Texas Tech website

“Helping Charge Nurses Create Stability When Staffing Is Turbulent,” Emerging RN Leader, Rose O. Sherman, May 6, 2021

1st Year Nurse Turnover is High – Is Your Organization Actually Contributing to It?

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Hospitals are struggling to hold on to all nurses, but especially the new ones. Eighteen percent of new nurses will change jobs, or even professions, within the first year after graduation. An additional one-third leave their organizations within 2 years. Nursing turnover can be extremely costly for health systems. Besides just the hard cost of recruiting and onboarding, it is hard to build a nurse leader pipeline when there is fluctuating talent being brought up within the system.

1st year nurses may be talking to their nursing school peers, and hearing about better opportunities at other hospitals. Or 1st year nurses may have no ties to a city/region which makes them more likely to interview other places. But even worse, your organization itself may be contributing to young nurses are leaving the organization. It could be creating a reputation among young nurses to avoid your hospital and go elsewhere.

How can your health system leadership, or your more seasoned nurses, actually contribute to 1st year nurse turnover?

  • Not valuing 1st year nurses, or at least are not showing it. Older nurses may make comments about Millennial workers or work ethics/work styles.
  • 1st year nurses could feel they are stuck picking up the slack for other nurses, or doing work other nurses do not want to do.
  • 1st year nurses may be given little role clarity. They may feel like goals are ambiguous, and that more experienced nurses are not helping to prepare them.
  • 1st year nurses may see little opportunity for growth or leadership development.

How can your organization turn this phenomenon around?

Offer better role clarity, which can also help alleviate stress

First year nurses have just had 14-16 years of schooling or more, where curriculums are clear from the first day. Then they begin working and realize work and life are messy and there is role ambiguity. This can lead to a low sense of control over job performance, and ultimately stress. What can nurse leaders do to stop this? For starters, make sure role expectations and performance is communicated well and across multiple channels. Have periodic check-ins with your new nurses. Let them know how their performance is contributing, and offer support.

Offer better communication; a 1st year nurse needs management to communicate about critical issues

Most surveys and studies show that Millennial workers want more communication and feedback, or at least more than other generations have. While older generations value a big paycheck or advancement opportunities, Millennial workers are more likely to aim for career or organization purpose. Show your 1st year nurses how their contributions help the larger health system at a macro level, and how they contribute to your team at a micro level. Management and supervisors should be available, or at least visible to nurses who are finding their way early in careers. Solicit input from young nurses on critical work issues. Incent your team to share 360-feedback to improve how critical issues are handled. This could show 1st year nurses that you value communication, and show they are a part of critical issues and decisions.

Offer rewards or recognitions for accomplishments

Nurses who feel valued, appreciated, and respected—and who enjoy professional communication and working relationships—will stay at an organization and remain engaged in their profession. This is especially true for nurses newly out of school.  Offer recognition for accomplishments to show young nurses they are valued. Recognizing and rewarding nurses does not have to be complicated or time-consuming. It could be on-the-spot recognition, maximizing staff meetings, fun activities, feedback surveys, or general retention activities.

It’s not uncommon to forget to show associates that they are highly valued. Sometimes a shout out will do; other times an offer of lunch with the boss or an invite to attend an off-site training will help demonstrate that you are indeed happy to have this young nurse on your team.

Offer support from more experienced nurses

Young nurses are not looking for authoritarian leadership, they want coaching to help them learn and grow as professionals. Retaining nurses requires adjusting to adapt to this generation, so make sure the right older nurse is coaching. The right coach/mentor can help a young nurse to see how their contributions are valued. It can also help encourage continuous learning, can help young nurses to build networks/join professional organizations, and can even help teach young nurses about emotional intelligence. For example, Franciscan St. Francis Hospital in Indianapolis implemented a preceptor and mentor program to help new graduate nurses during their first year of employment. This decreased the organization’s 1st year turnover rate from 31% to 10% in 2 years. There is nothing in a textbook that can replace real-life experience of a seasoned nurse who has navigated a full career. If your health system doesn’t already have a young nurse mentor program, maybe it is time to start.  

