2026 Trends in Nurse Scheduling Transcript

HealthStream’s 2026 Trends in Nurse Scheduling report examines how healthcare organizations are managing nurse staffing in an increasingly complex clinical environment, highlighting key gaps in visibility, flexibility, and system integration. Based on survey input from more than 400 professionals involved in nurse staffing and scheduling decisions, the report provides a grounded view of current practices and where they are falling short. It points to persistent challenges such as fragmented scheduling processes, difficulty filling shifts, and the growing impact of burnout and turnover on workforce stability.

During this webinar, HealthStream leaders walk through these findings, framing the report as a reflection of real-world experiences rather than just a set of metrics. The discussion emphasizes how common practices — like department-level scheduling and reliance on manual processes — limit coordination across units and create inefficiencies that strain both nurse leaders and staff. At the same time, presenters highlight areas of progress identified in the report, including the widespread adoption of self-scheduling and the shift toward more flexible, blended staffing models that account for patient acuity and real-time needs.

The conversation then turns to what these trends mean in practice. Speakers explore the operational and human impact of scheduling challenges, particularly the ongoing difficulty of building and filling shifts, which remains one of the most pressing issues for organizations. They also address the expanding role of float pools, the need for better data integration across systems, and the cautious but growing interest in AI-supported scheduling tools. Throughout the session, the focus stays on how organizations can move beyond reactive, unit-level approaches and begin to treat scheduling as a coordinated, system-wide effort that supports retention, efficiency, and high-quality patient care.

Click here to access the full webinar.

Timestamp Overview

[00:01:06] Webinar Tools and Downloading the Report

[00:01:56] Meet the Speakers

[00:05:16] Six Key Findings

[00:07:12] Poll: Staffing Visibility

[00:08:12] Finding One: Managing the Schedule  

[00:11:40] Finding Two: Self-Scheduling

[00:16:47] Poll: Acuity in Staffing

[00:18:14] Finding Three: Blended Models

[00:20:08] Finding Four: Filling Shifts

[00:24:20] Poll: Float Pool Structure

[00:25:35] Finding Five: Managing Float Pools

[00:27:16] Finding Six: AI and Scheduling

[00:33:36] Three Big Takeaways

[00:36:25] Final Poll: What Resonates

[00:39:00] Audience Q and A

Full Transcription

Disclaimer: This transcription was written by AI, thanks to Descript, and has not been edited for content. 

Welcome and Overview

[00:00:00] Sandra Kent: Hello, and welcome to our 2026 Trends in Nurse Scheduling webinar, where we will be reviewing what 450 nursing professionals have told us about the current state of nurse staffing. We're so glad you've joined us today for this thought leadership webinar.

[00:00:29] Here at HealthStream, we're the leader in healthcare workforce solutions. We help organizations work better through varied products focused on scheduling, credentialing, learning, and clinical development, along with our hStream platform that connects everything through our HealthStream ecosystem.

[00:00:50] My name is Sandra Kent Kent, and I am the senior product marketing manager here at HealthStream, and your moderator today.  

Webinar Tools and Downloading the Report

[00:01:06] Sandra Kent: Just a few little things. At the top of your console are buttons to display or hide various panels. You can use the reaction buttons, so if you see something you like, let us know with your reaction buttons. You can also download the nurse scheduling report that we'll be discussing today by clicking on Get the Report button listed. And then if you would like to see a demo of any of our HealthStream products, you can also hit the Request a Demo form, and one of our awesome representatives will reach out to you.

[00:01:29] You will also see Ask a Question box on your console, so if you have any questions, feel free to put them in there. And if we have time at the end of today's webinar, we'll be going through them as much as time allows. So we are recording today's webinar, and we will be sending out a link to the recording and a link to the report as well after today's webinar is over.

Meet the Speakers

[00:01:56] Sandra Kent: And I'm excited to introduce you today our speakers, Dr. Emily Brooks. She's a highly respected healthcare leader with a strong background as a nurse leader. She's a former chief nursing officer and currently our VP of onboarding and success here at HealthStream. She brings deep expertise in clinical leadership and driving operational improvements along with, across all -- I'm sorry, across healthcare organizations. Also joining us is Catherine Musclow. She is a registered nurse with a background as nurse manager in critical care and ICU, along with managing and supervising nurse supervisors for a 600-bed hospital. And now she's our editorial director here at HealthStream. Welcome, ladies. And Catherine, I am going to turn it over to you to get us started.  

