Latest / Becker’s Healthcare - Clinical Leadership Podcast / Caren Lewis on Nurse Retention, Workforce Development and Building the Next Generation of Nurses

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Caren Lewis on Nurse Retention, Workforce Development and Building the Next Generation of Nurses · Becker’s Healthcare - Clinical Leadership Podcast

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  - Hello, everyone, and welcome to the Becker's Healthcare
• 1:00
  - Clinical Leadership podcast.
• 1:02
  - I'm Mackenzie Bean, associate vice president and managing
• 1:05
  - editor of Becker's Hospital Review.
• 1:08
  - Today, I am so, so thrilled to be
• 1:10
  - joined by Karen Lewis, who is senior vice
• 1:12
  - president and system chief chief nursing executive at
• 1:15
  - MultiCare Health System.
• 1:17
  - Karen, thanks for joining us on the podcast.
• 1:20
  - Oh, I appreciate it, Mackenzie. Glad to be
• 1:22
  - here.
• 1:23
  - Glad to have you. I'm hoping you can
• 1:25
  - kick off the episode by just sharing a
• 1:27
  - little bit more about
• 1:29
  - yourself and your role for any listeners who
• 1:31
  - might not be, as familiar with your work.
• 1:34
  - Yes. Thank you. I appreciate it. So let
• 1:37
  - me start by saying,
• 1:39
  - as a nurse, my background is primarily critical
• 1:42
  - care and OR, so perioperative services.
• 1:46
  - So through that, it's been a really amazing
• 1:48
  - journey to go from delivering care to the
• 1:51
  - bedside,
• 1:52
  - to stepping into various informal and formal leadership
• 1:56
  - positions that really led me to
• 1:59
  - sort of a fork in in my career
• 2:02
  - that I was like, do I wanna stay
• 2:05
  - sort of leading a direct patient care area?
• 2:07
  - Or do I really wanna
• 2:10
  - step out and try to do something that
• 2:12
  - can impact
• 2:14
  - my nursing professionals really as a group that
• 2:16
  - I work with while touching the patients and
• 2:19
  - families too. And that's really the route I
• 2:21
  - decided and it's taken me,
• 2:24
  - along a journey through several systems,
• 2:27
  - unplanned,
• 2:28
  - with counterclockwise
• 2:30
  - around the nation. And I'm currently
• 2:32
  - with MultiCare Health System as the system chief
• 2:35
  - nurse executive here.
• 2:37
  - We currently have
• 2:38
  - 13,
• 2:40
  - acute care facilities
• 2:42
  - and,
• 2:43
  - widespread of ambulatory and post acute. So
• 2:47
  - each of our acute care facilities and each
• 2:49
  - of our networks or patient carriers have their
• 2:52
  - own nurse executives, and I'm here
• 2:54
  - to support them
• 2:56
  - to help us work through our strategy on
• 2:58
  - providing the best care we can
• 3:00
  - and to help us be able to engage
• 3:03
  - in a very
• 3:04
  - goal oriented positive outcome and safe environment for
• 3:07
  - our patients. Thank you.
• 3:09
  - Thank you. I appreciate the overview. And I
• 3:11
  - guess first off, I just wanna ask how's
• 3:13
  - the Pacific Northwest
• 3:15
  - treating you as you're doing your national tour
• 3:17
  - of all the regions?
• 3:19
  - Oh my gosh. I absolutely
• 3:21
  - love it. It is so funny. My career,
• 3:24
  - as you can tell from the accent,
• 3:26
  - started in the South. And so,
• 3:29
  - spent many, many years,
• 3:31
  - at my home organization in the South,
• 3:34
  - then to Washington, DC, then Connecticut,
• 3:37
  - and then most recently Wisconsin
• 3:39
  - before coming here. So
• 3:41
  - when I went north, I loved it because
• 3:44
  - I really enjoyed the weather, loved being on
• 3:47
  - the water, etcetera.
• 3:48
  - And as I've moved across the country, it's
• 3:51
  - just interesting. It's getting
• 3:53
  - more green.
• 3:54
  - So more green, more beautiful.
• 3:56
  - And here we have the mountains and the
• 3:58
  - water combined. And so it's incredibly lovely. Yesterday
• 4:03
  - evening,
• 4:04
  - kind of settling down, getting ready for our
• 4:06
  - work week, looked out and saw Mount Rainier
• 4:08
  - shining
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  - on us. And that's just
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  - I've only been here six months, but I
• 4:14
  - can tell it's gonna be something that doesn't
• 4:16
  - get old.
