CNOs and other healthcare executives are strategizing to address recruitment and retention, workplace violence, and virtual nursing challenges, say these nurse leaders.
Nurse leaders have had many challenges to face this year as the nursing shortage continues.
CNOs and other healthcare executives have been brainstorming ideas for addressing this shortage as well as disruptors such as AI and virtual care.
From Nov. 6 to Nov. 8, the members of the HealthLeaders Workforce Decision Makers Exchange will meet in Washington D.C. to discuss critical workforce issues in nursing, and innovative solutions to address recruitment and retention, technology, and workplace violence challenges.
According to Putnam, one of the biggest hurdles for recruitment and retention is keeping the workload burden off of the direct patient care nurse.
"[They're] the largest part of the nursing workforce," Putnam said, "so how do we as individual health systems, hospitals, [and] clinics…listen to our first line nurses?"
Putnam uses the term "first line" rather than "front line" for a very specific reason.
"I think frontline sounds like a war zone," Putnam said, "and I don't want my nurses to think they're in a war zone every day, even though it's very difficult."
Another hurdle is generational differences. Gen Z nurses who are just now coming into the workforce have different expectations of the job than previous generations have had, and according to Putnam, recruiting Gen Z starts with technology.
"Gen Z-ers are our first truly digitally native generation," Putnam said. "The technology is important, and I think we have to figure out ways to utilize that in such a way that helps them and utilizes their skill sets."
Social media, diversity, flexible scheduling, and work-life balance are also top priorities for Gen Z, according to Putnam.
"The Gen Z-ers love work, but they also have other priorities in life," Putnam said. "Work needs to have purpose, and what better purpose is there than being a nurse?"
Workplace violence
Nurses face a lot on the job, and unfortunately workplace violence continues to be a large issue for nursing workforces in health systems everywhere. According to Szkolnicki, workplace violence impacts the workforce in a fundamental, traumatic way.
"Nurses [face] the emotional toll, the vicarious trauma, because they are feeling what their patient is feeling," Szkolnicki said. "The fact that our patients and their family members sometimes attack us, maybe even physically…it's horrible."
Szkolnicki emphasized the need for laws to catch up when it comes to harming a healthcare worker.
"Gratefully, in a lot of states, they are passing acts to make sure that it's a felony when you physically attack a nurse," Szkolnicki said.
For Szkolnicki, it comes down to having the basic need of feeling safe at work.
"We all have a basic need to feel safe where we are," Szkolnicki said. "It's something that is very serious and requires a very disciplined and deliberate approach."
Virtual nursing
The surge in new technology has been a large disruptor in nursing, particularly in the case of virtual nursing. According to Boston-Leary, virtual nursing has been growing exponentially in the past year or two.
"Some organizations have jumped in it fully with both feet, some are treading water and probably just letting come up to the waist," Boston-Leary said, "and some are still on the fence because they want to see the outcomes [of] implementing this technology."
Virtual nursing can be implemented in many different ways, which is why the ANA is establishing principles around virtual nursing, according to Boston-Leary.
"A nurse leader, a colleague of mine, said that it feels like the wild, wild west," Boston-Leary said. "So how do we tame this beast?"
Boston-Leary emphasized the concern about rural hospitals and health systems that cannot afford the technology. Part of the ANA's goal is to understand the various options and applications of virtual nursing, and how smaller systems can use and receive resources for virtual nursing programs.
"There's a Cadillac version that probably would not be affordable by most," Boston-Leary said, "but what's the American-made car version of this that's more available, accessible, and affordable to organizations that don't have a lot of the resources that large institutions do."
Looking ahead
Boston-Leary listed several immediate concerns facing CNOs, including the supply chain.
"The hottest issue is supply chain, with climate change and how that impacted our supply [of] IV solutions because our major manufacturing plants in the U.S were disrupted by Hurricane Helene," Boston-Leary said. "It's impacting care delivery [and] surgeries are being cancelled at this point."
Another concern is racism and discrimination in nursing, specifically because of legislative impacts on diversity, equity, and inclusion, Boston-Leary explained.
"There's data that show that because of the major shift after the murder of George Floyd that caused this [issue] to become front and center, a number of people of color, leaders, were hired into these roles," Boston-Leary said, "and a lot of these department roles have gone away."
Boston-Leary also described the growing divide in nursing between staff and leadership, and the general unease surrounding AI in healthcare.
"You have this divide that's growing between nurses and nursing leadership about [what's] important, and margin versus mission," Boston-Leary said, "and then you have AI where people are not sure what to do with it, whether they should be scared of it, or embrace it, or both."
All of these issues and more will be discussed at the Workforce Decision Makers Exchange, so stay tuned for more coverage.
The HealthLeaders Exchange is an exclusive, executive community for sharing ideas, solutions, and insights.
Here are some ways nurses can take care of themselves, says this nurse educator.
Nurses have a stressful job, between caring for patients, communicating with families, and being on their feet for several hours at a time.
According to Maryn Moreni, associate professor of nursing faculty at the Arizona College of Nursing, prioritizing self-care is crucial for maintaining well-being and can help reduce compassion fatigue and lower stress levels, allowing nurses to approach each shift with renewed energy and focus. Self-care can enhance mental and physical health, ultimately leading to improved patient care.
It's also important that CNOs encourage self-care in their workforces to promote wellness and a healthy work environment.
Here are 10 self care tips for nurses, according to Moreni.
Click here to view the accompanying contributed article.
Health systems should partner with their local and international communities to build their workforce, says this CNO.
On this episode of HL Shorts, we hear from Dr. Rachel Miles chief nursing officer of AdventHealth, Rocky Mountain Region, about strategies for recruiting nurses both locally and internationally. Tune in to hear her insights.