[00:02:49] Catherine Musclow: Thank you, Sandra. Excited to be here. As Sandra mentioned, I'm Catherine Musclow. I'm a registered nurse by background, and I've spent years in critical care at the bedside and in nursing leader. Today, I get to bring all of that experience into my role here at HealthStream as editorial director. And really what that means is I have the privilege of digging into research like this, that we're going to share today and more importantly, connecting the dots. So translating what it really means for the people doing this work every single day. So let's dive in. First, a quick look at where this data that we're going to talk about comes from.

[00:03:27] So in the fall of 2025, we surveyed healthcare professionals across the continuum. So we looked at nurse leaders, executives, nurses, educators, and operations team. And for today's conversation, we're really going to zero in on the over 400 respondents who directly, who are directly involved in both staffing, scheduling, and operational decisions.

[00:03:52] So this group that we surveyed it's broad. It spans acute care, long-term care, ambulatory settings, you name it. We're looking at really these findings in really a narrow slice. So looking at it from a meaningful industry-wide snapshot of what's happening right now. I also want to be transparent though about this data.

[00:04:14] It's self-reported. It reflects perceptions and lived experiences not just audited or not audited metrics. So here's the thing, this is important because those perceptions really matter. Data is super important, and those metrics are really important, but also these experiences. What nurses and leaders share in surveys like this, it's real. It really aligns with what we hear in conversations with amongst each other every single day. So that consistency to me is exactly what makes these insights so powerful but also so actionable. Emily Brooks why don't you talk about the key findings from this study?  

[00:04:54] Emily Brooks: Absolutely. Thank you. Hi, everyone. I'm Emily Brooks. I'm the vice president of onboarding and success here at HealthStream. Like Catherine, I'm a nurse, and I'm a nurse with a critical care background, nursing education, nurse leadership, and was a CNO before coming to HealthStream. As a disclaimer, Catherine and I have actually worked together in a hospital before, so we know each other well and we share a lot of the same stories, but not all.

Six Key Findings

[00:05:16] Emily Brooks: So before we dig into each finding individually, let's take a step back and look at the bigger picture so that you can see all six together, and then the story really becomes clear. And this isn't a story about just technology or staffing ratios. It is a reality about a workforce that's stretched thin, but as we know, incredibly resourceful.

[00:05:36] And it's about the gap between where scheduling practices are today and where they need to go. So our first finding, 57% of organizations are still managing scheduling at the department level, and that sounds like an operational detail, but it's actually the root cause of a lot of other problems because when everyone's managing their own silo, nobody can see the big picture.

[00:05:57] Finding two, 77% of organizations now offer self-scheduling, and that's up from 68% just last year. So nurses are getting much more control over their schedules, and that certainly matters for retention. Finding three, 60% are using a blended approach to staffing decisions, combining ratios, acuity, and manual adjustments for flexibility.

[00:06:20] So we're moving away from the one size fits all, and we are making progress. Finding four, building and filling shifts is still the hardest part of the job, and I'm pretty sure that resonates with everybody. It scores 6.5 out of 10 on difficulty, and with the cost of replacing one RN well over $50,000, it's not just a scheduling problem anymore, it is a financial one.

[00:06:43] Finding five, 81% of organizations manage floating across departments. And finding six, less than 10% of organizations have implemented AI for any scheduling use case. The interest is there, the readiness isn't quite yet. So Catherine and I will walk through these six findings, and we have some interactive polling discussions throughout, so please read them carefully and click directly in your screen, and we look forward to your feedback.

Poll: Staffing Visibility

[00:07:12] Emily Brooks: And we're going to start with our first polling question. How visible is your staffing picture across units today? Scale of one to 10, with one being low visibility and 10 being high visibility. And I'll give you some time to ponder, a few minutes, a few seconds, and we'll move ahead then.

[00:07:36] Click right in your screen, on the number there. Okay, looks like we're at about 50% of respondents. Okay, Catherine.  

Finding One: Managing the Schedule  

[00:08:12] Catherine Musclow: All right. Thank you. So let's dive a little deeper into finding one that Emily mentioned before. So department-level scheduling leaves blind spots. This is where we really want to start and focus because it's the foundational challenge that makes everything else harder. So here's the picture.

[00:08:29] So there's 57% of the organizations that we surveyed are primarily managing schedule at the department level. Only 17% have a centralized scheduling system, and 21% are using more of a hybrid approach. So now department-level scheduling is probably how most of us have learned to do it. It gives unit managers control, it's familiar, and it works up to a point.

[00:08:55] The problem is that when every unit's managing its own schedule in isolation, nobody has a clear view of the whole organization. Actually, when we surveyed these nurses, we, or the nurses in our report, they found that there was a 5.4 out of 10 visibility score. And I think back to myself, as a nurse leader, one of the things that we often found was that I was on my own island, right? I was worried about my own staff and how I was going to schedule and have enough nurses to schedule and meet my patient needs sometimes even in four-hour increments, while in reality the person or the unit across the hall could have had enough nurses and maybe a low acuity or a low census, and they were getting ready to flex their nurses home.

