Nurse wellbeing is critical to positive patient outcomes and the overall success of a health system.
Being a nurse is difficult.
The job entails long hours, substantial workloads, and the heavy emotional burden of guiding patients through some of the toughest moments of their lives.
Nurse wellbeing is essential to the success of a health system, and it is the CNO's job to make sure they are providing programs and support to help keep their staff safe and well.
According to April Prunty, director of nursing professional development at Allina Health, more than half of the healthcare workforce is made up of nurses or nurse-related positions, so the wellbeing and success of nurses affects everyone. If nurses are not in top shape, Prunty explained, that causes a decline in patient outcomes.
"If our nurses and our nursing team members aren't doing well, they are not in a good position to provide that excellent patient care," Prunty said. "There is also some evidence to suggest that if nurses are doing well, the rest of the healthcare team is doing well."
Understanding wellbeing
Wellbeing looks different for each nurse. Some might prioritize flexible scheduling and better work-life balance, while others might want more opportunities to connect with others or time to process events.
" One of the key tenets of nurse wellbeing is really understanding what wellbeing means for the individual nurse," Prunty said. " It does look different for everybody, but there's some key principles that can be woven throughout to support wellbeing."
CNOs need to show their support and learn about their staff to understand what those needs are.
"One of the things that we often hear from nursing staff is that they really appreciate visibility," Prunty said.
Nurse leaders should take time to informally round on units and connect with staff, Prunty recommended. CNOs can take that opportunity to listen to what the nurses are telling them, so they can provide the correct support and continue to advocate for them.
"Continuing to advocate for staff [at] whatever table they're sitting at to make sure that staff have the resources that they need to continue providing excellent patient care is always important," Prunty said.
Changing the environment
The next step is to make the work environment healthier and safer. Prunty referenced the uptick in workplace violence as one of the key challenges in the healthcare industry, as well as the increased levels of care required by patients.
"We're seeing a lot of changes in some of our healthcare settings," Prunty said, "and we need to make sure that our staff feel safe coming to work, and that they're adequately prepared to care for the complexity of patients that we're seeing."
Prunty recommends that CNOs allow for adequate breaks throughout the day so that nurses can take a breather, while feeling empowered to do so.
Prunty said there are a few different phases to supporting staff who have experienced a traumatic event or high-stress situation.
The first is to provide support in the moment allow the nurse to take a step back, and reassure them that a colleague or a nurse manager has their back. The second is to make sure that the nurse has time to process what happened.
Prunty said Allina Health implemented both employee assistance programs and a spiritual care team that can support staff in real time.
"We need to be attuned to the impact of the experiences that our nurses are feeling," Prunty said. "I think the importance is having the support and resources in the right place at the right time."
Leaders also need to ensure that nurses feel like their tasks are a value add, and that they are giving nurses back time at the bedside.
"It's really important for executive nursing leaders to think about what [our workflows are] and what [our processes are], and how [we can] improve efficiency," Prunty said, "so that we are maximizing the time that we have with our patientsand making sure that we're promoting a healthy work environment."
Supplying resources
Prunty suggested that CNOs try something creative when providing resources to support nurse wellbeing. In addition to the standard employee assistance programs, a few of the sites across the Allina Health system have calming rooms, where nurses can go to take a break.
"It's a space [where] you can listen to calming music [or] meditate and take a deep breath," Prunty said. "A space where you can physically close the door and sort of separate yourself from what's happening on your unity during your clinic."
Allina Health also has robust employee well-being programs through the Penny George Institute for Health and Healing. The programs allow staff to receive coaching on a variety of different topics through online asynchronous learning.
"I think this is really our opportunity to say OK, what's working, [and] what's not working," Prunty said, "and it's OK, we can try something else."
It's critical that CNOs communicate the existence of resources as well, so that nurses can find and use them. Prunty emphasized the difficulty of communicating with nurses, since nurses do not have time to frequently check their e-mails.
Allina Health has tiered huddles that are focused on safety issues, and a communications team that disseminates all the necessary information on a weekly basis to staff. Prunty said they are also looking at ways to integrate resources into the EHR, including a button that can be pressed if nurses need resources during the documentation process.
Prunty also explained that they are leveraging social media and signage to provide even more avenues of communication.
"As our health system continues to grow in complexity and expand in geographic areas," Prunty said, "we really need to think about how [we can] reach all of our staff, because that's part of feeling included . Knowing what’s going on and not feeling left out of messaging."