Offer opportunities for growth for high-performing young nurses

1st year nurses want to see that their health system is willing to invest in them and prepare them for future leadership roles. Actively supporting career development through online and in-person training courses can help maximize skills, growth potential and professional opportunities. For a young nurse, the first opportunity for team leadership is generally the Charge Nurse role. Leading and delegating to peers, especially to older peers, is stressful. As a manager or director, you may see that offering these roles to young nurses without leadership development and preparation may lead to stress for young nurses. So offer Charge Nurse leadership development.

East Alabama Medical Center (EAMC) is a 340-bed hospital in a rural area. Because it is an area where there is a smaller talent pool than larger metro areas, EAMC really prioritizes growing its talent from within. Rosemary Cummings is the Director of Medical Surgical Services at EAMC, and recently implemented NCharge to prepare young nurses for leadership roles. She commented “We take a lot of pride in how we do things from a quality and cost perspective. It <NCharge> helps our frontline nurse supervisors to see we’re investing in them. Development at this organization is an important piece of who we are. I think that’s why people stay.”

NCharge: “Nurses Learning to Lead” is an evidence-based curriculum that gives first level supervisory nurses the insights, interpersonal skills, and business knowledge they need to more effectively manage, inspire, and lead. Courses are delivered either classroom-based or virtually. NCharge is for nurses who desire to build management and leadership skills and/or want to learn about the business-related aspects of nursing. Health systems use NCharge to build a nurse leader pipeline, ensure a smooth transition from peer to leader, and to increase nurse engagement and retention.

Feel free to read our related articles!

“Preparing Millennial Charge Nurses to be Successful Leaders”

“Encouraging Your Nurses’ Career Path?”

“What Your Nurses Didn’t Learn in Nursing School”

Sources

“Millennial Workers Want More than a Paycheck. So What Exactly do They Want?” Monster Inc, Roberta Matuson

“Nurse Retention Toolkit: Everyday Ways to Recognize and Reward Nurses,” HC Marketplace, Lydia Ostermeier MSN, RN, CHCR and Bonnie Clair, BSN, RN

“Strategies to reduce nursing turnover,” Nursing Made Incredibly Easy, Lisa Lockhart MHA, MSN, RN, NE-BC, April 2020

“7 Things That Cause Nurse Turnover (and 8 Things That Stop It)” ita group

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Nursing Trends to Watch in 2021

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First off, take the 2020 nursing trends article we wrote back in January of 2020, and throw it in the shredder. Whew, no one saw 2020 coming, and hopefully we’re soon to see it leaving. But there are some trends for 2021 and onwards that we see bubbling up from American Nurse Today, American Nurse Journal, AMN Healthcare, the Bureau of Labor Statistics, plus some respected nurse leadership bloggers who we follow. Here are several high-level trends to prepare for as we head into a new and hopefully more optimistic year:

Shake-Ups in the Traditional Demographics and Backgrounds of Nurses

According to the U.S. Bureau of Labor Statistics, there will be an additional 735,000 nursing jobs by 2024. With this increased demand, future wage growth, and revived interest in nursing after 2020 was the Year of the Nurse, nurse recruiting will expand to non-traditional labor pools. For one, male nurses will become more common. Already 12% of RNs are now men, up from 2% in 1970.

Nurse recruitment will also focus on nurses from different countries, or bilingual RNs. There are 60-65 million people in the U.S. whose native language is something other than English, so patient safety can be a risk factor with language barriers.

The field of nursing is becoming more accessible, with great pay and flexible hours, making it a workforce that is ever changing and growing.

Increased Focus and Awareness on the Obstacles that Nurses Face

Nurses faced unprecedented challenges in 2020. Extreme stress led to burnout. Nurses are subject to substantially higher rates of workplace violence injuries than other professions. They’re more likely to experience incidents of hitting, kicking and beating in inpatient facilities, and these injuries often go unreported. Bullying and harassment are also issues that nurses have faced. In 2020 especially, nurses unexpectedly dealt with limited PPE supplies and elevated risk of personal illness, so all around it’s a tough job in a really tough year.

There is some good news. In the 2020 Nursing Trends and Salary Survey organized by the American Nurse Journal (ANJ), 85% of nurses surveyed said the pandemic hasn’t changed their career plans, and they intend to stay with the nursing profession. With more organizations emphasizing the importance of self-care, and with increased national and legislative attention, nurses should expect working conditions to improve and access to more resources to address these workplace challenges . Health leaders will need to provide nurses with the resources and tools they need to care for patients without sacrificing their own health along the way. COVID-19 has brought this issue into the spotlight, so expect increased awareness this year.