[00:09:41] Without having that full visibility, it put us in a little bit of a -- it did a disservice to us. And that's really the consequence. Leaders don't know if the unit next door is overstaffed while they're scrambling to fill a hole, and I feel like I can attest to that wholeheartedly.

[00:09:57] Only 38% of respondents said that their scheduling system integrates with other systems. And then when they looked at EHR integration, less than 20% said that they integrated with EHR. So think about what that means. You're making staffing decisions without access to real-time patient acuity data. You're basically flying partially blind. And the downstream effects are pretty costly, so there's excess overtime greater reliance on staffing agency, and burnout all which ultimately chip away at retention We see this play out with health systems all the time. The good news is that organizations don't really have to choose between unit level autonomy and system-wide visibility.

[00:10:41] A hybrid enterprise model can really give you both. Think of it as really like a centralized control tower with local landing strips. House supervisors and service line leaders can see everything, but unit managers would still have the flexibility to manage their teams. So when you tie in float pools, self-scheduling, and incentives into a single integrated platform, you can really fill shifts faster, you can spend less hopefully on premium labor, and frankly, your charge nurse has to stop having to make a 15-minute or 15 phone calls at 5 a.m., or if you're the nurse leader, staying late or working on a Saturday to try to fill those last minute holes.

[00:11:23] I think though the practical first step is to invest in a single source of truth for workforce data, one that will help us integrate our scheduling system with time and attendance credentials, and hopefully HR.

Finding Two: Self-Scheduling

[00:11:40] Catherine Musclow: So for finding two we found this is probably, not really any news to us nurse leaders, but that self-scheduling is really the new standard. It's pretty exciting. Seventy-seven percent of organizations now offer self-scheduling, which like Emily mentioned before, is up from 68% last year, and that's a pretty significant jump in just a year. So when we look at why this really matters, I think the research is pretty clear. Flexible nurse-driven scheduling is directly linked to higher job satisfaction and retention. So when nurses feel like they have a say in their schedule, they're most likely to stay. What's interesting though is the method split.

[00:12:20] So about 49% of organizations are using a healthcare-specific app for self-scheduling, while 46% are still relying on manual spreadsheets or paper. And I feel like I could raise my hand to that. We relied a little bit on both when I was a nurse leader. We had our paper that would sometimes go missing in the middle of the night or go missing the next day.

[00:12:41] And then we would also have an application that we used to help us with our schedule. So both get the job done but they create very different experiences for staff and also have the risks for leaders. One finding that I find really telling is that 70% of the respondents were satisfied with their scheduling operations overall, but only 46% were satisfied with their scheduling software.

[00:13:08] So that gap told me that scheduling processes are ultimately evolving faster than the technology being used to support them. And I think, like we do in nursing we figured out workarounds that, the tools just haven't caught up to. So what I think, my biggest takeaway, is for our nurse leaders today was about self-scheduling, is that offering it is really not enough.

[00:13:31] I think the fairness piece is what really matters just as much as the access piece. And in our conversations with nurses, one of the recurring frustrations that we saw was that yes, it's not that self-scheduling exists, it's that the rules sometimes felt inconsistent or they weren't really clear. Who gets first pick of the prime shifts? Are holiday assignments equitable? When a manager overrides a nurse's selection, is there a clear reason? Because I'm sure all of us nurse leaders could attest to the fact that your nurses are paying close attention to that schedule, and they know who works how many weekends, and they know who worked the last holiday even when we might not pay as close of attention to it.

[00:14:13] In, we do in paper format sometimes but it's not a solid representation and there's definitely some room for error. Organizations doing this though have typically published transparent scheduling rules. So some rotate who gets first access to shifts, or I should say, organizations that are doing this well have published transparent scheduling rules. So who gets first access to shifts, some set like a skill mix constraints that run in the background. And I think for me, if you're going to choose a self-scheduling or a scheduling application, the policy matters just as much as the platform does  

[00:14:54] Emily Brooks: So Catherine Musclow, you're making me think back to 25 years ago. When you first start nursing and you get the binder, and it's X'd out certain days where there's enough nurses signed up. And then fast-forward to a hospital where I worked recently, and it was self-scheduling, and we did make workarounds. It was all on paper, but then we had a weekend makeup shift on a piece of paper. We had holidays priorities on a shift of paper or on a piece of paper. We had this on paper, that on paper, and all of it was posted above where you had to sign up for your shifts. So fairness, equitability, yes, we were absolutely trying very hard to incorporate that, but with a very antiquated system and without a whole lot of visibility.

