Nurse sabbaticals pay off for Nationwide Children's

Sabbaticals in nursing. It is a concept some hospital leaders might dismiss, given the complexities of staffing. But Columbus, Ohio-based Nationwide Children's Hospital is leaning in. 

"As leaders, we box ourselves in sometimes and put rules around things that prevent us from innovating," Lee Ann Wallace, BSN, RN, chief nursing officer of the nation's third-largest pediatric hospital, told Becker's. "We have to challenge each other. … We can't just let the workforce pay rules or schedule rules get in our way." 

As such, the health system has reimagined sabbaticals to offer nurses more flexibility and a break from high-acuity, high-stress care delivery environments. Sabbaticals are a well-established practice in academia and typically offered to tenured faculty members. While criteria around work commitments, and the length and frequency of sabbaticals vary, they typically involve several paid months off from normal teaching duties to travel and pursue research or other scholarly work.

Leaders at Nationwide Children's knew a sabbatical in the traditional sense would not work logistically in many nursing units, but they were steadfast in considering innovative approaches. 

"We really tried to reimagine the word 'sabbatical,'" Ms. Wallace said. "What other strategies feel like, look like, a sabbatical for them?"

In 2022, the hospital began offering "sabbaticals" of sorts to nurses in high-acuity spaces, including behavioral health. The offering involves allowing nurses to essentially take a break from emotionally taxing spaces for weeks at a time. For example, once every three months a behavioral health nurse may choose to work a six-week schedule on a low-acuity unit. The option is also offered to nurses in one neonatal intensive care unit with particularly high-acuity patients.

Other sabbatical-inspired models Nationwide Children's is exploring in some units include school year schedules and shared FTEs. The former has been offered to nurses in some of the hospital's pediatric intensive care units where volumes tend to be more predictable. Respiratory season is often intense in the PICU, with summer volumes being reduced, Ms. Wallace said. Through that option, nurses are full time and employed for the entire year but are essentially off in the summer months. 

The shared FTEs model is geared toward more tenured nurses working in specialized areas such as hematology oncology and enables them to work one week out of the month as a home health nurse. 

Nationwide Children's is still working to track and understand the outcomes of the models, though anecdotally, the response has been positive. 

"We've seen dramatic improvement in our turnover in the last couple of years, but I don't want to attribute all of it to this because the world has changed, and I think everyone is experiencing a stabilization of the workforce, so we're trying to be really careful about understanding the data and what it shows," Ms. Wallace said. 

"Anecdotally, culturally, it feels better. People feel more refreshed, and in particular in the behavioral health space where we've had a lot of focus on this, turnover has gone down a lot, especially in those extremely high acuity patient areas." 

These efforts are "all about retention" and were based on feedback leaders heard from nurses during exit interviews and town halls.

"They kept telling us, 'We are tired. We are stressed and it's just the whole acuity is wearing on us,'" Ms. Wallace said. "We said OK, how do we think about increasing retention and how do we keep them not just in the organization but in the actual area that they are trained to work in."

The healthcare workforce's needs and expectations are constantly evolving — a reality leaders at the hospital have been reminded of as they continue to expand these models and measure outcomes.

"Sabbaticals is really as innovative as virtual nursing was innovative," Ms. Wallace said. "These aren't things we ever did because we didn't think we needed to: school schedules with summers off, working in a sister unit or shared FTEs. … Now, we have to. So we have to challenge ourselves to think differently about how people work, where they work, how many hours they work and what they're doing when they work." 

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