Latest / Becker’s Healthcare - Clinical Leadership Podcast / Building a Stronger Nursing Workforce Through Leadership, Belonging and Retention with Mandy Richards

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Building a Stronger Nursing Workforce Through Leadership, Belonging and Retention with Mandy Richards · Becker’s Healthcare - Clinical Leadership Podcast

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  - There's a small circle of people who truly
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  - understand what it takes to lead a health
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  - system right now. The decisions are enormous.
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  - The variables are constantly shifting, and the stakes
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  - of getting a call wrong don't stay contained.
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  - That's not a complaint. It's a structural reality.
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  - And it's why the most effective c suite
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  - leaders are deliberate about where they go to
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  - pressure test their thinking.
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  - Becker's fourteenth annual CEO and CFO roundtable
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  - brings together more than 1,500
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  - executive level attendees
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  - and nearly 400 speakers for four days built
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  - around growth, financial sustainability,
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  - workforce strategy, and the leadership questions that don't
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  - have easy answers.
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  - Join us November second through the fifth in
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  - Chicago.
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  - For the agenda and event details,
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  - visit beckershospitalreview.com
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  - and click on the events tab in the
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  - upper right.
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  - Hello, everyone, and welcome to the Becker's Healthcare
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  - Clinical Leadership podcast.
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  - I'm Mackenzie Bean, associate vice president and managing
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  - editor of Becker's Hospital Review.
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  - Today, it is my distinct pleasure to be
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  - joined by doctor Mandy Richards, who is a
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  - chief nursing executive and president of children's health
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  - at Intermountain Health.
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  - Mandy, thank you so much for joining us
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  - on the podcast today. How are you doing?
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  - I'm well, Mackenzie. A pleasure to be here,
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  - and thanks for having me. It's such a
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  - pleasure to have you. I know you were
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  - recently on our podcast with my colleague,
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  - Mariah.
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  - So I'm looking forward to
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  - going even deeper into the conversation today and
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  - keeping that conversation going. But for any listeners
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  - who maybe didn't catch that episode, do you
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  - mind just sharing a little bit more about
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  - yourself and your role?
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  - For sure. And I had a great conversation
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  - with Mariah.
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  - I've been a nurse executive for over twenty
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  - four years or a nurse for over twenty
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  - four years,
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  - and I've worked across the country in many
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  - nurse executive roles. But having now been at
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  - Intermountain for three and a half years, we've
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  - done some incredible things within nursing with the
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  - team, and I couldn't be more proud to
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  - be here to share some of that with
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  - you today.
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  - Oh, and let's dive into
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  - exactly that. I wanna start with
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  - the workforce piece. There's obviously a huge focus
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  - right now in terms of
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  - creating a
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  - health
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  - care institution and a destination that nurses want
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  - to stay and continue to practice. So can
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  - you talk through how you're thinking through the
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  - workforce piece and where do vacancy and turnover
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  - stand specifically compared to last year?
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  - Thanks Mackenzie. Yeah turnover raise is something that
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  - nursing executives really look at because we want
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  - our nurses to stay.
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  - And so
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  - we have done a great deal of work
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  - on our turnover rates. In fact we've decreased
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  - them by a percent so we're now down
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  - to 12.6%
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  - with some of our regions, because we're in
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  - a six state region, as low as 8%.
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  - And so that's been deliberate work that we've
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  - done over the last year. But it's important
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  - to compare that to the national average, which
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  - is sitting around 18 to 19%,
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  - so very significant. So we've done a lot
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  - of work to try and get those numbers
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  - down, so we're pleased to see the result
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  - this year so far.
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  - Yes. Some significant improvements, especially as you said,
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  - comparing to that national average.
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  - Let's go one bit deeper into some of
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  - those efforts that have worked of all of
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  - the things that you've tried on the retention
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  - and nurse satisfaction piece. What's what's been most
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  - notable and moved the needle?
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  - That's a great question. So some of the
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  - things that we've found is
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  - we we have a process called leader check
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  - ins So nurses don't leave because we ask
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  - them too often. How are you doing? What
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  - can I do to advance your your nursing
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  - career? They leave because they feel unsupported
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  - So we have found here at intermountain that
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  - if we have frequent touch points
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  - where our leaders understand
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  - the unique concerns each individual nurse has, what
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  - their career aspirations are, and just is there
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  - is there any barriers to delivering,
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  - you know, excellent patient care. So when we
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  - engage them in what's working well, what's not,
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  - we actually build really trusting relationships and we
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  - drive engagement.