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  - Mhmm. Not a bad view from your window.
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  - Right? And there's something so grounding and peaceful
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  - about having that nature. And the whales. I
• 4:25
  - have to say. And the whales. Oh, nice.
• 4:27
  - Fell in love with them. And yeah. Fell
• 4:29
  - in love with them in New England and,
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  - totally enjoyed them here. Enjoy seeing the orcas
• 4:35
  - and humpbacks out playing.
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  - Yeah. I'm sure.
• 4:39
  - And you said you've been in your role
• 4:41
  - for six months.
• 4:43
  - Can you talk a little bit about
• 4:46
  - your focus on nurse vacancy and turnover in
• 4:48
  - that time? Where are where is MultiCare at
• 4:50
  - at that journey right now, and what are
• 4:52
  - you focusing on as it pertains to that?
• 4:55
  - Yeah. Actually,
• 4:57
  - I would say we are doing a little
• 4:59
  - bit better than many of my
• 5:02
  - friends and colleagues across the nation who are
• 5:05
  - in different areas of the country where it's
• 5:07
  - more challenging.
• 5:09
  - We actually,
• 5:10
  - I believe
• 5:11
  - year before last, we were at about a
• 5:14
  - 13,
• 5:15
  - maybe 13.4%
• 5:16
  - turnover rate for RNs.
• 5:18
  - This last year, we were at 9.8.
• 5:21
  - We're actually doing really good. I don't have
• 5:23
  - our latest numbers, but I do know in
• 5:26
  - just pulse checks with the CNOs in our
• 5:28
  - facilities,
• 5:29
  - they're feeling feeling really good about retaining the
• 5:32
  - nurses right now. And we have a fabulous,
• 5:37
  - international trained,
• 5:39
  - group of nurses that work with us. And,
• 5:42
  - we're really enjoying
• 5:44
  - them being part of our teams too. So
• 5:47
  - while we always want more, we always wanna
• 5:50
  - fill every single role.
• 5:52
  - We're we're actually feeling pretty good about it
• 5:54
  - at the moment.
• 5:56
  - That's great to hear. You know, you've
• 5:58
  - worked at so many different health systems in
• 6:01
  - various nursing leadership roles.
• 6:03
  - What have you learned about retention
• 6:06
  - in that time? What actually moves the needle
• 6:07
  - and gets nurses to stay?
• 6:10
  - Yeah. I think a couple of things, I
• 6:12
  - think.
• 6:13
  - The old saying that
• 6:17
  - new nurses and or nurses in particular, we're
• 6:20
  - all really build our relationship with our manager.
• 6:23
  - And so our leader does make a difference
• 6:26
  - in the work environment.
• 6:28
  - So I think in having conversations
• 6:30
  - with our nurses and some of our nurse
• 6:33
  - executives, we really feel like the work we've
• 6:35
  - done in mentoring
• 6:37
  - and working to have and maintain
• 6:40
  - strong nursing leadership
• 6:42
  - is very important.
• 6:43
  - I think,
• 6:45
  - the other thing that's made a difference,
• 6:47
  - we have an excellent nurse residency.
• 6:50
  - That's a little bit different than what how
• 6:53
  - I've had it,
• 6:55
  - I would say created in other organizations.
• 6:58
  - We do our nurse residency
• 7:00
  - by specialty.
• 7:02
  - So there'll be a perioperative residency.
• 7:05
  - There may be an OBGYN, a med surg,
• 7:07
  - a critical care residency.
• 7:09
  - And the nurses really seem to resonate. It
• 7:13
  - it seems to resonate well with them. And
• 7:15
  - they like being
• 7:17
  - involved in the their chosen specialty from the
• 7:21
  - very beginning.
• 7:22
  - And so the closer we can get them
• 7:24
  - to getting to know their leaders and and
• 7:27
  - learning about their specialty and moving from that
• 7:29
  - novice
• 7:30
  - to
• 7:32
  - understanding more about their job and really the
• 7:35
  - scope of care they're going to provide as
• 7:36
  - they work to really being a true expert.
• 7:39
  - I think that gives them
• 7:42
  - a lot of security.
• 7:44
  - Very much on especially being able to be,
• 7:46
  - like you said, with their peers or their
• 7:48
  - superiors above them within their own specialty right
• 7:51
  - from the get go. I'd imagine they're able
• 7:53
  - to
• 7:54
  - very much more so
• 7:56
  - tailor or personalize the the types of trainings
• 7:58
  - versus traditional onboarding as well.
