CNO Roundtable 2020

Staffing Challenges and the Silver Wave

Q: What is shaping up to be your biggest nurse staffing challenge of the new decade?

By Working NurseApril 27, 2020

3 min read

Robyn M. Nelson, RN, Ph.D., MSN

(pictured above)
Dean, College of Nursing
West Coast University

Nurse staffing challenges will increase if academia is unable to prepare sufficient new graduate RNs. There’s no shortage of applicants: According to the American Association of Colleges of Nursing, baccalaureate and graduate nursing programs turned away more than 75,000 qualified applicants in the 2018–19 school year. Unfortunately, there are many factors limiting nursing school capacity, including insufficient faculty and clinical sites that are already popping at the seams with students.

Schools will need to consider what creative strategies could be used to fill faculty vacancies (there is a significant disparity between the salaries of RNs in service and those in academia), but the clinical site situation could be improved if the BRN would approve the use of simulation for up to 50 percent of clinical practice time (which would NOT impact clinical competency!).

Lack of preceptors is also a concern. A clinical preceptor is a valuable mentor to the nursing student. Service and academia need to look at why there are insufficient preceptors and what can be done to change that. There are many possibilities: reward and recognition for RNs who assume the preceptor role; courtesy titles from academia; or even requiring RNs to serve as preceptors as part of their annual performance review. It’s all about math: More preceptors means more graduates, which means more staff. Source: Lippincott Recruiting and Retaining New Grads

Denise Robinson, RN, DNP, MPH, WOCN

Chief Nursing Officer
Loma Linda University Medical Center

One of the many challenges we face is the growth we’ve seen in our patient population, which will certainly increase further as we move into our new hospital and attract new patients. California patients are challenging, so maintaining the level of care we provide as our volume increases is key.

Irena Zuanic, RN, MSN, NEA-BC

Vice President / Chief Nursing Officer
PIH Health Good Samaritan Hospital

The biggest nurse staffing challenge from my perspective is succession planning, especially for nursing leadership at all levels. As a chief nursing executive, I strive to identify and inspire new leaders who will help us address staffing challenges by creating a healthy work environment. It is essential to be strategic about the future of nursing leadership. We need to recruit and mentor young nursing professionals for those roles. This has multiple benefits because mentorship is bi-directional: While the young leaders learn from our experience, we also learn from their perspectives on nursing, work-life balance, technology and innovation.

THE SILVER WAVE

Q: As highly experienced Boomer nurses retire, what steps is your organization taking to preserve institutional knowledge and build the expertise of your younger nursing cohorts?

Lori Burnell, RN, Ph.D., NEA-BC

Sr. Vice President / Chief Nursing Officer
Valley Presbyterian Hospital

We are preparing for the “Silver Wave” by implementing a formal nurse-leader succession-planning process along with a robust mentorship program for frontline nursing staff. We have already initiated the first step of our succession-planning process: to define and document the attributes the next generation of nurse leaders will need to be successful. Based on these attributes, our current nurse leaders will identify high-potential candidates. The nursing leadership team will then examine the specific competencies for each role and design an orientation curriculum. We have also implemented strategies to build on the expertise of our younger nursing cohorts.

Two years ago, we purchased the Vizient/AACN Nurse Residency Program, which includes an evidence-based curriculum, final project requirements and interactive group exercises. Additionally, we promoted a postgraduate RN from our residency program to the role of educator for nursing advancement. This new fulltime position is responsible for facilitating the nurse residency program and ensuring that each resident’s final project is relevant to nursing praxis in our organization. This position also provides mentorship and serves as a role model for new nurses.

Patricia S. Matos, RN, DNP, NEA-BC

Chief Nursing Officer
Resnick Neuropsychiatric Hospital (UCLA Health)

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UCLA Health

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Keystone Medical Resources, Inc.

Adventist Health

Los Angeles County DHS

PIH Health Downey Hospital

Hollywood Presbyterian Hospital

PIH Health Whittier

L.A. Care Health Plan

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UCLA Health has anticipated the wave of nurses who will retire over the next decade. Our health system has a robust 12-month nurse residency program in which nurses are mentored closely, including an evidence-based project they must complete by the end of the year. Their posters are presented on graduation day. I have been consistently impressed by the high level of professionalism of the nurses’ work on these projects. Clearly, these nurses have learned to think critically and base their practice on evidence, not tradition. If the nurses continue this trajectory, they will be more than ready to fill the gaps left by the “Silver Wave.”

Gloria Sanchez-Rico, RN, BSN, MBA, NEA-BC

(pictured above, center)
Chief Nursing Officer / Senior Vice President
Huntington Hospital

The “Silver Wave” is a phenomenon we are already experiencing. We are seeing talented and experienced nurses from the bedside and leadership go into retirement and take so much knowledge and passion with them. We are doing our best to create opportunities to retain this valuable workforce, such as asking nurse managers to stay on per diem to help mentor less-experienced leaders. We have also asked nurses on the cusp of retirement to act as mentors to our nurse graduates — not as their managers, but as their colleagues. We are committed to finding ways to be flexible and creative so we can retain our most experienced nurses.

Denise Robinson, RN, DNP, MPH, WOCN

Chief Nursing Officer
Loma Linda University Medical Center

We are fortunate to partner with Loma Linda University School of Nursing to train our incoming care providers. Our new nurses have access to both the LLU Medical Center and the Children’s Hospital, where they can not only work on healthcare teams as they learn, but also gain firsthand experience in caring for patients in our community.