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  - And so we have found that that actually
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  - works quite well. We also ensure that we
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  - are equipping our nursing leaders,
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  - and giving them a place to grow. So
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  - we've talked with Mariah about the I aspire
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  - program which was for our frontline nurses
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  - for them to be able to grow professionally
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  - but we've also done some work with our
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  - nurse leader academy
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  - and we're focused on helping these leaders
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  - build stronger relationships with their team and that
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  - actually helps them to navigate
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  - change effectively,
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  - and just to help those caregivers feel supported
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  - and heard. And so what we've found is
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  - those skills, they show up in the daily
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  - interactions
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  - and ultimately,
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  - people stay for leaders that they trust and
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  - the teams where they feel like they belong.
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  - And I would say lastly on this, we've
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  - also created an environment where nurses feel seen
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  - and supported and appreciated for all they're doing.
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  - So we use recognition programs like the DAISY
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  - award, which I'm sure you've heard about. It's
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  - a phenomenal award that's
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  - both national and international.
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  - But, also, we recognize
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  - our caregivers in daily huddles, staff meetings, do
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  - a lot of lead arounding.
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  - We want our caregivers ultimately to feel heard
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  - and that their work matters, and it definitely
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  - strengthen strengthens engagement and therefore retention, which is
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  - phenomenal.
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  - Mhmm. I I believe that you mentioned
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  - that huge focus on recognition so nurses feel
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  - seen and supported,
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  - but then also the the leadership piece of
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  - really giving your nurse leaders as confidence and
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  - the tools to grow and build that strong
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  - relationship
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  - with their team through the nurse leader academy.
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  - And then, of course, you mentioned the leadership
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  - check ins.
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  - Can you talk more about those? Are those
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  - just natural check ins throughout a shift, or
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  - is those really, like, a structured time for
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  - a nurse manager and a a nurse on
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  - the unit to connect more formally?
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  - Yeah. Great question. It is actually a formal
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  - check-in. So it's a sit down.
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  - So it's a purposeful conversation, not just, hey.
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  - You got a minute? It's actually a purposeful
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  - conversation where we're able to give some direct
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  - feedback, input, understand, you know, what are the
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  - is there pressures in life that we need
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  - to be aware of? How do we support
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  - them both clinically, but as a human, we're
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  - all people. We all have lives outside of
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  - work. The more you get to know someone,
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  - that's where the trusting relationships are developed. So
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  - they're more formal check ins. Mhmm.
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  - And how often do those usually occur?
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  - They usually occur, for our caregivers
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  - anywhere between quarterly
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  - or at least once a year. But the
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  - more we can do them, the better.
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  - Absolutely.
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  - And my last follow-up here is on the
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  - Nurse Leader Academy. Can you talk through a
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  - bit more of what that training looks like
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  - or how do you actually equip your nurse
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  - leaders
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  - to engage in that strong relationship building?
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  - Yeah. The Nurse Leader Academy
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  - was designed because nursing leaders' roles are different
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  - to other leaders in the organization. We have
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  - some really
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  - phenomenal professional development programs. And so what we
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  - deal did is we built upon
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  - leading through others which is another core leadership
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  - course we have at Intermountain
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  - and it is giving nursing leaders
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  - the fundamental
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  - building blocks for how to lead a nursing
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  - unit not just the clinical and quality agenda
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  - but a patient experience as well as caregiver
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  - engagement and and how do you really build
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  - crucial
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  - conversations
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  - within those bodies of nurses. So we actually
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  - equip them with having a lot of not
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  - only the didactic training but practice in some
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  - of those crucial conversations that they need to
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  - have on their unit to get an engaged
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  - workforce as well as the results. So it's
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  - helping equip them both with the knowledge as
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  - well as the practice, which has been really
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  - important.
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  - Mhmm. Sure. Very empowering.
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  - I wanna zoom in a bit on
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  - new nurse graduates who are joining the workforce
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  - at Intermountain Health. You know, across the country,
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  - there's been a large focus on,
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  - closing the clinical skills gap and also just
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  - helping especially new nurses feel so supported,
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  - especially in their first year. So they do
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  - want to stay with an organization. Can you
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  - talk through what that looks like at Intermountain
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  - Health? One, how are you finding them landing
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  - at the organization,
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  - and how do you specifically hone in on
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  - retention for that group?