• 8:01
  - They are. We are. And we're actually working
• 8:03
  - really closely with our, academic facilities
• 8:07
  - around the state where our hospitals are to
• 8:10
  - understand
• 8:11
  - how we can partner with them
• 8:13
  - to even
• 8:15
  - be able to help support increasing
• 8:18
  - the pathway into nursing.
• 8:20
  - What other kind of nursing student cohorts or
• 8:23
  - classes?
• 8:24
  - What about those, potential nurses out in our
• 8:26
  - community who have social determinants of learning?
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  - Maybe they can't go the hours of a
• 8:31
  - traditional,
• 8:32
  - higher academic facility. What can we do a
• 8:35
  - little bit different to help them in? Because
• 8:36
  - we've got, I know, some very interested,
• 8:39
  - compassionate members of our community that wanna give
• 8:41
  - back. So we really are looking to how
• 8:44
  - how can we do it a little differently
• 8:46
  - to get as many nurses,
• 8:48
  - into the into the
• 8:50
  - workforce as possible going forward. Mhmm.
• 8:53
  - I've never heard that term of social determinants
• 8:55
  - of learning, but I think it's so important
• 8:58
  - and it makes sense to consider as you're
• 9:00
  - thinking about pipeline development.
• 9:02
  - Can you share an example of one of
• 9:04
  - the more unique things you're thinking about or
• 9:06
  - considering?
• 9:08
  - Yeah. So we actually have a cohort that
• 9:11
  - we're gonna be starting this fall
• 9:13
  - with,
• 9:14
  - one of our academic partners.
• 9:16
  - And it's going to be a cohort of
• 9:18
  - about, I think it's 25,
• 9:21
  - new nursing students or community members coming into
• 9:24
  - nursing.
• 9:25
  - And we will
• 9:26
  - be working to let's just say the social
• 9:28
  - determinant of learning for a particular person is
• 9:32
  - that it's a two income family, maybe have
• 9:35
  - one or two children at home.
• 9:37
  - One of the people in the home works
• 9:39
  - Monday through Friday during days.
• 9:41
  - So it makes a diff it makes it
• 9:42
  - difficult for the other person who might wanna
• 9:45
  - get into nursing or health care to be
• 9:47
  - able to go to school. Sometimes childcare can
• 9:50
  - be, very expensive,
• 9:52
  - right, these days. And so
• 9:54
  - we're looking to see how can we offer
• 9:57
  - flexible. So
• 9:59
  - what classes can we do online?
• 10:01
  - What kind of clinicals could we do evenings
• 10:04
  - and weekends that would be able to help
• 10:06
  - them
• 10:07
  - really get into would mesh well with their
• 10:10
  - life from work life integration
• 10:12
  - perspective and help get them on their professional
• 10:16
  - path and into working with us. So that's
• 10:19
  - one social determinant of learning and what we're
• 10:21
  - gonna do a little bit try this fall.
• 10:24
  - That's really exciting. I'm as a mom of
• 10:26
  - a toddler, I I know how busy those
• 10:29
  - things get, how hard the Monday through Friday
• 10:31
  - is. Yeah. Yeah. It resonates. It doesn't match.
• 10:34
  - Very much so.
• 10:36
  - One thing I wanna ask you about is
• 10:37
  - the clinical skills gap for new nurses who
• 10:40
  - are coming right out of school
• 10:42
  - on the job.
• 10:44
  - I've heard a lot of nursing executives talk
• 10:47
  - about
• 10:47
  - the growing challenge there and how they're working
• 10:50
  - to really address it at their own systems.
• 10:52
  - And any thoughts on that challenge?
• 10:55
  - Yes. I think that's that's totally true. Rings
• 10:59
  - true, Mackenzie.
• 11:02
  - One of the things
• 11:04
  - is the use of the sim labs
• 11:06
  - and the equipment for the schools to have
• 11:09
  - what we have. They don't have the capital
• 11:11
  - budgets, etcetera,
• 11:13
  - to really buy everything to replicate all the
• 11:16
  - equipment we have. So it's important for us
• 11:18
  - to be partners with them
• 11:20
  - to help them have some of that equipment
• 11:24
  - whenever we can
• 11:25
  - so that the nurses can prepare.
• 11:28
  - But it's true. We are seeing nurses come
• 11:31
  - out with
• 11:33
  - good didactic learning,
• 11:35
  - but maybe
• 11:37
  - they haven't done I'll I'll use an example,
• 11:39
  - a Hoyer lift.
• 11:41
  - So it is a type of lift we
• 11:43
  - use,
• 11:44
  - to be able to a patient that can't
• 11:46
  - get up themselves, to be able to lift
• 11:48
  - them up out of bed and or transfer
• 11:51
  - them.