Preparing new nurses
CNOs need to find innovative ways to build resiliency among new nurses. According to Prunty, the disruption to academic programming by the COVID-19 pandemic caused many new nurses to enter the industry with less clinical experience.
"I think it really is an opportunity for us to think differently about how we bring people in and help them through that transition," Prunty said.
Allina Health has implemented a strong nurse residency program that Prunty says is addressing the needs of the new generation of nurses. The program gives nurses the opportunity to build community with those going through similar experiences.
"We're talking a lot about moral distress, moral injury, processing grief and loss, [and] having crucial conversations," Prunty said. " Things that are really challenging for folks as they enter the nursing workforce."
There is also an opportunity to revamp academic programs and partnerships sto support nurses in their transition to the workforce.
Prunty emphasized the need for leaders to stay flexible.
"I would say the agility and curiosity in approaching the new needs of this workforce are going to be critical," Prunty said, "to make sure that they have what they need to take care of patients."
Leading by example
There are a few things CNOs can do to positively influence the work environment and keep spirits high, and visibility is a key component.
"I think rounding and making sure people see you as a person," Prunty said, "and you [making] that connection with your teams is critically important."
CNOs need to keep advocating for nurses in as many spaces as possible, and to help people outside the nursing realm understand the role of a nurse.
It's difficult to explain to others the invisible labor that is associated with providing excellent patient care, Prunty stated, and it's important that that's recognized and acknowledged as a critical part of providing care.
"I think any opportunity to just be curious and help people understand," Prunty said, "and tell our story as nurses, I think is really important."
The seven key standards are designed to help leaders "incorporate appropriate staffing into everyday operations and patient care," according to a press release. They are also meant to promote a healthy work environment in line with the AACN's HWE standards.
Direct care nurses participate in all aspects of staffing, including planning, implementation, and evaluation.
Hospital patient care areas establish, evaluate, and refine unit-specific staffing guidelines based upon their impact on patient and nurse outcomes.
For every shift, patient assignments are based on an accurate assessment of the current nursing workload generated by each patient's needs and align nurse competency with patient characteristics.
Clinical leaders such as charge nurses, educators, and nurse managers are not included in patient assignments, except in rare crisis situations.
Staffing plans and patient assignments support the unique needs of nurses who are new to the unit.
Organizational staffing plans are designed to prioritize the health of the work environment and thus drive nurse retention and optimal patient outcomes.
Organizational staffing plans anticipate that critically ill or injured patients generally require a ratio of one nurse to two patients.
According to Vicky Good, chief clinical officer at AACN, the standards provide a potential solution to multiple issues in the nursing industry.
"The link between healthy work environments and patient safety, nurse recruitment and retention, and an organization's bottom line is irrefutable," Good said in the press release. "These standards, coupled with a deep commitment to collaboration and change, provide an opportunity for evidence-based transformation that can profoundly improve the U.S. healthcare system's ability to meet patients' needs."
CNO impact
What do these standards mean for CNOs?
Though not mandatory, the new AACN guidelines can serve as a potential blueprint or starting point for nurse leaders to reference when looking at staffing policies and making changes that reflect a healthier work environment.
Good previously told HealthLeaders that the research shows the positive impact of healthy work environments on staff and patient outcomes. Patient outcomes improve, nurse turnover decreases along with burnout and moral distress, and the perception and quality of care improve.
“The evidence is clear that having a healthy work environment is [a] cornerstone to nurse well-being and retention,” Good said, “but now the research even demonstrates [the impact on] our patients.”
Nurses are being recognized for the work they do during this long-standing week of observance.
Amidst the chaos of the healthcare industry, it's important to honor the nurses serving on the front lines who provide patients with compassionate care, as well as the nurse leaders who support them.
The annual celebration of National Nurses Week takes place on May 6-12, and HealthLeaders is taking part. Join us for our very own Nursing Week, where we'll recognize the important role that nurse leaders play in the success of their organizations and community.
Flexibility is key for workforce development, says this nurse leader.
On this week’s episode of HL Shorts, we hear from Peggy Norton-Rosko, the new chief nurse executive at the University of Maryland Medical System (UMMS), about strategies for recruiting and retaining nurses in all generations. Tune in to hear her insights.
CNOs have complex intersecting issues to overcome in the modern landscape of nursing.
Modern problems require modern solutions, and in nursing it's no different.
Current pain points for nurse leaders surpass the realm of just caring for patients. From the rise of AI to the surge of negative perceptions on social media, CNOs have a lot to address.