[00:15:36] There was a lot of people pulling it down so that they could see, what is my holiday this year? Somebody else can't see it. So that, that really resonated pretty strong still in, 2026, the use of manual and paper. But then having all those rules and having visibility in a system and how much easier that could make it, so that you could go in and see, hey, I was sick last weekend with a stomach bug. I have to make up my weekend here. Perfect. That's done. I don't need to worry about it. It's already assigned. That flexibility, especially for nurse leaders then, so that we're not doing the firefighting an hour before a shift when we realize we don't actually have any nurses on the unit, which is also a very real reality  

[00:16:18] Catherine Musclow: Yeah I was thinking, Emily, you said 25 years ago the paper was X'd out, but I would guess that people are probably still using that same practice.

[00:16:26] Emily Brooks: I would think so, yes. Yeah.  

Poll: Acuity in Staffing

[00:16:47] Emily Brooks: Okay, our next poll question, and this time we will get an answer. Which model most accurately describes how your organization incorporates acuity into your scheduling and staffing decisions? So you've got a lot of answers here. We'll take a few minutes, read through it carefully and, give your best, honest answer that you can.  

[00:17:49] Okay, it looks we're at, it looks like we're just above 50%. And so a mixture of ratios, acuity, and manual seems to have won. And that's actually pretty consistent with what our nursing trends report showed as well, especially with ratios and acuity, and then the mixture of ratios only coming in close behind

Finding Three: Blended Models

[00:18:14] Emily Brooks: So let's talk about finding three and our blended schedule models, and they're rising. 60% of organizations, and we just saw this in the poll, are now using what we're calling a blended approach. That means we're combining patient ratios, acuity data, and manual adjustments to really figure out how many people, how many nurses we need on a shift.

[00:18:32] And 47% have specifically implemented acuity-based patient assignments also represented in our poll. So that's progress. That's real progress because we've known for years that acuity-based staffing definitely leads to better outcomes for patients and better experiences for nurses. It's good to see that actually happening in real life, but here's the thing, and here's the reality. Even a well-designed ratio model is static. It's built for the average shift. It doesn't know that you had three unexpected admissions at 11 on a busy med surg floor, or that suddenly you need a patient in the ICU with ECMO, or that your patient population has gotten significantly more complex over the past six months.

[00:19:13] So yes, ratios matter, but readiness, the right skills, right place, right time are really what's needed for the best nurse experience and patient care. And so regulatory bodies are catching up to this. We know there's a lot of scrutiny around the link between staffing and patient safety, and that is only increasing. So this is no longer just a conversation about workforce. It is also becoming a conversation about compliance. And so look at your models in your hospital. Reflect a little bit on those poll answers. Which shifts consistently feel understaffed even when you're technically at ratio? And that's your signal.

[00:19:48] That's where a blended approach could and would make the biggest difference. And what does that blended approach look like for your organization? So that's the thought process that we really need to continue to advance our scheduling models and our scheduling practices.

Finding Four: Filling Shifts

[00:20:08] Emily Brooks: So finding four, building and filling shifts is the biggest challenge, and this one I think is very familiar to everybody. So we asked leaders to rate their biggest scheduling challenges on a scale of 1 to 10. The overall difficulty of billing and building and filling shifts came in at about 6 1/2. And do you know, I'll be honest, when we were discussing this, I think that number is really conservative because what's underneath is completely exhausting.

[00:20:34] The back and forth, the last minute scrambles, the firefighting, the charge nurse, like Catherine said, who's making 15 calls before 6 a.m. trying to find coverage for the 7 a.m. shift, that night shift nurse who went home to sleep and their phone is just constantly vibrating or dinging. You're on vacation and your work bestie is calling, begging you to come work, forgetting that you're on vacation.

[00:20:57] And so there's a lot of feelings here. There's a lot of emotion. And every leader I talk to knows exactly what this looks like, just as every nurse knows exactly what it feels like. And so here's the financial reality. It costs on average about $60,000 to replace one registered nurse, one. And so for every one-point drop in turnover rate, organizations then save close to $300,000.

[00:21:21] So when we're talking about this as a scheduling problem, and we're trying to make it a strategic problem, we're also talking about it as a very real financial problem. And the thing that we don't often talk enough about is why people leave. And, Catherine mentioned this in the very beginning, a lot of this traces back to the schedule.

[00:21:38] When nurses feel like they're being called in at the last minute, guilted into overtime, either by their nurse manager or their bestie, or floated without their input where they may not feel they have the best competency, that's where disengagement starts. And that's, that schedule then is often where respect shows up or doesn't.

[00:21:57] So practically thinking, we know three things that would make the biggest difference. We know these, and we know them well. Number one, post schedules further out. That gives people greater visibility and greater control over their lives. And two, be transparent with shift incentives. People are more willing to pick up when they know what's in it for them.