Technology Enhances How Nurses and Patients Interact and Communicate

We have already seen that telehealth and chatbot services are making it easier for patients to access care. 2020 has accelerated usage of virtual health, perhaps faster than many of us are comfortable with. Relaxation of rules around reimbursement for telehealth visits in the wake of COVID-19 has shown health care providers and patients alike how effectively virtual communication tools can work. These telecommunication services will continue to be the norm, and blend into nurse job descriptions and care administering tactics.

Telehealth is moving past just being a window for patients with minor complaints. It is becoming a boon for nurses, plus therapists and providers using technology to manage patients with mobility challenges or who are considered high-risk for the virus. Nurses and healthcare providers will need to continually improve their communication skills via virtual platforms, just as their patient population has needed to.

Besides just using technology for direct communications, the field of health informatics will grow. Using IT systems to create more collaboration between and patient and providers will change nursing roles in 2021 and beyond. Expect some nurses to fully buy-in to the use of informatics and move to the discipline as a full-time specialty in 2021.

Technology in nursing-to-patient communication is here to stay, and nurses will need to become confident and comfortable with it. Privacy concerns and compliance with HIPAA will have to adjust of course, making sure platforms being used are secure for communication of sensitive data. But it’s a new world we’re adjusting to. Technology can bring better communication and collaboration, and nurses have to be smart in how they use it.

Addressing Gaps in Health Equity – and Nurses Could Lead the Way

Health equity and disparities in healthcare became a large focus area during the pandemic. While health system leaders, politicians, and community leaders increased their focus on the social determinants of health and diversity during the pandemic, there will be an even greater focus in 2021. Payers, providers, and the entire health ecosystem will boost efforts to address these issues going forward. As corporate and community leaders are well intentioned, leadership should be from nurses. Finding where the gaps in care are will ultimately be tasked to nursing staff. Nurses can find actual combative steps for these inequities and recommend tactics to fill in care gaps.

Nurses may be able to help bridge social gaps, finding deficiencies in care for certain populations. From the ground level, nurses can make sure patients have a voice and that families (and even communities) are incorporated into the design and operations of their community health systems.

Recognizing, Respecting, and Investing in Nurses to Grow into Transformative Leadership Roles

Investing in growing nurse leadership and management skills translates into increased productivity and even improved patient outcomes. Growing nurse leadership is even more important during high stress times and times of change. Organizations investing in nurse leadership development will see benefits of efficiency in team management, organization, and delivery of care. With the global shortage of nurses, it is critical to focus on building up the competencies of our existing nursing workforce to ensure nurses are performing to their full potential.

Leadership development may be done in person, or it can be virtual. A curriculum like NCharge: “Nurses Learning to Lead” may be a program for your staff to consider, with a variety of flexible delivery methods. Courses like Charge Nurse Fundamentals enhance individual and unit performance by helping nurses understand the business aspects of Value Based Purchasing, as well as the various roles of an effective charge nurse. It also helps nurses create an individual action plan to identify challenges and maximize opportunities faced in today’s complex hospital environment. Other NCharge courses include “Critical Thinking for Charge Nurses,” “Leading Change in a Dynamic Climate,” and “Supervisory Skills for Positive Outcomes.” Organizations like Nemours Children’s Hospital offer NCharge to help communicate financial performance indicators for example. Learn more by reading our related article on Nemours Children’s Hospital.

Sources

  • “2021 Nursing Trends We Expect to See in 2021,” Carson-Newman University Online, January 19, 2021
  • “Trends Transforming The Nursing Industry Outlook in 2021,” Team Linchpin, linchpinseo.com/trends-nursing-industry, February 13, 2021
  • “Our future through my rearview mirror: Turn the troubling events of 2020 into opportunities in 2021,” Lillee Gelinas, MSN, RN, CPPS, FAAN, Editor-in-Chief, My American Nurse, January 8 2021
  • “Top 10 Nursing Trends for 2021,” Purdue University Global
  • “Top 7 Healthcare Technology Trends in 2021,” Nikita Shumov, MindStudios
  • “Top Nursing Trends for 2021: Paving the Way for Better Care in the Future,” Tiger Connect

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Moments of Joy, and Hope, from a Challenging Year

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In what has been a year unlike any other, we are reminded of the importance of taking time to celebrate hopeful moments of joy. We’ve seen just how much frontline healthcare workers are putting on the line to provide safe, compassionate care during this pandemic. We have gathered photos from dear customers across the country as the COVID-19 vaccine is administered to Frontline Heroes.

