Providence's 'secret sauce' for accountability in the hybrid era

Online modules can save leaders time and energy when conveying new information, but some conversations — especially those around expectation-setting — are more effective offline, Keegan Fisher, division chief human resources officer for Providence's North division, told Becker's

The Renton, Wash.-based health system is no stranger to hybrid arrangements. Its virtual nursing program grants workers flexibility and has proven to improve retention, especially among first-years. But camaraderie does not flourish behind a screen, as Providence's CEO, Rod Hochman, MD, recently pointed out; and as nurse bullying continues to climb, camaraderie is more important than ever. 

Lateral incivility in the nursing profession is not new, but it's a heightening concern, Mr. Fisher said. Today's nurses are under immense stress, and bully behavior — gossiping, belittling, excluding — thrives in pressure cookers. 

Health systems are increasingly feeling the pressure to correct such behavior as retention becomes a crucial element of their talent and financial strategies: "I don't know any caregiver who has multiple job options who would want to stay in a workforce where they are subject to bullying," Mr. Fisher said. So Providence's nursing leadership team highlighted burnout — and the tensions it can spur — as strategic imperatives for 2023. 

The health system identified a few responses, including a web-based training to teach all leaders how to create a positive workplace for their caregivers. But the real game-changers occurred in person, according to Mr. Fisher. Chief nursing officers and HR leaders within his division gathered in person for a summit earlier in the year and decided they needed an in-person approach on individual units when it comes to workplace toxicity. 

"Since [the summit], our HR business partners within our division have taken that on the road. They have identified teams that felt that an in-person training would be more engaging than just a web-based module," Mr. Fisher said. "We're engaging not only nurse managers, but also their acute care RNs, so the bedside nurses are doing this together with their leaders." 

"The value, the 'secret sauce' of this, is that the caregivers and their leaders together are hearing what their expectations are of one another," Mr. Fisher continued. "Often, we talk about, 'see something, say something.' We know that our caregivers deal with so many challenges — not only with patients and needing to respond to a higher acuity of patients in the hospital setting — but they also share that interest with their leaders of building a place that they belong. This training this year has been a real way to engage and improve that dialogue." 

The jury is still out on how bullying will evolve (and how HR leaders will address it) as more roles shift remote; but Mr. Fisher's division has seen improved engagement since adding the in-person training, according to results he received this month from the system's caregiver experience survey.

"I do think [the hybrid era] is going to require a different approach for our leaders to ensure that they're still building a team dynamic that feels accountable to one another when not everyone may be on the floor every single day. I feel like that's where HR and nursing will have to strategize together on the approaches that we will deploy to build a shared accountability and a camaraderie," Mr. Fisher said. "Within nursing typically, that's been able to be done through patient handoffs or huddles on the unit. And now that is going to take a different direction." 

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