[00:22:15] Three, invest in predictive data. If you can see and you know which shifts are likely to go unfilled a week in advance, you're then in a proactive state rather than reacting in a panic. So think about visibility, think about predictability, but also we can't forget burnout, because we always have that one nurse who will always pick up whenever asked, driving towards burnout.

[00:22:38] And so this is why nurse leaders are telling us that this is one of the biggest scheduling challenges.  

[00:22:46] Catherine Musclow: Emily Brooks, I was just thinking before you jump to that poll question that, that last piece, the burnout piece, it's, as a nurse leader, I think post-COVID, we're probably all thinking about burnout and the mental health and the wellness of our nurses.

[00:23:00] But I think even pre-COVID, while we were still thinking about the burnout and, how our nurses are feeling and, where their kind of mental state is, it wasn't as much, at least in my opinion, at the forefront our, of our minds. So having a tool that would give me some type of data to say, "Hey, Emily has worked consistently, 60 hours a week or 50 plus hours a week every week for the last three months," like you need to check in on that person. Because I think oftentimes we're so bombarded as nurse leaders with just our day-to-day that we're -- not the last thing, the schedule's extremely important, but it's another thing on our plate that we have to manage.

[00:23:42] So having just the visibility of understanding where and how many hours a week your nurses are working, I think is super important and also can help with that burnout piece.  

[00:23:54] Emily Brooks: And yes and yes, and it's the burnout piece with the nurses. It's also the burnout piece with our nurse leaders, and not having the tools at hand to be able to be proactive with scheduling. Maybe not having, I can see in the comments, an acuity tool to really help build that schedule with ratios, with acuity, and then being able to flex appropriately. So yes, we have very real burnout with our clinical nurses at the bedside, but we also have a compounded burnout with our nurse leaders, so 100%.

Poll: Float Pool Structure

[00:24:20] Emily Brooks: And here is our poll question. I'm glad we stopped here, gave people a little bit of a jump to start putting their answers in. So how are your float pools organized? System-wide; by care setting, think med-surg, ICU, labor and delivery; region-wide; or maybe you don't have a float pool.

[00:25:04] Fifty percent is my magic number. Okay, the results are in. Looks like care setting wins, followed by system-wide, followed by no float pool, and region-wide. So this is a little bit different. This is very interesting that when I had a group of HealthStream users in a room, we talked all about this. So this is why it's so important to actually do these polls and then have some discussion around them. So what did our report tell us?

Finding Five: Managing Float Pools

[00:25:35] Emily Brooks: Finding five is all about float pools, and there's a lot of good news here. But there's also a few numbers that actually made me step back and think a little bit. So 81% of organizations manage floating across departments. Sixty-two percent in our Nursing Trends poll have centralized float pools, and 39% run them out of a central staffing office.

[00:25:55] And so all of that seems to be heading in the right direction. But, here's the thing. Only 34% of organizations automatically exclude staff from a shift when their credentials or competencies have expired. So that's nearly one in three said they weren't even sure if their system does this. So suddenly, yes, we don't just have a scheduling issue, but now we have a patient safety issue, a liability issue.

[00:26:19] We want to be, and we need to be confident that we have the right nurse at the right time with the right patients. And so more broadly, think about whether your float pool governance has kept pace with how much that float pool has grown or changed over the years. Scaling the pool is the easy part.

[00:26:36] Maintaining visibility, competency standards, and safeguards, that's the harder work. And so a good starting question is, do you know today which of your nurses in your float pool have credentials or competencies that may be expiring in the next 60 to 90 days? And if that answer isn't a quick yes, then that's where I would start investigating. Do you have the technology? Do you have the scheduling system with those competency standards, visibility, and safeguards? And how are we driving towards that very best nurse experience delivering safe patient care?

Finding Six: AI and Scheduling

[00:27:16] Catherine Musclow: So now I'm going to bring it to our last finding, which was AI integration. So AI integration is growing, but adoption is still lagging. I want to be transparent. In my opinion, AI is only as good as the data behind it, and really the people using it. So what we found was that right now less than 10% of organizations are actually using AI for scheduling in any meaningful way.

[00:27:42] So that includes everything from building the initial schedule to predicting open shifts rebalancing based on patient needs or acuity supporting fair scheduling, and then even making recommendations based on competencies. So Emily was just mentioning do we have visibility into our floor nurses? Do we know if their competencies are up to date, or am I scheduling someone that I think might be or think is ECMO certified but actually is not, or maybe they didn't recertify or they're not up to date on their competencies? So all of that showed us that still we have under 10% of our organizations using AI.

