They can certainly help, according to this CNE.
Recruitment and retention are particularly difficult right now in healthcare, especially in nursing.
Health systems are struggling to find new nurses who will stay at their hospitals permanently. Many veteran nurses are retiring and taking their knowledge and experience with them. This combined with the overall shortage of staff leaves new nurses feeling overworked and without the guidance and mentorship of their predecessors.
Maribeth McLaughlin, vice president and chief nurse executive at UPMC, says the COVID-19 pandemic also contributed to this issue.
“During the pandemic, if you think about back in the beginning in 2020,” McLaughlin says, “for many of us, our pipelines with the schools of nursing, our academic partners…really kind of fell apart.”
Students moved to remote settings, relationships were strained, and curriculums changed, she says. And it affected academic partnerships all across the healthcare industry.
A crucial first step for CNOs dealing with this issue is to reestablish academic partnerships with nursing schools to help create clear pathways into the industry for students who are working to become nurses.
McLaughlin says UPMC partners with about 140 different schools, and a senior nurse leader runs point with each of those relationships. UPMC also created an academic affairs office, with oversight from a CNO, that helps with finding placements for students, building relationships, and partnering on new and innovative programs.
Additionally, health systems can take certain measures to support their own employees going back to school.
McLaughlin says UPMC expanded the diploma at its schools of nursing, and partnered with other universities so their students can become nurses and continue to work towards bachelor’s degrees. UPMC also has a tuition reimbursement program, in which many of the participating students are UPMC employees who are in entry level positions and want to become nurses.
“There are an overwhelming number of people who want to still become nurses,” McLaughlin says. “The challenge is helping them, not just with tuition, [but also with] going back to school, and with trying to work and go to nursing school.”
CNOs should focus on pipelines and targeted recruitment, and ensure that there are good student experiences in the health system. McLaughlin says UPMC created student ambassadors in all of the units across all the hospitals, as well as the student nurse internship program. Both programs allow students to get clinical experience before they graduate, making them better candidates for recruitment.
The education of future nurses can go far beyond university and collegiate experience as well.
“[We have started] to think about how to get into the middle schools and high schools,” McLaughlin says. “Not just for nursing, but for all of our patient care roles in a hospital, to be able to really grow our professions for the future.”
Support from outside agencies can also make these pipelines possible. For instance, the Vanderbilt School of Nursing was recently granted funds from the Health Resources and Services Administration’s (HRSA) Bureau of Health Workforce to help build the new Nurse Education, Practice, Quality, and Retention Simulation Education Training Program. The $1.5 million grant is intended to help expand offerings for students, faculty, and other health professionals and to provide them with more learning and career-building opportunities.
The grant is funded by the Department of Health and Human Services and is part of the HRSA’s Nurse Education, Practice, Quality and Retention (NEPQR) grant program. The goal behind the grant program, according to the HRSA, is to forge a pathway for students to enter the clinical environment by creating and implementing Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) to Registered Nurse (RN) bridge programs, and the employment of clinical nurse faculty. The funds can be used for program development, direct LPN/LVN to RN student support, curriculum and partnership development, and for recruiting faculty and clinical preceptors.
Support after recruitment
How can CNOs build upon this progress?
Creating the pipelines is only half the battle. CNOs must provide support for incoming nurses and make sure they feel valued and have opportunities for advancement in their careers.
“Rotating shifts is not easy,” McLaughlin says. “Being a nurse in a hospital, you’re going to work off shifts, you’re going to work weekends, [and] you’re going to work holidays.”
The support needs to go beyond just the clinical.
McLaughlin says UPMC is restructuring the onboarding and education processes to be more supportive at the bedside, and to consider what nurses need in a residency beyond the support that is typically provided. New nurses need help learning how to rotate shifts and how to take care of themselves throughout their shifts. They should be given advice on how to sleep in different patterns, eat properly, wear the right shoes and clothing, look at their schedules, and know how many shifts they should be working.
“We have a wellbeing committee of frontline staff and we’ve been working with our own health plan to develop a tool kit,” McLaughlin says. “That’s where we’re now very focused, trying to support those nurses.”
There are other kinds of support as well that must be made available to new nurses. Nurses need to have the right teaching skills and know how to deescalate situations, delegate, work in teams, and process what they are going through on an emotional level, McLaughlin states.
She says UPMC created “condition support,” which is a resource that nurses can use to get help with deescalating situations.
“Those are all things that are really important for all our staff,” McLauglin says, “so that we can help them as they transition to the workforce, [and] learn the skills they need. …We’re trying to give them as many of those tools and support as we can.”
CNOs should focus on academic partners and making sure student experiences are positive, and then focus on first year turnover. McLaughin recommends checking in with employees and asking more targeted questions to find out how they are doing.
“Try to create mechanisms for identifying people who are beginning to be at risk or are struggling [with] anything from the work to emotions or situations,” McLaughlin says. “And then [look] at scheduling, and [look] at the ability to be as flexible as you possibly can be, so that people feel like they have that work-life harmony.”
G Hatfield is the nursing editor for HealthLeaders.
CNOs should reestablish academic partnerships with nursing institutions to help create pipelines into the nursing industry.
Health systems must provide good student experiences and career advancement opportunities for new nurses.
More support needs to be provided to new nurses in order to set them up for success.