The 2024 HealthLeaders CNO Exchange wrapped up last week in Florida after three days of enthusiastic idea-sharing and elevated discussion about the biggest topics in nursing. Here's how CNOs are tackling the key issues that are keeping them on their toes.
Creative recruiting
Recruiting is a huge piece of the puzzle, especially amid the nursing shortage. The Exchange members spoke about implementing scholarship and tuition reimbursement programs as a way to both recruit and retain nurses who are beginning their careers or continuing their education. CNOs should also consider elevating the role of LPNs to help support patient care in a more effective way.
Additionally, the members talked about the importance of sourcing new nurses from local communities in a socially responsible way. If the community is serving itself, it can result in improved recruitment, retention, representation, and potentially less workplace violence incidents. Having that positive cycle of community can also influence the narrative surrounding nursing and push a more positive message about the profession.
Growing new leaders
One of the biggest challenges in the nursing industry is the growing generational gap between tenured nurses and new nurses. Concerns have been raised about how to keep the knowledge of retiring nurses in the industry and how to deal with the fallout of nurse leader turnover.
At the Exchange, many members expressed the need for more nurse leaders and educators to help guide the next generation of nurses. They advocated for academic partnerships and the creation of pipelines into the nursing industry, and for starting the education process earlier.
Rather than starting nurse residency programs after new nurses graduate, CNOs could consider starting those programs during the students' junior or senior year, so that they can finish up their education and residencies simultaneously and be ready to work right away. The members also recommended that CNOs identify leaders among their workforce early and invest in growing their careers.
Building resiliency
Another generational challenge with new nurses is their lack of experience with the difficulties that come with nursing. To the Exchange members, it's important that nurses are taught throughout their education about what happens on a nursing shift and how to handle tough situations with patients, families, visitors, and other hospital staff.
On the leadership side, CNOs need to understand wellbeing and see their nurses as whole people who are processing events both at work and at home. The members emphasized the importance of this especially with nurse managers, who are often spread too thin and who are trying to appease both the frontline nurses and higher leadership.
Additionally, with workplace violence increasing across the industry, it's critical that CNOs and other nurse leaders develop more effective prevention methods. The members recommended partnering with security to create better responses when incidents occur, and empowering nurses to feel confident handling tough situations with patients.
Integrating technology
When it comes to technology, it seems like all roads lead to virtual nursing and AI. Currently, virtual nursing is largely being used to offload documentation from bedside nurses, for mentorship opportunities, and to assist with admissions and discharges. Virtual nursing has a broad future ahead, and the members spoke about how the future of all healthcare is virtual, beyond just nursing.
The Exchange members also emphasized the importance of giving nurses a seat at the table in AI integration and implementation discussions, so that the technology doesn't become a burden. CNOs need to pay attention to the messaging around AI and communicate clearly with their nurses about how the goal is to support them, not act as a replacement.
See more key takeaways from the 2024 CNO Exchange here.
The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at our LinkedIn page.
From the frontline to the C-Suite, nurse leaders say they need a seat at the table.
Nurse leaders have a lot on their plates.
From ensuring nurses have a say in the integration of AI into healthcare systems, to improving the public perception of nursing, to demonstrating the value of nursing to the C-Suite, a CNO’s work is complex.
In times like these strategizing with peers is key, and that’s exactly what dozens of nurse leaders from across the country are doing right now.
The HealthLeaders CNO Exchange is well on its way as the participating members discuss these pain points in nursing and innovative solutions for dealing with them.
Here are three areas where nurse leaders say nurses need a seat at the table.
AI
The emergence of AI in healthcare has the potential to turn the industry upside down, and in many ways it already has.
The biggest concern amongst nurses, according to the Exchange members, is making sure that nurses have a seat at the table in determining how AI will be integrated into their health systems. The implementation of any new technology can become a hindrance if not implemented correctly, so it is crucial that CNOs partner with technology teams to determine the best ways to move forward.
Another key factor is messaging. CNOs need to make sure they are communicating to their nurses that AI is not there to replace them, but rather to support them and help offload some of the more administrative tasks so they can spend more time at the bedside.
Perception of nursing
In terms of recruitment and retention, the public perception of nursing on social media has been affecting the number of people wanting to become nurses. According to the members, the public outlook on the profession has become very negative, and nurse leaders have lost control of the narrative.
Some of the solutions that were discussed include utilizing social media to spin a more positive message about nursing and about working in healthcare. CNOs should consider bringing in experts who are familiar with social media and enlisting their help to create a more positive message that can then help draw new potential candidates into the industry.
