Barbara Jacobs has played an instrumental role in HealthLeaders leadership events over the years.
HealthLeaders is sad to say goodbye to Barbara Jacobs, MSN, RN-BC, NEA-BC, who recently retired as vice president of Nursing and CNO at Luminis Health Anne Arundel Medical Center in Annapolis, Maryland. Barb has played an instrumental role in our leadership events over the years, and we’ve reached out to her, time after time, for her unique perspective and insight about nursing practice.
As a founding member of our HealthLeaders CNO Exchange, she has been instrumental in connecting professionals to this peer network, as well as championing new leaders. We talked to her before she left Luminis Health to hear her advice for executives as the pandemic has altered the profession in unprecedented ways.
HealthLeaders: We have seen an exodus of nurses after the pandemic and now most healthcare organizations have a nursing shortage. What should healthcare leaders understand about this profession to attract and maintain a stable workforce?
Barbara Jacobs: It is important for everyone to realize that nursing is not just a profession for nurses; rather, nursing is who we are—it is truly a part of our heart and soul. Nurses receive incredible positives and are motivated by the relationships they have with patients and families, and with each other, and these positives allow nurses to do this demanding work. Feeling like you have made a difference in the life of another person by using expert clinical skills—and also expert people skills—is something immensely powerful. These relationships are what matters to nurses, and healthcare institutions must create environments that allow nurses to leave work feeling like they have made a difference to their patients, families, and colleagues. If we do not create these environments, we will continue to see nurses leave the bedside.
I often like to stop, day or night, and think about how hundreds of patients and families are receiving care by a nurse in our system at that very moment. We must work hard as healthcare leaders to recognize what matters to nurses.
HL: What factors during the pandemic led to nurse burnout?
Jacobs: The nursing workforce was strained before the pandemic with increasing concerns around incivility, safety, and equity of care. I was able to work with a group of nurse leaders who came together through the Beryl Institute to author a paper where we wrote about burnout and recovery. (Rushton CH, Wood LJ, Grimley K, Mansfield J, Jacobs B, Wolf JA. Rebuilding a foundation of trust: A call to action in creating a safe environment for everyone. Patient Experience Journal. 2021; 8(3):5-12. doi: 10.35680/2372-0247.1651.)
The pandemic created stresses in the workplace but, in addition, it created significant stresses in home environments which caused nurses to reconsider their work. These stresses, combined with the retirement of large numbers of highly experienced baby boomer nurses, all contributed to burnout.
HL: How has burnout impacted nursing?
Jacobs: The pandemic led to situations that made nurses consider life choices as they tried to balance home and work life. Most institutions needed to make dramatic changes in practice, often at an extremely fast pace, asking nurses to work in less comfortable situations. I believe the combination of stresses at home and in the workplace at this time it has affected the amount of energy and enthusiasm nurses can give their workplace.
It is a challenging time for leadership, as it is essential that the frontline staff feel that they are being considered and supported while undergoing the continued change required. It will take great leaders to guide people through these next years.
HL: What can leaders do to reverse the trend?
Jacobs: It is essential that healthcare leaders remember that the heart of healthcare is in the hands of the staff who touch the patient and family the most. This staff must feel supported and that they are personally achieving what matters most to them. With the extreme financial concerns affecting healthcare right now, every system is looking at how to alter models of care to provide patient care in a more cost-effective way.
We must proceed with caution as we recognize that there is a large number of less-experienced staff in the hospital workforce. As we work for efficiencies, the burdens of non-nursing activities cannot fall back on these less-experienced nursing teams. As new models emerge to keep nurses at the bedside, they must allow nurses to very concretely feel that they are making a difference in people’s lives. We are humans taking care of humans and we must care for people at both sides of this statement to succeed.
Barbara Jacobs, MSN, RN-BC, NEA-BC
HL: What does today’s nursing workforce look like?
Jacobs: The workforce of today is quite different than three years ago. With the large group of baby boomer nurses retiring and the loss of other experienced nurses, most systems are replacing these staff with newly graduated nurses. This experience gap requires us to support this staff in different ways, including providing strong nurse residencies and clinical resources for these staff. In addition, systems are experimenting with adding different members to the care team, like increased numbers of LPNs, additional foreign trained staff, paramedics, and others.
HL: Can you cite an example of a patient you particularly remember?
Jacobs: There are many patients to remember. One was a patient on my unit when I was a young “head nurse.” She was 57 years old with crippling rheumatoid arthritis, leaving her with limited use of her hands and requiring the use of a wheelchair. An experimental treatment had caused aplastic anemia, and in 1980, we just had to hope her bone marrow would start producing white cells and that we could keep her free from infections. She had a lot of near-death experiences and was hospitalized for many months.
As she finally was preparing to go home, she gave me two hand-crocheted clothes hangers that she had made with her crippled hands. I still have them, and every time I see them, I think of her hands and how we both touched each other’s lives. It was for patient experiences like this that I became a nurse.
HL: Given the chance to start out in the profession today, is there anything you would do differently?
Jacobs: I think if I came out of nursing school today, I might have put myself on the immediate track to become a nurse practitioner. But I wonder if that might have kept me from working in nursing management as much as I have done.
As nurse leaders, I think there are lots of opportunities to make the leadership roles more interesting and appealing to newer nurses. It is an incredible feeling to think you might have played a part as a leader in improving the care to many patients and had influence in the environment and lives of many nurses. We need to better portray the leadership role to excite more young staff to following this track for personal fulfillment.
Julie Auton is the leadership programs editor for HealthLeaders.