Becker's Hospital Review

53 CMO / CARE DELIVERY Where are all the med-surg nurses? By Erica Carbajal S t. Louis-based BJC HealthCare hoped to see more nurses go into medical-surgical once the COVID-19 pandemic died down and competitive pay rates for travel assignments in critical care and emergency departments stabilized. at hasn't happened. More than 70 percent of the system's agency dollars are currently being spent on nurses to work in med-surg units, Tommye Austin, PhD, RN, senior vice president and chief nursing executive at the health system, told Becker's. When it comes to the national nursing shortage, many hospitals are feeling the effects hardest in med-surg, the areas that account for most of their beds. Before the pandemic, Cleveland Clinic Marymount Hospital in Garfield Heights, Ohio, would see more than 30 med-surg nurse hires in a single summer. "Now, however, every hospital across the country has openings that need to be filled," the hospital's CNO, Barbara Zinner, DNP, RN, said in an October blog post. Perceptions about med-surg as a specialty don't help. Oen, it's considered a "stepping stone rather than a fulfilling career path," Dr. Zinner said. And it's oen thought of as more strenuous than other specialties, given med-surg nursing requires a broad range of knowledge to care for patients who may each have very different conditions and needs. So what will it take to attract and retain more med-surg nurses? On-the-job support & flexibility For one, much more additional support so nurses can, as an American Nurses Association leader recently put it, "just be nurses" and practice at the top of their license, spending less time on tasks that aren't direct patient care. A study from 2018 concluded nurses spend about 10 percent of their time on non-nursing tasks that can be delegated — a figure that has likely risen with worsening staffing shortages over the past few years. On this front, BJC HealthCare is looking to roll out virtual nursing in med-surg areas systemwide in 2024, based on success it has seen piloting virtual nursing at four of its facilities. Virtual nurses support med-surg nurses by assisting with the admissions process, patient education and discharge, Dr. Austin said. "We've also seen the virtual nurse be used as a mentoring resource because of the number of new grads we have," as new nurses who may be intimated to ask their nurse preceptor questions can call experienced virtual nurses for support, she said. Cleveland Clinic Marymount Hospital has leaned more heavily on Nursing needs investment, not 'thoughts and prayers,' advocate says By Nick Thomas P roper investment in nursing is what is needed and not empty executive platitudes, says Rebecca Love, MSN, RN, TedTalk speaker and chief clinical officer for nurse staffing company IntelyCare. Speaking exclusively to Becker's, Ms. Love said the persistent narrative of a labor shortage in healthcare misses the point, with an all-time high of about 5 million qualified nurses in the country. The real problem is that many health systems and their executives fail to invest properly in retaining such qualified staff by making their work environments attractive places to be. Instead, all that is typically offered are empty words. "I think nurses are well aware of the emptiness of platitudes by hospital executives when discussing the nursing crisis," she said. "Statements like 'heroes work here' or 'I can't thank our nurses enough' often come across to the frontline nurses as empty platitudes similar to the statement of thoughts and prayers said by our elected officials after a mass casualty event." The lack of priority given to nurses is evident in the reality that nurses are the only healthcare professionals who do not have reimbursable services, Ms. Love added. "This places nurses as the only healthcare professionals that are a 100 percent cost to healthcare systems, and as such, nurses are staffed to the lowest cost denominator in all healthcare settings," she said. With more than half of newly qualified nurses needing a side gig to make ends meet, overstretched workers are under increasing pressure, which will lead to more medical errors similar to the RaDonda Vaught case, said Ms. Love. Ms. Vaught was convicted in 2022 for a fatal medication error made in 2017. "It's always the nurses that are written up," she said. "I don't think we as nurses ever thought we could go to jail for making a mistake. All of us could have been RaDonda Vaught." Much more than words akin to "thoughts and prayers" must be offered to the nation's nursing staff, including the reimbursement for services. "As we all know in business, where the money goes, so does investment," Ms. Love said. "And if there is one place that healthcare must invest to stabilize a crumbling delivery system, it is investing in nursing. And the only way to invest in nursing is to create reimbursement for nursing services." n

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