  • Emory Healthcare, Georgia
  • Beaumont Health, Michigan
  • Beaumont Health, Michigan
  • Advocate Aurora Health, Illinois
  • Advocate Aurora Health, Illinois
  • Advocate Aurora Health, Illinois
  • Norton Healthcare, Kentucky
  • Norton Healthcare, Kentucky
  • HCA Rapides Regional Medical Center, Louisiana
  • HCA Rapides Regional Medical Center, Louisiana
  • Mercy Hospital South, Missouri
  • Unity Point Health, Iowa
  • UTSW, Texas
  • Yale NewHaven Health, Connecticut
  • Yale New Haven Health, Connecticut
  • HCA Grand Strand Medical Center, South Carolina
  • Yale NewHaven Health, Connecticut
  • HCA Henrico Doctor’s Hospital, Virginia
  • HCA Houston Healthcare Southeast, Texas
  • HCA Summerville Medical Center, South Carolina
  • HCA Tristar Division, Tennessee
  • HCA West Hills Hospital & Medical Center, California
  • HCA Westside Medical Center, Florida

Utilizing the Pathway Framework to Thrive During the COVID Crisis

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This is an executive summary of a session from the ANCC Virtual Summit 2020, “Thriving in Crisis: Utilizing the Pathway Framework.” This summary focuses on the excerpt delivered by Patience Harris, BSN, RN, Sr. Pathway Specialist at the American Nurses Association.

2020 has been a strenuous year on the healthcare system. Nurses especially have felt much of the professional strain in the year of COVID-19. This year has led to nurse anxiety, for a crisis we are not able to see, understand, or prepare for. Nurses are dealing with issues like PPE and work efficiency problems and are adjusting to modified work schedules and responsibilities.

Given this challenging situation, now may be the best time for nursing leaders to recreate and maintain a positive practice environment that will ensure nurse teams feel supported, engaged, and listened to. The ANCC Pathway to Excellence® Framework can help you create a system that will enable your teams to be better partners and even thrive. Here are the Pathway Standards and examples of how they can be used.

Shared Decision Making

As a leader, engage staff at all levels through strategic planning. Because of the pandemic, shared governance councils may not be able to meet as regularly or formally as before, so be creative in how you will continue to seek input from your frontline nurses. Connecting with nurses regularly is key to show them that they have a voice and that leadership is serious about incorporating shared decision-making. For example, consider using a virtual Zoom call for rounding on the unit to give nurses opportunities to speak with senior leaders. Ask bedside nurses to participate in these rounding sessions with the CNO, but not the direct manager for the best and most honest feedback. The CNO at Metropolitan Methodist Hospital (San Antonio), for example, invites frontline nurses to spend time with her monthly to connect on issues.

Be sure to give feedback up the ladder as well. Share input from nurses directly with your Boards or Councils! Rather than just high-level nursing reports, share individual nursing stories or internal newsletters. Your organization’s Board will probably love this sentiment.

Leadership

Put strategies in place to protect, support and retain your leaders, in particular your nurse managers. At Memorial Hospital (California) for example, it was decided that meetings would be less about protocol and more about caring for the leader. By doing this, Memorial Hospital found issues and concerns that had never come up before within a larger group setting. What are other ways to support your nurse managers? Leadership could commit to being easily accessible, rounding regularly, and/or resiliency rounding in concert with pastoral care and social services that are available.

