As hospitals confront unprecedented staffing shortages, financial strain and rapidly evolving patient needs, nursing leaders across the country are rethinking not just how to stabilize the workforce today, but how to rebuild it for the long term.
The question is no longer whether the profession must evolve, but how quickly organizations can redesign roles, strengthen culture and invest in the people who keep care delivery moving.
“I meet regularly with my frontline nurse ladders to address immediate operational challenges and eliminate barriers to ensure the delivery of excellent patient care every day,” said James Fenush, RN, vice president of nursing emergency services and clinical support services at Penn State Health Milton S. Hershey (Pa.) Medical Center. The daily check-ins keep the team focused and problem solving for the moment.
But then he also has to look beyond the daily stresses as a leader and remain focused on strategic priorities, including innovation as well as faculty and staff experience.
“Balancing short-term problem solving with long-term strategic advancement is crucial,” he said. “If we fail to consistently drive progress in these priority areas, we risk losing sight of the workforce transformation necessary to sustain our mission and move our organization forward.”
Everywhere, systems are walking a difficult line: easing immediate operational pressures while building the foundations for a more resilient, empowered and sustainable nursing workforce. Nursing has experienced workforce shortages for years, but Athena Minor, DNP, MSN, RN, said this is the first time she’s seen those shortages affect nearly all disciplines from specialty care to family practice, nursing and ancillary staff.
“Challenges that must be addressed through both long-term and short-term strategies are numerous,” she said. “While patient care gaps are the largest concern, there are also challenges presented through wage battles and greater demands for work-life balance, not to mention issues with denials and reimbursement uncertainties. Put all of this together and it becomes clear that healthcare leaders must be holistic in strategic approaches.”
Healthcare teams are being asked to do more with less resources while maintaining quality care. Organizations must provide a just culture and reasonable work-life balance for staff and constantly recruit in talent.
“It is a big ask; however, we have found a measure of balance through unique staffing models, cross-training opportunities and shared governance,” said Dr. Minor. “Investing in our people has been our greatest strategy, one which we will carry into the future as we continue to explore pathways to sustainable workforce transformation.”
Leaders say that means elevating shared governance, expanding training pipelines, creating flexible staffing models, modernizing workflows and redesigning the work environment itself — all while battling ongoing shortages across nearly every clinical and ancillary role.
Mila Sprouse, EdD, MSN, RN, CNO of North Puget Sound Region at Renton, Wash.-based Providence, said she is balancing short-term pressures with long-term transformation by staying grounded in the system’s mission. She has ramped up practice governance and strengthened shared decision-making through a practice council where participation increased 40% in six months.
“We are launching a formalized Healthy Work Environment initiative to further empower caregivers to co-create solutions and shape a workplace that supports them today and prepares them for tomorrow,” she said.
Molly Moran, DNP, RN, associate vice president of ambulatory nursing at Rush University Medical Center in Chicago is also balancing the immediate workforce pressures and patient care needs through flexible staffing models, cross-training and providing clinician well-being and wellness resources. The hospital is using technology to streamline clinic workflows and providing training and education to build “strategic agility” in preparation for the future of healthcare delivery.
“These efforts have led to investments in long-term transformation, including strengthening academic partnerships, implementing an RN fellowship program for nurses new to ambulatory care or our organization, and reimagining how to leverage nurses of all experience levels from new graduates to those nearing retirement,” she said. “Together, this work ensures our workforce is supported today while positioned for success tomorrow.”
