Much has been written about the mental health epidemic and chronic staffing problems that are currently plaguing the nursing industry, and with good reason. The profession is reeling after two years of a brutal fight against Covid-19. Still, another crisis is brewing that has received far less attention. There’s a very real threat of a leadership void in nursing at both the facility and industry level, as older nurses retire and others leave the profession due to burnout.
According to recent data from Trusted Health, just 1 in 10 nurses say their idea of a successful career in nursing involves advancing into nurse administration and leadership roles. That raises the specter of a vacuum at the top at precisely the moment when that leadership is needed most.
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Sarah Gray Sarah is the Founding Clinician at Trusted Health, the leading labor marketplace for healthcare professionals. Trusted matches nurses with a range of flexible jobs that meet their preferences and career goals, offer support from a dedicated Clinical Care Team and unmatched insight into compensation and contract details. Sarah is a graduate of the […]
Like so many of the issues facing the healthcare industry right now, while this one has been exacerbated by the events of the last few years, it actually predates the pandemic. Generational rifts have meant that many younger nurses find the profession’s culture and general rigidity are inconsistent with their lifestyles and career aspirations.
First-year turnover accounted for nearly one-quarter of RN separations, according to a 2021 retention and staffing from NSI Nursing Solutions, and that trend has persisted over the years. While many of these nurses simply look for a new opportunity, some will leave the field entirely, worsening the clinician shortage and depleting the leadership pipeline.
The good news is the same actions that can help with retaining nurses will also foster a new generation of leaders. Here are three steps the industry must take immediately to address nursing’s leadership pipeline problem.
Address bullying and incivility
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The generation gap that has plagued so many workplaces where Millennials and Baby Boomers work together has been particularly fractious in nursing. The persistence of the “nurses eat their young” mantra has led to a deeply entrenched cultural practice of bullying. Certainly, there are older nurses who reject this. But in my experience, many still see it as a rite of passage and continue to perpetuate it.
The sheer number of nurses who said that they don’t want to go into nursing leadership because of “nursing politics/culture” is shocking – it dwarfed all other responses at 66%.
Hospitals need to address bullying through a multifaceted approach: educating all parties about what bullying looks like, offering training to new managers, building relationships between nursing departments and their HR partners, and holding employees accountable for their behavior. Facilities and systems that don’t tackle this issue head on are destined to lose the very nurses who have the greatest potential to help the profession evolve in new and healthier ways.
Reinvent nursing career paths
Like their counterparts in other industries, Millennial nurses are far less inclined to stay at one or two organizations and work their way up the clinical ladder, one of the traditional glide paths to a leadership role.
Twenty-one percent of the nurses in Trusted’s survey said that they weren’t interested in being associated with a single hospital or health system, and 35% said that a successful career includes moving among hospitals, clinics and units to gain varied experiences.
Based on this, hospitals need to create easier and lower-risk avenues for nurses to find variety, explore and be challenged and stimulated in new ways. This might include reimagining float pools or creating structured rotational programs that enable nurses to develop their skills across specialties, care settings and geographic locations. That’s in addition to embracing and providing mentorship for nurses who are interested in leadership but looking for it in a non-traditional role.
Rethink staffing and scheduling
Nurse managers regularly report spending at least half of their time on scheduling. Given this, it’s unsurprising that 14% of respondents said that the amount of time that leaders spend on staffing and scheduling is a deterrent to becoming leaders themselves.
Hospitals are experimenting with a variety of different approaches to this issue.
Bon Secours enlisted a team of workforce professionals who are specifically trained in staffing and scheduling, and rolled out a new scheduling system that lets nurses book extra shifts in advance. Mercy, one of the largest health systems in the U.S., is in the midst of a multi-year overhaul of their nursing workforce, and has worked with the team at Trusted to use data and AI to predict and identify the right staffing mix, made up of staff, travel and per diem nurses. Both approaches take the burden off of frontline managers and leaders, freeing them up to focus on patient care and the other things that first drew them into the profession.
Nursing is desperately in need of a new vision. So much about the profession was untenable before Covid-19 hit, and the last few years have been, in many ways, the proverbial straw that broke the camel’s back.
The nurses who have remained in the field despite the horrors of the pandemic deserve meaningful, widespread changes that help this field live up to its potential. They deserve to have their voices heard and elevated through positions of power so that they can remake nursing into something healthier and more sustainable.
Photo: Fly View Productions, Getty Images
Sarah is the Founding Clinician at Trusted Health, the leading labor marketplace for healthcare professionals. Trusted matches nurses with a range of flexible jobs that meet their preferences and career goals, offer support from a dedicated Clinical Care Team and unmatched insight into compensation and contract details.
Sarah is a graduate of the University of Pennsylvania's Nursing School and began her nursing career at UCSF Benioff Children's Hospital. Prior to moving away from the bedside, she was a Clinical Nurse III and an Evidence Based Practice Fellow, and served on multiple hospital-wide committee boards. At Trusted, she utilizes her clinical insight and passion for innovation to change how nurses manage their careers and solve for inefficiencies within healthcare staffing.
