How healthcare systems can work to keep nurses

Nurses have endured significant stress over the past two years, but healthcare organizations can take steps to reduce burnout before good nurses leave.

Nicole Banister of Caravan Health

Nicole Banister is senior vice president of transformation at Caravan Health, a company which supports accountable care organizations and helps them improve their performance.

During National Nurses Week, Banister spoke with Chief Healthcare Executive about ways healthcare organizations can support nurses.

Many nurses say they have been exhausted after more than two years of working through the COVID-19 pandemic. Some nurses have left the profession due to the stress, and many of those who have stuck around are in hospitals or systems that are understaffed.

“That is the element that we are still managing today. We’ve been through two years of high need, high stress, long work hours,” Banister said.

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Even though COVID-19 cases and hospitalizations are far below the pandemic peaks we saw in January, that weight and stress doesn’t go away easily, Banister said.

Banister has seen nurses moving into different roles, such as surgical nurses in hospitals moving to outpatient providers where they can get more flexible hours. Health system leaders facing the prospect of losing good nurses should consider working with them to find other positions in the organization.

“It’s an excellent strategy to think about staff retention,” she said.

Caravan is working with value-based care organizations that are having success in keeping nurses by helping them find other roles where they can thrive.

“Nurses have excellent skills in communication,” Banister said. “Leveraging that experience in a new role can really be rewarding for a nurse.”

And it can pay off for the organization as well.

In value-based care, nurses can serve as strong leaders for accountable care organizations, because they have experiences with a variety of different providers and clinicians.

“They would be good candidates for leadership in value-based care, ACO champion roles,” Banister said.

Nurses can also play a vital role in helping patients manage the transition from the hospital to either a long-term care facility or recovery at home, Banister said. Nurses can work with patients to make sure they understand their instructions and medications to assist recovery and avoid a readmission to the hospital.

Health systems also need to consider offering nurses more flexible scheduling options. Nurses are increasingly calling for more options in scheduling, and that’s a factor driving some nurses to per diem work.

“There’s lots of opportunity to offer flexible scheduling that maybe in the past weren’t considered,” Banister said.

Banister also said health system leaders don’t have to devise the scheduling remedy themselves.

Health leaders can reach out to nursing teams to ask about any ideas they have for more flexible scheduling.

“They might come up with things they’ve never thought of before,” Banister said.

Health systems can also leverage technology and tools to address scheduling issues, she said.

For nurses that have been working so hard over the past two years, Banister also encouraged providers to make sure that nurses can get time off when they request it and to urge them to use vacation time.

Some nurses, who have been carrying the emotional trauma of caring for sick and dying COVID-19 patients, need more than a vacation week.

Health providers have to make sure nurses know about the mental health resources that are available to them, and use them.

A recent survey found most nurses said the job was taking a toll on their health, but only few were taking advantage of their employers’ mental health resources.

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“It’s not enough to remind folks of the employer assistance programs and mental health programs at open enrollment once a year,” Banister said. “It needs to happen throughout the year.”

“It’s a continuous open door of communication and reminder of the support,” she said.

Health systems can also boost the morale of nurses by recognizing their accomplishments. In any work environment, it’s easy to get bogged down in day-to-day tasks, but taking time to recognize nurses helps them feel valued.

In smaller healthcare organizations that don’t have the resources of larger providers, leaders should think about the culture they are trying to create to help retain nurses.

Leaders of smaller hospitals should utilize one big advantage: “You know everyone.”

“You can set up an expectation that people do come to work and find joy in their work,” Banister said.