Safety

Because decisions made by Pathway organizations are shared, safety solutions often come from the frontline nurses. Nurses at Providence Hood River Memorial Hospital (Oregon) helped solved common PPE dilemmas on their unit. Nurses also helped fix ongoing issues, like the continuous ICU overflow of patients who were going to new teams, and the communication issues resulting from that. Also, at this hospital, the nurses who were in charge of supplies and workflow adjustments found that processes needed to evolve swiftly in dealing with the resuscitation of patients with COVID-19. The CNO at Providence Hood River Memorial stated that “this is a dramatic change to our usual clinical practice. We learned that our staff really are the experts when it comes to defining workflows, so they must be involved.” Staff ownership on the unit level is key, as it empowers staff to be agile and responsive as they address safety in the workplace.

Quality

In the Pathway framework, nursing participation and quality in evidence-based practice is key. Pathway organizations involve nurses in the development and implementation of quality initiatives. In 2020, many new processes, innovations, and treatments which were nurse-generated have become standards. Nurses were involved in the development of COVID-19 airway management isolation chamber (CAMIC) for example. When it comes to quality, nursing must be involved; nurses are key stakeholders for quality, innovation, and safety initiatives to be successful.

Well-Being

Well-being includes promotion of a culture that is civil, offers day-to-day recognition, and addresses physical and compassion fatigue, plus nurse resilience. This Pathway standard is even more vital during the coronavirus landscape we’re in now. Nurse executives need to be proactive in finding ways to combat nurse stress, burnout and even PTSD.

As nurses are working through this crisis, living the Pathways standard of Well-Being is a guide to mitigate the conditions that lead to stress and burnout. Consider Memorial Health South (Florida) which lets its staff know that they care about well-being by delivering yard signs to nurses’ homes that say “You Rock” and are actually signed by the CNO and other nurse leaders. The organization also started “Hope Huddles” where staff members read inspirational quotes and stories. Another health organization, St. Luke’s Global City Medical Center, a Pathway organization in the Philippines, has a rotating flower pod that goes from unit to unit with large flower arrangements and inspirational stories. St. Luke’s also turned its own auditorium into a free grocery store for its staff who have less time for shopping. It also offers free laundry and shuttle services, as well as hazard pay and housing accommodations for those in the most stretched units.

Professional Development

Nurses know that learning is an ongoing process, and is important even in the midst of a crisis. Pathway organizations recognize the importance of staff orientation, collaboration, and professional development in providing safe and effective patient care. In this time of COVID-19, most organizations have implemented some form of cross-training to accommodate viral testing needs and the influx of patients.

During a crisis, onboarding and orientation as we typically know it may not always be possible but can be accomplished through less traditional ways such as virtual meetings or online learning. One Texas health organization recognized the need for leadership development and implemented a professional practice transition program. What made it was that its frontline staff was encouraged to participate, without needing to commit to a leadership role in advance.

Great Communication is Key

The common factor in all of these standards is communication. Now more than ever, effective communication is critical to providing high-quality patient care and to staying engaged with all team members. In these demanding times, even giving bad news to staff is better than leaving them feeling left in the dark. But keep in mind that communication overload can cause problems too. As innovations and processes change quickly, be aware of how and when you communicate to avoid overwhelming your team.

ANCC’s Magnet Recognition Program® recognizes hospital organizations for excellence in patient care and superior nursing processes. Bristol Hospital, a small community hospital in Connecticut and Catalyst Learning customer, is extremely proud to be among the elite 7% of health care organizations with Magnet designation nationally. To uphold this high standard, Bristol has embraced dedication to one theme: developing great leaders at all levels of nursing, including charge and other first-level supervisory nurses.

“Critical thinking, decision making, effective communication, and conflict resolution all help to advance our nurses’ practice. The participants were most engaged in the communication and conflict style assessments. I believe it gave them a greater understanding of how effective communication and conflict resolution skills impact patient care. As the charge nurse, these skills are essential.”

Kerry Yeager, Clinical Informatics Specialist at Bristol.

Being a frontline nurse leader is a high-pressure role that is often assumed with little or no formal leadership training. Catalyst Learning’s NCharge: Nurses Learning to Lead is a dynamic, flexible series designed to improve the leadership, business management, and interpersonal skills of frontline nursing leaders. Critical leadership skills like communication, delegation, and conflict resolution require ample practice time. That’s one of the key reasons up to 70% of the time in NCharge courses is spent in group discussions and interactive activities. Learn more.

