This blog is from a recent HealthStream webinar entitled “Building Back Your Workforce in Healthcare’s New Norm.” The webinar was moderated by HealthStream’s Trisha Coady, Senior Vice President and General Manager, Workforce Development Solutions and featured Dr. Bonnie Clipper, DNP, MA, MBA, RN, CENP, FACHE, FAAN, Managing Director, Innovation Advantage, Diane Hanson, RN, BSN, MM, FNAP, CNO, EBSCO and Editor in Chief, Dynamic Health, and Linda Groah, MSN, RN, CNOR, NEA-BC, FAAN, CEO and Executive Director, AORN.
Recruitment and retention have long been critical issues in healthcare, but the impact of the pandemic has sharpened healthcare leaders focus on these issues. Coady began by sharing that the bad news on retention actually got worse last year. Hospital staff turnover increased in 2021 by 1.7% to 19.5% and nursing turnover increased by 2.8% to 18.7%. Nursing shortages are a vicious cycle. They create working environments where errors are more likely to happen, where mortality and morbidity rates are higher and burnout is more likely, thus creating environments where retention is a concern. Healthcare leaders need a plan to build back a strong and resilient workforce. So, what are the essentials of such a plan?
Coady began by asking Dr. Clipper about lessons learned from the observation of both successful and unsuccessful onboarding strategies. Dr. Clipper began by citing some rather alarming statistics from a recently published study that indicated that a staggering 55% of Gen Z nurses do not plan to stay in nursing until retirement. Those nurses cited two factors in their planned departure from nursing: 1.) They feel unsafe due to sub-par onboarding and orientation practices and 2.) They perceive a lack of commitment from healthcare leaders to improve their workload and workflow. Dr. Clipper stressed the importance of working with schools on transitions to practice and leveraging technological solutions such as learning management systems and virtual reality to help nurses learn skills and build confidence.
Groah stressed the importance of onboarding in establishing the organization’s culture of lifelong learning. “I think that lifelong learning actually starts with instilling a commitment to learning during orientation,” said Groah. She also stressed the importance of helping new nurses establish a career path early in their careers and cited the importance of leadership’s commitment to support nursing education as a partnership between each individual nurse and the facility.
All of the panelists agreed that the growing number of digital natives in the healthcare workforce makes it important to incorporate technology in new and creative ways including using technology in onboarding and engagement strategies. Dr. Clipper encouraged listeners to embrace the kinds of technology that can improve care delivery workflows as well as learning workflows and onboarding. Specifically, technology such as artificial intelligence and predictive analytics can really help improve workflow along with remote patient monitoring and other virtual care models that may be helpful as workflow solutions.
Groah shared that, during the pandemic, AORN began to incorporate more interactive response design into their training and have also incorporated micro-learning into their app. “These are the things that people want. This is the way that young people want to be educated. The interactive approach has proven to be the most effective one for younger nurses,” shared Groah. She also shared the importance of “stackable” learning as not all students will want or be able to absorb large amounts of content in just one sitting.
Hansen also shared that because of the current demographic makeup of the healthcare workforce, the use of technology is an expectation. “Technology solutions need to be fast in order to answer clinical questions at the point of care. The solutions need to be evidence-based in order to provide really good decision support that results in excellent clinical quality. It also really needs to be faster and more relevant than Google or YouTube; otherwise, they will go there because that is what they are used to,” said Hansen.
Of course, the process of building back the healthcare workforce requires commitment from healthcare leaders. Coady shared that nurse retention is, not surprisingly, highest within organizations with a strong commitment to developing and engaging their staff. However, how to best create that culture can prove to be a significant challenge for leaders.
Hansen encouraged leaders to remain focused on providing opportunities for growth. “It is important for leaders to focus on continuous learning and make new nurses feel supported and to help them know that they are part of something bigger than themselves,” said Hansen. She went on to stress the importance of creating a great culture and a connected team. In addition, she had some practical suggestions for engagement and development strategies such as, offering nurse residency programs, providing dedicated time for the acquisition of new skills, using learning checklists, maintaining licensure and specialty certifications, and simply helping nurses focus on what is next in their careers.
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