Inova Health's chief nurse executive offers long-term steps to recruit and retain nurses.
During the dark days of the COVID-19 pandemic, nurse leaders were faced with critical staffing shortages when nurses were needed most, with one study indicating that 62.5% of chief nursing executives (CNEs) surveyed did not have adequate nursing staff and 79.1% experienced high nurse turnover.
Now that the worst of the pandemic appears to be behind us, along with the scramble for nurses, some healthcare organizations are taking more long-term steps to attract and retain nurses.
Inova Health, Northern Virginia's largest nonprofit healthcare provider, has instituted several such programs, says Maureen Sintich, DNP, MBA, RN, WHNP-BC, NEA-BC, Inova’s chief nurse executive and executive vice president.
Here are five of them:
1. Leaders should be visible
As the nursing shortage worsened during the COVID-19 pandemic, Inova Health’s nurse educators and clinical leaders stayed available and visible to support their teams—an effective practice that remains in place today.
“They were there, supporting our teams as we were learning new and different ways to care for our patients. Leadership visibility was critical,” Sintich says. “Whether it was a nurse, physician, service line leader, or administrative leader, we prioritized checking in and are continuing to do so now.”
Not only has leadership visibility throughout the health system continued, but it has expanded since the pandemic, Sintich says.
“We extended leadership visibility to a broader group of leaders, including nonclinical leaders,” she says.
2. Create a sense of purpose and belonging
Like other health systems across the country, Inova brought in travel nurses to augment its permanent staff, and continues to do so; however, the high pay rate that travel nurses can command makes hiring them on a large scale an unsustainable option, Sintich says.
“We recognize we can't compete with the travel nurse salaries, but we're very focused on our work environment and what we can compete with is creating that sense of purpose and belonging, as well as well-being,” she says. “We know that nurses want to be involved in meaningful work.”
Early in the pandemic, Inova redefined the meaning of shared governance across the system. As a result, nurses’ involvement in the planning and the structure was elevated from their unit or department level to the system level, prompting broad representation of frontline nurses, Sintich says.
“Trusted advisors who lead many of our councils are focused on professional development, improving quality, nursing informatics, improving technology, documentation, holistic care, caring science research, evidence-based practice implementation and many, many other areas,” she says.
One of the challenges was simply to make things easier, Sintich says.
“Whether it's documentation [or] having their equipment and supplies at their fingertips … they were spending time on non-nursing tasks and so we've worked with our IT and supply chain colleagues to streamline many of their requests,” she says. “We have proactive rounding by our IT teams to address any equipment issues proactively and redistributing supplies for easier access.”
3. Provide mental health services
“If there's anything that the pandemic highlighted, it was the mental health crisis as a whole, but it's also exponentially impacted our healthcare team members and our nurses, so another measure that we put in place early on was behavioral health nurse practitioners,” Sintich says.
The behavioral health nurse practitioners round on not only nurses but all team members across the health system, she says.
“Our team members were so grateful for this service and so appreciative that we are now hiring on-site counselors who are available to our teams,” she says.
4. Allow nurses to grow within their job
Bedside nurses often want to learn more while staying close to the bedside, so Inova created the Nursing Informatics Liaison Program to allow nurses to develop new skills, allowing them to grow within their career.
“We're identifying additional opportunities where nurses can bring their expertise to bear, whether it be focused on quality and safety, nurses as educators, or nurses in performance improvement,” Sintich says. “They’re able to take their time to learn new skills that they can apply both at the bedside, but as well as in meaningful organizational work.”
The liaison program, which grew out of the pandemic, also provides meaningful projects, she says, such as improving documentation, reducing the documentation burden, and ensuring appropriate quality measures.
5. Give new nurses individualized career development
“We’ve recognized that new nurses want to learn a number of different skills in their career, and rather than moving up the chain of command, they may not have a desire for a leadership role, but they may have a desire to learn different areas of expertise,” Sintich says.
For example, a newly graduated nurse may have started out in the medical-surgical department, but then decides to try labor and delivery, neonatal intensive care, or the operating room. A nurse may decide to go to graduate school to become a nurse practitioner. Inova provides career development for nurses who want to explore different areas of healthcare, Sintich says.
“We're very much focused on how we can best support our team members through that individualized career development plan, and what they may want to accomplish in their careers,” she says. “We also recognize that can change as they learn and grow, so we want to be able to take that into account as well.”
'We want them to feel joy in the work'
Nurses bring much more to the table than a caring spirit; they bring extraordinary capabilities, as well, Sintich says.
“When you hear people talk about nursing, you hear them talk about the art of nursing and no doubt we are a caring profession, but we don't necessarily talk about the science of nursing,” she says. “Nurses are experts. They're scientists, they're informaticists, they’re health policy leaders, educators, quality improvement experts, and so much more.”
For those reasons, Inova provides ways to support nurses through their career, Sintich says.
“We strive to provide that environment where nurses can thrive professionally and we want them to feel joy in the work because we know that there's what I believe to be sacred work,” she says.
“It’s not easy, but there is such a pride in the profession,” she says, “and we want every nurse that comes into the organization to feel that that sense of accomplishment and pride, as well as belonging.”
“Nurses are experts. They're scientists, they're informaticists, they’re health policy leaders, educators, quality improvement experts, and so much more.”
— Maureen Sintich, DNP, MBA, RN, WHNP-BC, NEA-BC, chief nurse executive and executive vice president, Inova Health
Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.
After implementing staffing stop-gap measures during the pandemic, healthcare organizations are taking long-term steps to attract and retain nurses.
Inova redefined the meaning of shared governance, elevating nurses’ involvement from the unit or department level to the system level.
Inova provides career development for nurses who want to explore different areas of healthcare than where they were trained.