Chief nursing officers: 3 tactics to solve healthcare industry challenges

Nurse Leader Insider, November 4, 2019

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By Jennifer Thew, RN

Nursing is about identifying problems and creating innovative solutions.  As a nurse leader, it is essential to think outside the box to effectively tackle the many challenges occurring in today's healthcare industry. When it comes to issues like technology, staff retention, and nurse manager development, the status quo is no longer enough. Nurse leaders must have a vision for the future and the knowledge and skills to implement solutions that will propel the nursing profession forward.

Below is a roundup of stories HealthLeaders has written about three nursing leaders and how they've overcome challenges facing the nursing profession with the following tactics. 

Karen Mayer, RN—Want to keep nurses at the bedside? Here's how.
Recruiting and retaining bedside nurses with the right skills and work experience is essential to delivering high-quality patient care. But it is no easy task. Nurses with experience, particularly in a specialty, can be hard to find and newly licensed nurses often have their sights set on the next career opportunity.

In fact, Press Ganey's analysis of 250,000 RNs who participated in the 2017 National Database of Nursing Quality Indicators RN Survey found close to 21% of nurses planned to leave their current jobs within one year, including those retiring. When asked about their job plans over the next three years, 26% said they will pursue other options ranging from new positions in an organization to retirement.

Karen Mayer, RN, PhD, MHA, RN, NEA-BC, FACHE, chief nursing officer and vice president of patient care services at Rush Oak Park Hospital, in Oak Park, Illinois, has seen the challenges of nurse recruitment and retention first hand. When she started at the organization, the nurse turnover rate was about 22%, and some departments had vacancy rates as high as 24%, she says. According to the recruitment firm NSI Nursing Solutions, Inc., the average national turnover rate for bedside RNs was 16.8% in 2017.

"When you have bad outcomes, and leadership is beating you up and telling you how bad you are, as a staff nurse—even if you are a great nurse—you feel hopeless because nobody wants to work in an environment where they feel like they're providing bad care," Mayer says. "There were excellent, excellent nurses working here, yet the punitive environment resulted in a lack of respect [toward nurses] by physicians [and] administrators, and from nurse to nurse."

Through dedication and years of hard work, she was able to drop the organization's turnover rate to 8.3%.

Mayer shares how this was achieved through a combination of solutions, interventions, and change in the organizational culture.

Ronda J. McKay, RN—Technology can zap fear of the unknown

More and more, technology is being incorporated into healthcare, especially as virtual care is on the rise. But having more technology does not always mean healthcare leaders are optimizing its use.

As Ronda McKay, DNP, RN, CNS, chief nursing officer and vice president of patient care at Community Hospital in Munster, Indiana, points out, investing in technology means more than just purchasing it. Rather, leaders must understand various technology's capabilities and think about how it can be used to optimize existing processes.

For example, in 2014 when Community Hospital cared for the first person in the U.S with a confirmed case of Middle East Respiratory Syndrome, McKay utilized her organization's technology, including reports generated from the existing EHR, to determine who had been exposed to the patient while inside the hospital.

"I think that you need to prepare for the unpredictable, invest in technology and services for your organization, and invest in education and collaboration of your employees," she says.

McKay shares how nurse leaders can handle intense situations with the help of technology.
Paula McKinney, RN—Investing in nurse manager development pays off
Typically, nurses who were good clinicians moved up the ladder to nurse management. However, they did not usually receive extensive training before they started in the role.

Yet, professional development is essential as healthcare becomes increasingly complex and nurse managers play larger roles in improving financial, clinical, and quality outcomes.

"If they don't learn how to be a good leader, and they're just managing the processes, then they [could] set their unit up to create an unhealthy work environment," says Paula McKinney, RN, DNP, NE-BC, vice president, patient services at Woodlawn Hospital in Rochester, Indiana.

In McKinney's study, "Improve Nurse Manager Competency With Experiential Learning," published in the October 2016 issue of Nurse Management, 86% of the respondents said they had no formal leadership development when they first became a nurse manager.

"If you promote someone to nurse manager and [he or she leaves] you within 12 to 18 months, you're losing a great deal of money. It could be up to $100,000," she says. "I think there's some cost savings involved in better preparing them to be leaders and managers instead of letting them be out there on their own to flounder and then they end up leaving the job."

McKinney discusses how experiential learning improved nurse manager job preparedness. 

Nurse executives like these will share their ideas and successes in healthcare at the upcoming HealthLeaders CNO Exchange held November 13–15 in Ojai, California. The CNO Exchange is one of six healthcare thought-leadership and networking events that HealthLeaders holds annually. For more information about the HealthLeaders Exchange program,

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.

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