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What Your Nurses Didn’t Learn in Nursing School

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For nurses, especially those who are new to peer leadership positions, “soft skills” are important in career development. Being the best clinical and bedside nurse may mean little if other nurses are not buying into a new leader’s vision. “Soft skill” development is vital for new Charge RNs, and these skills can quickly help set a new nurse leader apart from others. But these skills are hard to quantify and are not widely taught. Most nurses get into the profession to help patients, not to lead teams. HCA designed its Charge Nurse Leadership Program to address this critical skills gap:

“The vision was to build a program based on the voice of nurses. The program would incorporate what the front line needed and wanted from a leadership perspective, with attention to meeting their needs and providing support for their careers.”

Nurse Leader, Volume 17, Issue 4, p.331-334, “Investing in the Front Line: Preparing the Best Nursing Leaders for the Next Generation”

So how can we encourage our nurses to develop these skills? And what are the top skills or techniques that should be learned?

Ways to Encourage Your Nurses

Change the entire “soft skill” dialogue

The first way to encourage nurses to have a positive attitude towards soft skill development is to discourage the narrative that these skills are actually “soft.” These qualities can sometimes be interpreted as less valuable by team members, but try to keep that from happening. Tell the team that in today’s super complex healthcare environment, and especially during the pandemic, that skills like communication, critical thinking, and teamwork are the skills that will yield big results when it comes to achieving organizational and team goals. Bristol Hospital builds on its Magnet success by teaching charge nurses these key skills:

“Critical thinking, decision making, effective communication, and conflict resolution all help to advance our nurses’ practice,” stated Kerry Yeager, Clinical Informatics Specialist at Bristol. “The participants were most engaged in the communication and conflict style assessments. I believe it gave them a greater understanding of how effective communication and conflict resolution skills impact patient care. As the charge nurse, these skills are essential.”

Teach nurses to write down goals, and find motivation to obtain them

Any newly learned skill or technique needs motivation behind it, and soft skill learning and development is no different. Teach nurses to write down reasoning for learning new techniques. For example, if your nurse wants to learn how to delegate work more efficiently, have her write down past situations where that skill would have helped the team, how it can help her lead in the future, and how she can practice that skill in the future.

Encourage working individually on each desired “soft skill,” – intentionality about practicing them

Like any skill learned, practicing helps us to improve. Encourage nurses to think small at first, gradually increasing intentionality until a desired outcome becomes easier. For example, if there is a charge nurse on your team who generally is quiet and stays in the background in a group meeting, ask her to share a few more opinions at the next meeting. This may help with learning and may lead to her more actively contributing, and this skill may become more natural for her later.

Encourage your team to take care of themselves

Let your nurses know that taking care of themselves requires thought, time, and practice. It might mean finding a nutritionist, therapist, mentor, or trainer. Identifying nursing “needs” and devising a plan to fulfill them requires a mix of soft skills, including time management, confidence, and adaptability. Investing in oneself is crucial.

Which ‘Soft Skills’ Should You Encourage Your Team to Improve?

Encourage practicing conflict resolution techniques

Better conflict resolution helps the entire team. In healthcare facilities, navigating conflicting personalities between coworkers, patients, and their families is hard, but a good nurse leader can resolve issues and minimize stressors. Healthcare delivery is stressful enough, even without personality differences. So with your team, practice resolving issues. There are many frameworks which can be used.
See this article to learn more, “Nurse Conflict Resolution Strategies.”

Communication

For any nurse, and especially for nurses new to leadership, it is crucial to be able to listen, understand, and give instruction. When communicating with patients or colleagues, getting a point across without being condescending or uncompromising is a skill that should be practiced. Voicing suggestions and opinions with peers or those in a position of authority requires practice.
According to Wellstar’s JONA case study on “The Effectiveness of Charge Nurse Training”:

“Among the leadership skills that were identified as being important to the role, communication was the most consistently reported area in which charge nurses needed to demonstrate effectiveness.”

Positivity and professionalism

When Nurse Managers and Directors are looking for young nurse talent for future leadership roles, they value those who lead by example, and are looking to improve. Encourage your team to practice positivity and professionalism by showing initiative and by thriving under direction. Let nurses know that serving as a good example and demonstrating a strong work ethic, flexibility, and positive attitude will help pave the way to future leadership positions.