[00:28:23] So when we asked leaders really why the answers were pretty clear. About 77% pointed to immature AI tools. 47% said that cost was a concern, and then 40% cited that there was regulatory uncertainty. And in my opinion, those aren't just excuses, they're real valid concerns.

[00:28:46] But what's interesting was that when we asked those same leaders about their priorities, so improving scheduling so one of the questions we asked, sorry, was improving scheduling efficiency, and that scored three point nine out of five. And then using technology to reduce workload came in at three point seven.

[00:29:04] So what we saw there was that the desire is there but the readiness just hasn't quite caught up yet. So the question we ask ourselves really, or we can ask ourselves, is: where does that leave us? And I think there's a really practical, responsible path forward. It doesn't mean going all in on AI tomorrow. It starts with data, because the truth is, like I mentioned before, that AI is as good, it- or is only as good as the data it has access to. So if our scheduling system isn't connected to your time and attendance system or your HR platform or your credentialing data it's missing that critical context, so it can't really see that full picture.

[00:29:45] So I think that step one if you were going to try to adopt AI, it's really that integration piece. Step two is starting small with a very specific measurable use case. So maybe it's using AI to help you predict open shifts a week out or identifying fairness gaps in how schedules are assigned. Start there and then measure the impact. Look at your hour saves your reductions in premium labor costs. But also that will all help you build that clear ROI and then scale from there with the right governance in place. So set those rules. Before though -- before we deploy any AI-powered scheduling tool or before you choose any AI scheduling tool, put together an AI steering group because scheduling decisions don't just impact operations.

[00:30:35] They're going to impact your staffing levels, your nurse-to-patient ratios, and then ultimately patient safety. So when AI is influencing those decisions, it needs to have that same level of oversight and rigor as any clinical tool you would trust. In nursing, we put together AI steering groups for everything, every new piece of equipment that we bring in. For the most part, we want the nurse's input, the actual user's input. So why not do that with the same type of thing when we're looking at an AI scheduling system?  

[00:31:06] Emily Brooks: And I think that's crucial, Catherine, when you think about change management when it comes to AI, and that is that shared decision-making. It's pulling some of the biggest naysayers and saying, "Hey, I'd love to have your input. I'd love to have your feedback on how AI can make a difference for you in your everyday job." And, in that bigger group that I was talking to, we really went down and had some great conversation about where would AI actually add the most value, not just at the leader level for scheduling and making sure all the systems talk and are connected, but what does that look like at the bedside and for workflow, and how do they all integrate together so that you have a system that tells you, "Hey, Catherine, you've got some really sick patients on your unit.

[00:31:45] Here's an accurate acuity score that is really going to reflect what it feels like and what it looks like." And maybe not even necessarily just from a registered nurse perspective, but what does the entirety of that care team need to look like to meet that need? Having the competency piece factored in, having the different types of care teams factored into that. And so again, like I said, we had some great lively discussion, and we identified several barriers that still exist today, and Katherine, you mentioned them. Systems not talking to one another. Does this system talk to my competency system, talk to my staffing shift system? Does it talk to the EHR?

[00:32:24] In a perfect world, what does that look like? What could it look like? But then how do we find those small wins to really capture on them, to show value at just a little, tiny, minuscule level, and then build it from there? So I actually love this conversation. I think we could probably talk for hours about the different aspects of AI and how they can really fit in and augment what nurses and the entire care team do today. So thank you.  

[00:32:50] Catherine Musclow: Yeah. I was actually just going to -- I was thinking, as a nurse leader, having a tool that could provide more data to the nurses but also to you as a nurse manager will save you probably some hours of sleep at night. Yeah. Because I just thought about some of, some of the messages that I would get in the middle of the night about switching --

[00:33:12] "Hey, I found so-and-so to switch a shift with me today or for tomorrow," but then it turns out, that person doesn't have the same skill set. So having that correct visibility or the ability for that nurse themselves to say, "Oh, I can't switch with Emily. Her skill set is not the same as mine. Or she doesn't have those specific credentials, okay.”

Three Big Takeaways

[00:33:36] Catherine Musclow: So I'm going to close out with the three big takeaways I think from today. So the first one is we have to stop treating scheduling like a unit-level fire drill, and really start treating it like a system capability. Yeah. And that means moving toward more of a hybrid enterprise approach where we have some centralized visibility, standardized rules, but still giving those individual units that flexibility that they need. I think when things like float pools, self-scheduling, and incentives are all connected in one system, everything ultimately works better.

[00:34:09] You fill shifts faster, you can reduce that premium labor, like I mentioned before. And all of us nurse leaders aren't -- and your charge nurses aren't constantly in that reactionary mode. And then the second piece is we have to hardwire flexibility and fairness. Retention starts with the schedule.