Value of nursing
One of the biggest hurdles that CNOs have to jump through is presenting the ROI for nursing to the rest of the C-Suite. According to the Exchange members, the cost of nursing is distributed between other parts of the budget, even though nursing makes up the largest portion of the healthcare workforce.
To the members, the important thing is that nurses are valued and appreciated for the services they provide, and recognized for the revenue that they bring to the health systems through quality care and patient interactions. One recommendation from the members is that CNOs should round with their CFOs, when possible, to demonstrate what's happening at the bedside, and have open lines of communication with other members of the C-Suite.
Stay tuned for more takeaways from the 2024 CNO Exchange.
The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at our LinkedIn page.
Workforce development continues to be a top concern for nurse leaders.
Many nurse leaders are strategizing as best they can to deal with the growing nursing shortage and how to incorporate new innovative solutions for redesigning care models to fit the modern care needs of patients.
Here are some of the workforce development issues keeping CNOs up at night.
Nurse leaders must come together to tackle these three main pain points in workforce development.
2024 has been a wild ride in the world of healthcare so far. With increasing turnover rates and the rapid rise of new technologies pushing their way to the forefront, the question of how to address core issues becomes increasingly dizzying.
In nursing, it's no different.
Many nurse leaders are strategizing as best they can to deal with the growing nursing shortage and how to incorporate new innovative solutions for redesigning care models to fit the modern care needs of patients.
From April 24 to 26, the members of the HealthLeaders CNO Exchange will be meeting in Miramar Beach, Florida, to talk about how to address the workforce development issues facing CNOs today.
Strategic workforce planning
To combat the nursing shortage, CNOs need to develop a plan of action that involves several different components. Leaders must come up with new recruitment strategies that include promoting diversity, equity, and inclusion as well as building pipelines through academic partnerships.
Retention strategies must include how to build resiliency, and transition-to-practice programs that help situate new graduate nurses in their roles. Additionally, leaders must offer educational and personal growth opportunities, along with robust and competitive career paths.
At the Exchange, the members will come up with new ideas to tackle these challenges as well as ideas for new innovative care models that have the potential for positive outcomes.
Digital solutions
Modern health systems should be up to speed on the best uses of AI and robotics, as well as successful methods of device integration. Leaders should be using data and analytics to support the nursing workforce and the nurse managers by minimizing the burden of documentation.
In addition to workforce strategy, the Exchange members will brainstorm digital solutions to fill gaps and enhance nurse workflows. They will also discuss how to plan and execute virtual nursing models, and the constraints, outcomes, and ROI of using virtual technology.
Leadership
The key to all of these strategies is strong leadership. CNOs should be fostering teamwork between colleagues and nurse departments, and they should be able to clearly communicate with staff and build relationships with them.
The Exchange members will discuss change management and how to get to a "Yes we can" culture. They will strategize ways to create healthier work environments by reducing staff assaults and implementing more effective patient behavior policies. Lastly, they will discuss C-suite trends and financial stewardship and come up with strategies that align the CNO with the CFO and improve performance metrics.
Follow along to learn more about these topics and solutions for workforce development.
The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at our LinkedIn page.
UMMS' new CNE aims to lead the health system on a journey to become a high reliability organization.
Peggy Norton-Rosko brings more than three decades of nursing experience and leadership. Most recently, Norton-Rosko served as the Regional Chief Nursing Officer for Trinity Health's Illinois and Indiana regions, where she oversaw nursing practices across a network that included an academic medical center, two community hospitals and a large ambulatory care network. She also served as an affiliate faculty member with the Loyola University Chicago Marcella Niehoff School of Nursing.
Following a nationwide search, Norton-Rosko has been named Chief Nurse Executive for the University of Maryland Medical System (UMMS), an academic-focused system which employs more than 9,300 nurses, effective May 20th.
For our latest installment of the Exec, we sat down with Norton-Rosko to discuss how she began her journey into nursing, her thoughts on the future of virtual nursing, and meeting the needs of a multigenerational workforce.
The nurse leaders at AONL looked to the future to solve the current workforce issues.
The 2024 AONL Conference wrapped up last week in New Orleans after three days of brainstorming, collaboration, and leadership discussion. There were many common themes throughout the sessions and the keynotes, but as expected, workforce development was front and center. Turnover rates are high among frontline nurses and in leadership positions, and even though predictions are positive, the current nursing shortage is going strong.
The nurse leaders in attendance offered many creative and innovative solutions for the different prongs of the workforce crisis. Here are the top five subjects they focused on.
