'Nontraditional' approach needed to beef up nursing pipelines, Memorial Hermann leader says

It's been almost four months since the National Council of State Boards of Nursing released a study that sounded alarms throughout healthcare. 

The National Forum of State Nursing Workforce Centers study, unveiled on April 13, spotlighted an oncoming national crisis — one in which 800,000 nurses are predicted to leave the workforce by 2027. 

The study pointed out that nurses are leaving their chosen profession in record numbers and that the statistics are expected to get worse. It also suggested myriad reasons for the predicted exodus, from burnout to anticipated retirement, and noted the existing pipeline strategies set to back fill these roles likely wouldn't be enough to manage an aging population that will need more, not less, healthcare.

In the wake of the release of the study, hospitals across the country have been doubling down on their creative recruitment and retainment strategies. Many have instituted new initiatives to attract students who are already committed to becoming nurses, as well as programs to incentivize others in their communities — from high school students to members of local organizations — to pursue a career in healthcare.

As the competition to recruit and retain nurses continues to be an issue, Becker's spoke with Bryan Sisk, DNP, chief nursing executive at Houston-based Memorial Hermann Health System. He and his team are actively trying to identify ways to get ahead of the challenges posed by the nursing workforce shortage.

Editor's note: Responses have been edited for clarity and brevity.

Question: What are you doing to empower your leaders and bedside nurses?

Bryan Sisk: I work closely with our senior leaders from multiple disciplines to elevate the voice of our entire workforce, including our nursing professionals. We have an amazing group of chief nursing officers who empower our nurses at all levels of the organization to express their opinions and ideas which, in turn, helps us gain a much more comprehensive understanding of the world around us. It also provides insight into the ways in which we can meet the needs of, and ultimately advance, the field of nursing. 

Harnessing the insights and perspectives of our own workforce can be a powerful tool in driving a unified initiative forward.

Question: What is the biggest challenge to managing the nursing shortage?

BS: To address the challenges of attracting and retaining healthcare professionals, we need a multipronged approach. While traditional nursing pathways exist, the limited availability of faculty and clinical placement opportunities creates a bottleneck for qualified applicants. Last year in Texas, we had to turn away thousands of qualified applicants to nursing schools — an issue that is not unique to our state.

Q: How can hospitals incentivize people to enter the nursing profession?

BS: We need to design more nontraditional approaches that provide on-the-job training and career progression to create and maintain a robust healthcare workforce. This approach involves identifying individuals interested in healthcare as a career and transitioning them into entry-level jobs that help them align with their ultimate goals, interests and skills. 

From there, we need defined pathway progressions to higher-level positions that are often on the same career pipeline, such as patient care technicians, phlebotomists, EKG monitor technicians, licensed practical nurses and, eventually, registered nurses. 

In order to achieve this, partnerships between healthcare providers and academic institutions need to be reevaluated so they can provide greater flexibility and on-the-job training opportunities. 

Q: Can you describe an initiative your team has taken to attract more people into nursing?

BS: One area we're focused on is high schoolers who are interested in clinical or nursing roles but don't know where to start and are overwhelmed at the sheer size of health systems or discouraged by the prerequisites or job experience requirements on job listings. Additionally, we know we have to provide wrap-around services like access to mentors and leaders across our organization, as well as other types of support to ensure success for these individuals.

Q: How can we personalize the educational experience so that future nurses can obtain an education in ways that work best with their lifestyle?

BS: To personalize the educational experience for future nurses, we must focus on two main areas. First, we need to consider the work schedules of staff with familial obligations to ensure they have the opportunity to attend school while still providing for their families. This can be challenging, but we are actively exploring solutions.

Second, we should support working individuals who already possess valuable healthcare experience in obtaining their nursing degrees. Patient care technicians, techs and other employees within our system have the potential to be incredible nurses. We could do this by sponsoring a day of their work week for school attendance, removing required experience standards from job descriptions and providing counseling related to benefits like tuition support. 

We are also working with our academic partners to create alternate timing of courses, support staff while they are at work, and enhance access to clinical experiences and simulation opportunities that mirror what they experience while they are attending their clinical academic program.

Aligning work experience with degree pathways in healthcare provides real-life experience and a chance to determine the right career path. The nursing skill set is valuable and diverse and offers a wide range of job opportunities outside of traditional bedside nursing, including finance, management, administration and more. We want to support our workforce and aspiring nurses in finding the best fit for them and in achieving their goals.

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