[00:34:29] Self-scheduling, we saw, more and more organizations are using self-scheduling. It's not a perk anymore. It's become expected by a lot of our nurses. But it only will work if people actually trust it. So that means things like rotating first access, making sure schedules are able to reflect acuity and skills, and really listening to the nurses when they say, "This doesn't feel fair," or, "This isn't working."

[00:34:56] Because honestly, that feeling when a schedule feels off- ... that's really where that turnover begins. And then the third piece before we jump into AI, we’ve really got to get that data foundation right. That means connecting the scheduling with the time and attendance with competencies, with HR data, and with credentials.

[00:35:16] So all of that really has to come together and has to be able to speak to each other. And then we can start small. Maybe it's, again, predicting those open shifts or auditing fairness, measure what's working, build some trust in it and then, and only then start to scaling and get bigger. For those of you who haven't had the opportunity to read our report or for those of you who have one of the pieces or one of the lines that kind of really stuck with me was the statement that, "By integrating flexibility with cutting edge technology and equitable practices, we can create a workplace where nurses feel valued and supported."

[00:35:55] And I think for me as a nurse leader, that's the goal. And probably all of us could attest to this. That's really the goal. Everything we talked about today is about taking steps towards that direction or in that direction. So before we really end, I think, Emily Brooks, you might have one additional poll question for this group?

[00:36:14] Emily Brooks: I do, if you want to advance forward.

[00:36:20] Catherine Musclow: There you go.  

[00:36:21] Emily Brooks: Okay.  

Final Poll: What Resonates

[00:36:25] Emily Brooks: So before we open it up for questions in the Q&A we want to hear from you. So we covered a lot of ground today, six findings, a lot of data, but we're curious, which one lands closest to home for you and your organization right now? Which is the one that resonates most and is keeping you awake at night? So read carefully. We'll give you some time to get those answers in --  

[00:37:02] Catherine, while they're answering, think back to your nurse manager days over the medical intensive care unit. Which one would've resonated the most with you in the height of COVID?

[00:37:12] Catherine Musclow: In the height of COVID, oof. So --

[00:37:15] Emily Brooks: -- many of these --  

[00:37:15] Catherine Musclow: I would want to --  

[00:37:16] Emily Brooks: -- say --  

[00:37:16] Catherine Musclow: -- all of these, honestly. Yeah. I feel like I could make -- I could talk about each one and how they resonate with me. Let me look one quickly. I think scheduling is leaving blind spots. But then also, oof --

[00:37:30] Emily Brooks: I know.  

[00:37:31] Catherine Musclow: It's a really hard question. Building and filling shifts is still --  building and filling shifts is still challenging. That's the one I'm going to go with. And I guess for me, I think that's one I would --

[00:37:38] Emily Brooks: -- pick.

[00:37:39] Catherine Musclow: Yeah. I think for me though, that one was the most challenging, and part of it was because you could make your schedule, you could balance your schedule, and then we didn't have the ability, besides our own knowledge, to really see while we're building that schedule what the skill set was. So in the ICU, I had to make sure I had an ECMO nurse, at least one, working. Yeah, a CRRT balloon pump nurse. So all of my device nurses, I had to make sure that they were also on every shift and it sometimes more than one of them on every shift in the event that I had multiple ECMO patients or multiple device patients. So I think that piece was probably my most difficult piece.  

[00:38:26] Emily Brooks: Let's see what our attendees said -- 38.5% will agree with you. Building and filling shifts is still challenging, followed by self-scheduling process needs work and department level scheduling is leaving blind spots Yeah. So that's pretty reflective of our trends report too, driving home a lot of the same messaging. Okay.  

Audience Q and A

[00:39:00] Emily Brooks: Hi, Sandra.  

[00:39:01] Sandra Kent: Hi, I'm back. So I've been checking the inbox, and we do have a few questions in here. First one, and I will just put it out to both of you guys, and whoever can answer it best, just feel free. But what lessons have you learned from implementing or managing float pools?

[00:39:23] Catherine Musclow: I guess I'll take this one first. So I'll say I think the biggest lesson I've learned is that flexibility is everything. But I think flexibility only works if someone's actively managing and advocating for those nurses. So just important as a nurse manager is for a unit it's also important for those float pool nurses to have some governance over them, that unit or that float pool themselves.

[00:39:48] They have the same needs as any of our other nursing staff so we need to make sure that we stay current on competencies and education. And I think what I had experienced is sometimes because they weren't anchored to a specific unit, it was easy for them to fall through the cracks. Yeah. So having that dedicated oversight for that group was essential.