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  - Yeah. Nurse, being a new grad nurse, I'll
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  - never forget when I was a new grad
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  - nurse. I started my training in Australia,
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  - and it was the strangest transition to practice
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  - because you're so used to having all the
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  - support around you and I remember when I
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  - first was giving medications to the first patient
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  - I felt it felt weird I felt like
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  - I was alone because I was so used
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  - to having my nurse preceptor by my side.
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  - And so it just is a it's an
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  - overwhelming feeling sometimes
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  - moving into independent practice. And so nurse residency
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  - programs are really important. They're twelve month programs
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  - that really help transition that nurse into practice
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  - using evidence based practice projects and it's a
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  - cohort
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  - of fellow new grad
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  - residency nurses that can support each other and
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  - so at Intermountain
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  - this program has really helped us. In 2024
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  - alone we hired over 1,600 new grads.
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  - And so you think that's a lot of
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  - nurses that we want to ensure have had
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  - a great experience and feel supported but nationally
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  - the turnover rate in that first year is
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  - around 30 to 40%
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  - which is so high. You think almost half
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  - of the nurses in the first year are
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  - not staying.
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  - So we have done a lot of work
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  - on new grad residency and it's a focus
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  - of a lot of nurse executives across the
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  - country.
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  - And our turnover rate in that first year
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  - is 23%
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  - which is substantially
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  - better than the national average and that's through
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  - the deliberate work of the nurse residency program
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  - and really helping our new grad nurses feel
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  - supported as they transition to practice.
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  - What do you think are some of those
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  - specific
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  - elements within the residency program itself that are
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  - making a difference? Or have you made tweaks
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  - in in recent years that you think has
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  - helped contribute to that 23% turnover rate?
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  - I think the biggest thing is giving them
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  - the structure to the transition
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  - as well as skill building, so clinical skill
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  - building.
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  - But the biggest difference has really been relationship.
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  - They want to feel like they belong. They
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  - want to feel like they are not alone
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  - like I did when I first started as
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  - a new grant. They want to feel like
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  - they're not alone and what they're feeling is
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  - normal. I I think that helps people to
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  - to know whenever they're transitioning to a new
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  - role, it's okay that you don't know what
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  - you don't know. And I would say that's
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  - true for the first nursing leadership role you
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  - take. You become
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  - being an expert at the bedside and then
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  - you move into a nursing
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  - administration leadership role. They're all new skills and
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  - you do feel ill equipped because it's not
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  - skills that you've ever had before. So it's
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  - again
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  - having that sense of feeling you're not alone,
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  - learning the skills required, of course, is going
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  - to take time and that's what the preceptors
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  - are for, but it's just feeling like you
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  - belong and it gives you a lot of
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  - confidence.
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  - That sense of belonging can be so powerful
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  - and I know you mentioned
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  - remembering your experience as a new nurse and
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  - some of that overwhelming feeling
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  - to end here. What would you tell a
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  - new nurse who's stepping into Intermountain Health and
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  - it's their first day on the job?
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  - I would tell them that this is one
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  - of the most meaningful careers that they could
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  - ever choose,
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  - that they have such an impact in the
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  - lives of patients at the time of their
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  - greatest need. And what a gift that is
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  - to be able to help patients,
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  - in critical times. I'd tell them that, hold
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  - on because in 2026,
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  - it's changing really quickly the way we deliver
• 11:20
  - care, with the new technology, new care models
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  - and new ways of working. But I also
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  - see that this is a great opportunity to
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  - shape how care is delivered. I I would
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  - tell them to stay curious, you know, lean
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  - into the change, but I'd also tell them
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  - to find a mentor early,
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  - in their residency program because that's what will
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  - help them transition to practice.
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  - And I would also just say, look, your
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  - voice matters just because you're a first year
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  - out,
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  - in nursing or you've been in nursing for
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  - a long time
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  - their voice really matters because it's it's shaping
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  - the next generation of nursing and how we're
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  - going to deliver care and so I would
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  - want them to speak up I'd want them
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  - to be creative
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  - and and let's continue to do this great
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  - work together.
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  - Mhmm.
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  - So well said. Hold on for one, amazing
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  - ride and one meaningful career is right, I
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  - think. So, Mandy, thank you so much for
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  - joining us on the podcast today and going
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  - one bit deeper on your workforce strategy. We
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  - we really appreciate it. Fantastic. Thanks, Mackenzie. You
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  - have a great day.
• 12:21
  - Thank you. You as well.