The truth is, skills usually labeled as “soft” will impact the “hard” issues like organizational financial goals, patient outcomes, and patient experience which healthcare systems are eager to impact.

NCharge®: “Nurses Learning to Lead”

Are you interested in preparing your nurses to lead, especially those new to frontline leadership roles? NCharge® is an evidence-based curriculum that gives first level supervisory nurses the insights, interpersonal skills, and business knowledge they need to more effectively manage, inspire, and lead. Our customers use NCharge to build nurse leader pipelines, increase nurse engagement and retention, and impact financial awareness and results. Critical leadership skills like communication, delegation, and conflict resolution require ample practice time. That’s one key reason that up to 70% of time in NCharge courses is spent in group discussions and interactive activities. Courses like “Supervisory Skills for Positive Outcomes” teach a collaborative approach to managing conflict, and Critical Thinking Skills for Charge Nurses teaches using a process to make informed decisions. Learn More!

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“The Importance of Soft Skills In Nursing,” Eastern Illinois University RNBSN literature, May 10, 2019

“Soft Skills That Deliver Hard Results,” Health Leaders Media, Jennifer Thew RN, November 26, 2019

“The Importance of Soft Skills in Nursing, Hondros College of Nursing, Beth Smith

“Fostering soft skills among new nurses,” Wolters Kluwer, January 28, 2019

“Top ten soft skills for nurses,” Lippincott Nursing Center, Valeria Dziados MSN, CRNP, ANP-C, AGACNP-C, March 9, 2019

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How Could Nursing Change in a post-COVID-19 World?

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A new era of health care preparedness is upon us. For the healthcare industry in general, scaling up can happen when backs are against the wall. We know we can quickly add capacity, or have the ability to add capacity when care delivery needs are vast (ICU for ex.) With this new can-do spirit, we’ll see new approaches to how healthcare will be organized, delivered and distributed. And it can be led by nurses.  Here are a few hypotheses of what some of those changes could be:

 

Increased Talent Supply from Younger Clinicians

Even before the pandemic, many clinicians were frustrated by the limitations of overstretched health systems. Some of these clinicians will leave the profession for good, or scale back hours. This experience also will inspire many young adults to pursue a career in medicine. We surely need them. Besides recent optics showing how important this field is, young adults now see how large the demand is for nursing services, and how much job security they would have in an otherwise uncertain world. Expect more males to enter the nursing profession. There hasn’t been a “nursing profession surge” since the 1970’s, but expect one in 2021 and the immediate future.

Nurses are finally getting the credit they have deserved all along; the words “thank you for your service” have probably never been spoken more in history. We hope this positivity and compassion keeps nurses going, and inspires the next wave of talent.

 

Distance Work….. and Distance Learning

The pandemic showed that more nursing work experiences can be taught digitally, so more nursing schools are offering some online learning. And many believe a rise in digital nursing jobs will emerge from the pandemic, in telehealth and work-from-home settings. These roles could be aesthetics nursing, medical writing, home healthcare, legal nurse consultant, insurance case manager RN, for example.

Leadership development for bedside nurses will change too. Instead of classroom-based Charge Nurse or Nurse Manager development, much will move online and be available when nurses are not needed at work. NCharge: “Nurses Learning to Lead” for example is now offering fully digital nurse leadership development for Charge Nurses. Courses like Charge Nurse Fundamentals, Critical Thinking Skills for Charge Nurses, and Supervisory Skills for Positive Outcomes are fully available online.

 

Allowing Nonphysicians (Nurses, NP’s, PA’s) to Play a Larger Role

This pandemic put a large strain on emergency rooms and ICU’s. The non-physician support team has never been more important. But this situation only spotlights a problem that predates COVID-19 by decades. Many hospitals, particularly rural hospitals, are struggling to financially keep the doors open, and many could provide care at lower costs by leaning more heavily on non-physician practitioners. We may see Congress, state legislatures, and state medical boards start to ease restrictions, to allow these clinicians to provide more care. Needing nurses to be frontline leaders is more important than ever.

 

“Investigator-in-Chief” is officially added to the Nursing Job Description

Nurses have always worn many hats, some they haven’t always received proper credit for. But the pandemic, with a virus that sometimes has undetectable symptoms, has brought to light the new role of “investigator.” Nurses have had to play the role of screeners and contact-tracing investigators, enforcers of high-risk group prevention procedures, run surveillance on nosocomial infection prevention, and decoders on how to communicate to isolated/stressed patients through cultural differences.