[00:40:16] Catherine Musclow: So one more thing is that when a float pool, I think, is centrally managed they really are able to shine and they're, I feel like they're most impactful. When you can move them to a centralized scheduling model, you really can allow, or you can get that bird's-eye view of the whole house, where you can actually see where the needs are across every unit and deploy your resources really in a way that makes sense. And I think that when a float pool goes from just a staffing tool that's -- sorry, that's when a float pool will go from just like a staffing tool to really a strategic asset.

[00:40:51] Emily Brooks: 100%, Catherine. I hit the nail right on the head. Even in a smaller hospital where the float pool may have been, 10 or 12 people, it was very evident they wanted to be a team. They wanted to have their own team, and they needed someone to be their leader, to be their manager, to keep them up to date with competency, to work with their PTO requests, to work with their scheduling. And so that was critically important to them, even on a smaller scale. So yes, 100% agree with you. Thank you.  

[00:41:21] Sandra Kent: All right, we have another. Do you have any suggestions for nurse burnout or scheduling equity while filling gaps? So we do have a couple other questions that kind of ask about scheduling equity, like people that don't want to work weekends or making sure you have the, like you said, the right nurse on call for the right situation that you have. So we've got several questions in those ways just about scheduling equity, filling gaps, making sure you have the right nurse in the right location at the right time.  

[00:41:55] Emily Brooks: Catherine, do you want me to start with this one?  

[00:41:57] Sandra Kent: Sure.  

[00:41:59] Emily Brooks: Okay. I think laying out those expectations upfront is critical. Having visibility with what are the actual requirements, putting that out for everybody to see becomes imperative. We work as nurses in union and in non-union hospitals. The rules can be very different. The rules can be held accountable very differently. But it really, it starts with visibility, it starts with transparency, and for a lot of our nursing teams, whether they're experienced nurses or newer to the profession, it is understanding the why behind it.

[00:42:31] And sometimes just a simple explanation of this is why it is the way it is can go a long way because it tells them that you're asking for their feedback, you're hearing their feedback, and you're trying really hard to incorporate their feedback. And that's really a big piece of it. It is a science, and it is very difficult to get people on board when they miss a weekend for no reason of their own, but it is a rule that they have to make it up. And so then we work with them to make sure that they're on a shift where they are able to make up their requirement. So really it comes down to great communication, flexibility, visibility, and hopefully the technology tools to make that an easier process for everybody

[00:43:13] Sandra Kent: Okay. One other, how do I help my organization make nurse scheduling a priority?

[00:43:22] Emily Brooks: I think that's like the best question ever. And it's probably the thinking side of me. Nurse scheduling has to be a priority. It has to be part of your strategic plan. And your nursing strategic plan needs to be developed through shared decision-making. You need to have the input of the voices at every level of nursing, all the way from the bedside all the way up to your chief nursing officer.

[00:43:45] And everybody needs to be in agreement that this is a priority because it is on our nursing strategic plan, and then celebrate the small wins, and as a team, identify what they look like. If we do this, here's the outcome. Why is that meaningful? If necessary, link it back to your nurse sensitive indicators. Link it back to turnover. Put your financial ROI around the entire thing. But it has to be an entire nursing team effort to have that on your nursing strategic plan. Okay.  

[00:44:19] Catherine Musclow: I was just thinking you could be -- oops, sorry. We could also make a case for nurse scheduling being a priority because we looked at how many travel nurses are we using, right? And we looked, 100%, at our vacancy and how many people have left, and we could probably tie a lot of that back to that burnout piece. They, these were nurses who were constantly scheduled or who had rotating shifts or had no really work-life balance per se.

[00:44:47] Emily Brooks: And then when you flip that and put the financial lens on it, you've then built a beautiful, perfect business case that will resonate with your CFO, with your CNO, if you're not the CNO, to really say, "Hey, why wouldn't we do this? We absolutely need to do this." And our goal could be perhaps to save X amount of dollars and then reinvest that back into your nursing staff, and how does that then benefit the organization financially and the patients from a patient safety aspect, and your nurses from turnover and their satisfaction and engagement?

[00:45:21] Sandra Kent: I think that is about all the time we have today for questions, so I'm going to move us along and close us out here. First of all, thank you everyone for attending today. We do appreciate it. We hope you've gained some valuable insights from today's webinar. And again, remember, we invite you to download the 2026 Trends in Nurse Scheduling report that is available. You will also receive it via email. So if you are planning though to be at any of these upcoming conferences, we will be too, and we would love for you to come by and meet us. So Workday Rising which is in Las Vegas in October, NAMs, which I believe is in New Orleans, and then ANCC Magnet is, I believe is Chicago.

[00:46:12] Or I could be wrong. But anyway thank you so much for joining us today, and we appreciate your time. Have a wonderful day. Thanks so much.