Nurse leaders should run with their strengths, according to this CNO.
As a passionate advocate for nurses, Dr. Rachel Miles is committed to ensuring caregivers and patients have a positive experience. Miles earned a Doctor of Nursing Practice degree from Regis University in Denver and her Master’s and Bachelor’s degrees in Nursing from the University of Central Florida. She recently served in executive roles within the Centura Health system, including Chief Nursing Officer for the Denver Metro Group and Vice President of Nursing Operations.
Miles was recently named chief nursing officer at AdventHealth Colorado and AdventHealth Porter in Denver. Miles has a track record of improving nurse engagement and retention while achieving strategic growth, and her leadership philosophy includes keeping frontline caregivers in mind when making decisions.
On our latest installment of The Exec, HealthLeaders sat down with Miles to discuss her journey into nursing, and her thoughts on trends in the nursing industry. Tune in to hear her insights.
Nurses should engage patients in their care plan, according to this CNO.
Nurses wear many hats in the industry, but their primary focus is on patient interaction and care delivery.
According to Cassie Lewis, chief nursing officer at Bon Secours’ Richmond market, part of Bon Secours Mercy Health, and HealthLeaders Exchange member, improving patient engagement begins with the day-to-day interactions between the patient and the bedside nurses who care for them.
Here are some tips on how nurses can engage with patients and make them feel more comfortable.
Health systems should work to meet patients where they are at and create programs with social determinants of health in mind, says this CNO.
On this episode of HL Shorts, we hear from Cassie Lewis, chief nursing officer at Bon Secours’ Richmond market, part of Bon Secours Mercy Health, and HealthLeaders Exchange member, about how health systems can address the social determinants of health (SDOH). Tune in to hear her insights.
The HealthLeaders Exchange is an exclusive, executive community for sharing ideas, solutions, and insights.
WVU Medicine has invested in a diploma program, says this CNE.
For years in West Virginia, nursing education has taken place within educational institutions.
Registered nurses typically complete a two-to-four-year program, then enter the workforce after earning their degrees and taking the proper exams.
However, WVU Medicine West Virginia University is investing in an alternative route.
According to Melanie Heuston, chief nurse executive at WVU Medicine and HealthLeaders Exchange member, the health system has implemented a hospital-based nursing school and registered nursing diploma program through its Center for Nursing Education.
"We're doing something that's a bit unconventional in the academic field," Heuston said. “We are developing and sponsoring our own 2-year diploma program that will serve as a pipeline of new nurses for our 24 hospitals.”
Heuston explained there are diploma programs that exist across the United States, but that this program is one of the first of its kind.
"We really wanted to be a bridge to people getting further education, so we are developing our Center for Nursing Education to offer West Virginians an alternative to the traditional path to becoming a nurse.”
Program specifics
Heuston described the program as a traditional education with a contemporary approach. The program is free of charge and students are given all necessary materials, including computers, books, and uniforms.
"We have been developing it for over a year, a very short timeline," Heuston said. "We are making an enormous investment in the new school to ensure students are immersed in a state-of-the-art facility.”
Recruiting faculty for the program has been successful, according to Heuston, and so has enrollment.
"We opened our enrollment this past summer on August 15," Heuston said. “Within a week, we had over 100 applicants, and today…we have 620 applicants [who] filled out the entire application for our inaugural class of 24."
The students will begin the program in August 2025, following a rigorous selection process that includes interviews. Enrollment is broad-based, Heuston explained, which is also known as holistic admissions.
"We’re not just looking at test scores," Heuston said. "We're actually going to interview for caring attributes to be ensured that they're the type of nurses that really want to work in a med surg clinical environment."
Program goals
The goal is to promote impatient bedside nursing as a long-standing career, according to Heuston.
"We're going to interview every candidate and we're hoping to expand very quickly," Heuston said. "The State Board of Nursing only allows us to take 24 students until we have the demonstrated outcomes."
"They have been supportive partners," Heuston said. "They want to see us succeed and have shared everything that they've done well to integrate into our environment."
Ultimately, the program is meant to be a pathway for continued education. Heuston said they have signed memorandums of understanding for local schools as well as with West Virginia University, to give the students a bridge to a bachelor's degree.
"We really want to promote the idea within our clinical ladder," Heuston said, "and give them free tuition to get their baccalaureate degree as well."
The HealthLeaders Exchange is an exclusive, executive community for sharing ideas, solutions, and insights.
This unique nurse identifier follows nurses for their entire career, says the NCSBN.
HealthLeaders spoke to Jason Schwartz, director of member outreach at the National Council of State Boards of Nursing (NCSBN), and Matt Sterzinger, director of information technology, about the NCSBN ID and its applications. Tune in to hear their insights.
The NCSBN ID can be used as a unique nurse identifier, according to the organization.
Health systems are feeling the effects off the nursing shortages as they try recruit and retain qualified nurses who want to continue being a part of the industry.
As more innovative staffing solutions arise, it's up to CNOs and other nurse leadership to take advantage of the systems and tools that are already in place to build a strong workforce.
According to Jason Schwartz, director of member outreach at the National Council of State Boards of Nursing (NCSBN), and Matt Sterzinger, director of information technology, one of those tools could be the NCSBN ID number.
The on-demand staffing model breeds loyalty and longevity, according to this CNO.
On this episode of HL Shorts, we hear from Jennifer Garnica, vice president of nursing and CNO at SSM Health St. Mary's Hospital, St. Louis, about how the W-2 on-demand staffing model is addressing staffing concerns. Tune in to hear her insights.