 

Clinical Cross-Training, Especially for Critical Care Skills

As some health systems saw high quantities of COVID-19 patients, nurses of all specialties are turning into critical care nurses. Any nurse treating the virus needs to quickly cross-train in ICU procedures, especially being trained to care for patients with ventilators and other oxygen-delivery systems. While nurses from various units in some hospitals were floated to the ED to assist with patient volume during the outbreak, some will want to stay with that focus and appreciate working in an essential service.

Currently, of 4 million trained U.S. nurses, only 15% work in critical care units. Look for nursing schools to ramp up clinical experience curriculums in the near future.

 

Labor Supply Chain Shifts, and Scaling Up

The pandemic has shown that healthcare is in need of more reliable supply chains. You might think this trend will only affect pharma and device/equipment companies, but it will affect us all. In nursing, this could affect labor. Relying on international nurses for example may be relooked. And we’re already seeing travel nurses struggling to find contracts, as many hospitals cut much non-essential care. Many hospitals are re-looking at finances, cutting overtime, cutting per diem nurses and managing through hiring and wage freezes. Elective procedures are coming back, but will the international and travel nurse trend be the same? In the pandemic, we’ve seen that nurses can learn ICU skills quickly and with limited orientation. So health systems may think more about retraining of local full-time nurses to fill future labor gaps, instead of relying on a more uncertain supply chain of traveling/seasonal nurse labor.

Because of the pandemic, federal and state governments are shifting more government-aid to train new healthcare workers in late 2020 and 2021. As many people have been laid off during the pandemic, the federal government will roll out programs to train left out labor pools into higher demand healthcare roles. Some nursing school admissions may be waiving certain entrance requirements as well, including flexible start times. With standardized testing centers shut down, universities are reassessing testing requirements, which could help more students to be admitted to nursing programs.

As we witnessed society nearly close down this Spring, empty streets in our busiest cities, and desperate city officials begging people to stay home, there is no doubt that the world has changed.  While most of us were at home, nurses have been fighting on the front lines. Stories of heroism are almost too many to count. As we eek into a new reality, some changes will come to the nursing industry, affecting nursing perceptions, processes, skills needed, and talent pool. Nurses will be where they have been throughout the pandemic; caring, advocating, leading, adapting, and innovating.

 

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“5 ways COVID-19 will change the future of work,” Cornerstone, Kris Dunn, July 20, 2020

“The backbone of healthcare: 3 CNOs on what COVID-19 has taught us about nursing,” Beckers Healthcare, Mackenzie Bean, May 11, 2020

“How will COVID-19 change the working lives of doctors and nurses? Philips, Jan Kimpen, April 14, 2020

“This is How COVID-19 is Changing The Future of Nursing for Students and Tenured Nurses,” Nurse.org, Kathleen Gaines, June 26 2020

“7 Ways COVID-19 Will Change the Future of Nursing for the Better,” Aspen University, Sarah Jividen, July 21, 2020

“Life after COVID-19: What Will Change?”, Medical Futurist, April 21, 2020

“How COVID-19 will impact the future of nurses,” Local 21 News Pittsburgh, Talia Kirkland, May 1, 2020

“9 ways COVID-19 may forever upend the U.S. health care industry,” Stat News, Lev Facher, May 19, 2020

“How Nurses are Keeping Up with Practice Agreement Changes During COVID-19,” Registered Nursing.org, April 17 2020

“What’s Changed in Nursing During the COVID-19 Pandemic,” Travel Nursing.com, Lee Soren, August 22 2020

“Nursing Perspectives on the Impacts of COVID-19,” The Journal of Nursing Research, Wolters Kluwer Health Inc. – Shu-Ching CHEN, June 2020

“Emergency Nursing, Post-Pandemic: What Changes Can We Expect,” American Mobile, Debra Wood RN

“How COVID-19 will impact the future of nurses,” Local 21 News in Harrisburg PA, news segment by Talia Kirkland and interview with Dr. Mary Glasgow, Dean of Nursing at Duquesne University

 

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