• 11:52
  - And a lot of schools and clinicals,
• 11:55
  - simulation labs don't have that. So that's just
• 11:58
  - an example of what we're finding
• 12:00
  - as our students come in. We need to
• 12:02
  - really include that in clinicals when they're students.
• 12:06
  - But if not, that's definitely one of the
• 12:08
  - items we have for check off,
• 12:11
  - during their residency and orientation because we need
• 12:13
  - to ensure,
• 12:15
  - you know, when they're through with that residency
• 12:17
  - and when they're through their orientation,
• 12:19
  - they're ready to go. They'll still be getting
• 12:20
  - support from their colleagues and peers.
• 12:23
  - But part of that job satisfaction is to
• 12:25
  - feel comfortable in it. Right? You want to
• 12:28
  - feel
• 12:29
  - confident and comfortable
• 12:31
  - in delivering that care to the patient. So
• 12:33
  - it is incumbent upon us to really, wherever
• 12:36
  - those gaps are, to be sure we really
• 12:38
  - match them,
• 12:40
  - early on. Mhmm.
• 12:41
  - I know that comfort and support, especially in
• 12:43
  - a nurse's first year, is so key to
• 12:45
  - retention too. We've seen all so many surveys
• 12:47
  - and news coming out about that first year
• 12:49
  - turnover,
• 12:50
  - not just nationally.
• 12:52
  - I think it's important
• 12:54
  - from
• 12:54
  - ensuring they have a good preceptor
• 12:57
  - from a clinical
• 12:58
  - skills perspective
• 13:00
  - and I would say techniques and competency perspective.
• 13:04
  - But then going back to that relationship with
• 13:06
  - their leader,
• 13:08
  - there's that psychosocial
• 13:10
  - or mental or emotional aspect too. That's so
• 13:13
  - important
• 13:14
  - to be sure while the preceptor's working on
• 13:17
  - the clinical skills with that new grad,
• 13:20
  - to be sure that that leader's staying close
• 13:22
  - with them and be sure they feel emotionally
• 13:26
  - supported
• 13:27
  - and and really feel good about that learning
• 13:29
  - path.
• 13:30
  - Mhmm.
• 13:31
  - Absolutely.
• 13:32
  - Curious, what would you tell a new nurse
• 13:35
  - starting on their first day this year?
• 13:39
  - I would say
• 13:40
  - you have no idea what opportunities
• 13:43
  - you are going to get in this career.
• 13:46
  - You have
• 13:47
  - chosen a good one. Every time I'm speaking
• 13:50
  - to,
• 13:51
  - young people out in the world today, I
• 13:54
  - just and they show any little interest on
• 13:56
  - nursing. I'm always saying, it's great.
• 13:59
  - Please try it. Because if you think about
• 14:01
  - it,
• 14:02
  - a lot of many people,
• 14:05
  - it's just ingrained in most of us to
• 14:07
  - want to help others. Right? To want to
• 14:09
  - care for others.
• 14:11
  - But a lot of,
• 14:13
  - service work is self limiting in its hours
• 14:17
  - or schedule or type of work. But for
• 14:20
  - nurses out there,
• 14:21
  - there's the one to one work with the
• 14:25
  - patients and their families, frankly.
• 14:28
  - There's
• 14:29
  - work with insurance companies, with tech companies,
• 14:33
  - with a credit or regulatory.
• 14:35
  - I mean, really there's so many things when
• 14:37
  - you get experience that you can go out
• 14:40
  - and do. And and talk about work life
• 14:42
  - integration.
• 14:43
  - You can work during the week, during the
• 14:45
  - day, during the night,
• 14:47
  - weekend, twelve hour shifts, eight hour shifts,
• 14:51
  - virtual nursing, flex nursing. It's really I I
• 14:55
  - have a hard time thinking of anything that
• 14:57
  - just might open more doors for someone
• 15:00
  - to look and really define their path forward.
• 15:03
  - And nursing's one of those things that does
• 15:05
  - it.
• 15:06
  - Well, I think that's such a great message
• 15:08
  - to end on. You are a prime example
• 15:10
  - of what an amazing career in nursing can
• 15:12
  - look like. So, Karen, thanks for joining us
• 15:14
  - on the podcast today and sharing more about
• 15:16
  - your work. It's been such a pleasure chatting
• 15:18
  - with you. I appreciate it, Mackenzie. You have
• 15:20
  - a terrific day.
• 15:22
  - Thank you. You too.