Issue link: https://beckershealthcare.uberflip.com/i/1491534
21 NURSING SPOTLIGHT 'Resilience isn't a pillar by itself': CommonSpirit's plan to support 44,000 nurses in 2023 By Erica Carbajal L eaders at small health systems might be quick to dismiss the idea of an internal nurse staffing agency, thinking it's not an option for them. Kathy Sanford, DBA, RN, would challenge that assumption. "People always think it's just something that large organizations can do," the executive vice president and chief nursing officer of Chicago-based CommonSpirit Health, told Becker's. "[But] I think we're going to have to learn to work together a little bit better." e 140-hospital organization operates in 21 states and has started hiring nurses for its own travel agency. e effort is part of the system's five-year strategic plan created right before the start of the COVID-19 pandemic. With the right partnerships, Dr. Sanford is optimistic an internal staffing agency can be a reality even for healthcare organizations with a much smaller geographic footprint. She suggested smaller systems think about combining with like-minded organizations that have similar missions and needs to develop their own staffing agency. "I think they can do that by working together in ways they've never done before," she said. Becker's spoke to Dr. Sanford about how to best support new nursing graduates, CommonSpirit's approach to prioritizing resilience, and other changes the system's 44,000 nurses would like to see in the coming year. Note: Responses have been lightly edited for length. Question: Turnover rates among new nursing grads were already relatively high pre-pandemic. Last March, you talked to Becker's about how COVID-19 further complicated that. How can health systems try to get ahead of this — what types of support are needed to reduce the turnover among nurses in their first few years on the job? Kathy Sanford: Turnover hasn't gone down dramatically since COVID-19 has waned a little bit, so that says to me that we really, really do have to take strategic actions. e No. 1 thing that we've found talking to new grads is they have to have a lot of support. New grads, no matter whether they graduated during COVID-19 or whether they graduated aer COVID-19, come into a situation where we are very, very busy; where most organizations don't have as many nurses as they'd like. And they don't have the attention paid to them that they need as new graduates. So we think it's essential to have a residency program for nurses just like there's a residency program for other professions, such as physicians. Of course, the nursing residency would not be as long, but ours is going to be a full year. We feel that making that transition from a student — where you have a classroom and you really only have one or two patients at a time, and you get to know that patient really well — is quite different from when you graduate and then have multiple patients to take care of and multiple activities that you're responsible for. So the No. 1 thing is they need support right out of school. ey need a preceptor. ey need a program. ey need to know they are not alone when they first start taking care of their own number of patients. It all just comes back to support. Q: Many nurses retired early during the pandemic. What are one to two key ways health systems can retain nurses nearing retirement in the workforce for longer? KS: One is try to have less lengthy schedules. Many nurses work 12-hour shis now, and that is pretty wearing as you get closer to retirement age. Not to say we don't have some really peppy people at all ages, but it does get wearing and so one of the things we are all going to have to look at is giving people who want to retire or are close to retirement, the opportunity to work shorter shis. at's a little bit difficult for management leadership because they have to fit that puzzle together and make sure there is enough staff there, but it is something that we can do. e second thing that we think is going to help us a lot is using more and more virtual nurses. And those virtual nurses are needed that have the wisdom and experience to help the other nurses to do things like admissions, discharges and transfers, educating the patients and making rounds with the physicians virtually — that will be a way, we think, to extend some of our nurses' careers because it's not so physically taxing. Q: Some hospitals were able to cut back on costly travel nurse reliance last year. How do you think contract labor trends may shift in 2023? KS: I think we're still going to have travel nurses. I remember that Leland Kaiser said this 30 years ago when I attended one of his meetings: e future physicians will become employees more and more and nurses will become private contractors more and more. Of course when he said that, as with all futurists, we thought, "How could that be?" Now, we're looking at things that he said 30 years ago that are happening. So I think we're always going to have travel nurses. What we're doing at CommonSpirit Health is putting in place our own travel agency. We have started hiring and already have some of those nurses out in our med-surge and critical care units. We intend to have 200 hired by the end of our fiscal year in the middle of 2023. It looks like that is coming along. We are meeting our goals for each month as we bring this program up. So that will be an opportunity for our nurses who want to be travel nurses to do that, and yet maintain their connection with us and their seniority; being part of an organization and still be able to travel when it is more convenient to their lifestyles. We're also going to look at local pools of people who don't want to travel but would like to be our employees, though still more like agency nurses in that they can really choose when they are available and when they want to work for us. We may be able to let those nurses, just like the nurses near retirement, have an opportunity to work different lengths of shis to fit into their lifestyle. One of the things I like to tell everybody who is in nursing leadership is there is no one answer. We're going to have to look at a variety of solutions to mitigate the shortage because we have a variety of issues, so we cannot just look at one thing or one way because one size does not fit all organizations and one size does not fit all for all of our nurses. Q: Clinician burnout remains a key challenge for healthcare leaders. How does CommonSpirit plan to tackle nurse burnout in 2023 or how is the health system changing its approach here? KS: We are planning to do a few things differently, but not a lot differently because