Nursing is a challenging profession – but often, the expected challenges of providing care are compounded by burdensome, administrative or non-clinical tasks that unnecessarily increase workload, burnout and turnover.
These time-consuming tasks are often a root cause of workplace dissatisfaction, taking nurses away from the work they entered the profession to do (patient care), and driving many nurses to leave the profession altogether.
With more than a third of nurses planning to leave, workforce solutions are urgently needed, and nursing leaders across the country are working to bring joy back to practice by thinking outside the box to solve some of nursing’s biggest challenges.
Kathy Howell, chief nursing executive for UCHealth, is one of these nursing innovators – finding new ways to staff hospitals, accomplish tasks, and better support nurses so they can practice at the top of scope and add satisfaction in their careers.
The challenges UCHealth and its nursing staff face aren’t unique, but the approaches Howell has employed are – and they represent three new opportunities for nursing leaders and health systems to think differently about solving the challenges nurses face.
“Every single health system leader should be removing the pebbles from nurses’ shoes,” Howell said. “They can do this by listening to their nurses and then doing something about it.”
Developed through a listening and learning approach, in which nurse executives regularly round, these three solutions address some of the common challenges nurses experience in the workplace.
Creating a safe working environment for nurses
Nurses deserve a safe place to work, yet violence against nurses has increased since the COVID-19 pandemic. Physical assaults are common. While they range in severity, they all add to the mental and physical burden nurses carry, Howell said.
Howell and her team enlisted the expertise of non-nurse behavioral health specialists in a role titled “behavioral health rounders” to proactively work with patients and staff, providing round-the-clock behavioral health provider support. These clinicians assess and intervene for at-risk patients and provide guidance for staff to assist in developing therapeutic strategies to mitigate and minimize violent incidents.
“Those are strategies that really benefit the patient, too,” Howell says. “Many times, they are acting out because they don’t have any control, and it is the scariest time in their life.”
The efforts to bolster staff are an investment, but one with immense return. “It’s been a game changer,” she says. “It’s been well worth it to create an environment where nurses feel safe and able to do the work that they’ve been called to do.”
New roles allow nurses to spend more time providing care
The addition of innovative support roles for nurses is also driving satisfaction. Technology malfunctions are frustrating in any setting. In a health care environment, they can be downright dangerous. Even a simple backlog of data adds to nurses’ stress, leaving them to troubleshoot obstacles such as computer issues instead of spending valuable time with patients.
Nurses’ frustration with tech breakdowns led Howell to introduce patient technology technicians – always-on technology professionals – at UCHealth hospitals. The technicians make sure all the equipment works and fix problems that arise, allowing nurses to provide uninterrupted patient care.
A patient technology technician at UCHealth.Source: UCHealth Pre- and post-implementation surveys showed dramatic results – 96% of nurses reported satisfaction with the time they spent managing technology, up from 14% before the pilot. According to Howell, “Many of the nurses said, ‘I can’t work on a unit without this role!’”
With that takeaway, there was only one next step: “We are implementing this role in all of our hospitals,” she said. “We’re hiring 140 patient technology technicians. So that’s a home run.”
Another new role at UCHealth is the patient care assistant (PCA). Under the supervision of an RN, these individuals assist nurses by providing basic patient care such as monitoring vital signs, enhanced mobility, taking blood glucose measurements and other care tasks. This improves nurse and patient satisfaction, and it frees up time for nurses to provide higher-skilled patient care interventions.
The PCA role also offers an entry point into health care, as applicants can be accepted with no prior health care experience and undergo a rigorous, six-week training program. Applicants are recruited through partnerships with local schools and community organizations, and the role provides a springboard into a career as a health care professional. More than 60% of UCHealth PCAs are pursuing higher education through the UCHealth Ascend Career Program, which offers varying levels of assistance for continuing education and professional growth – including full tuition for some programs, such as a Bachelor of Science in Nursing degree. This helps create opportunities for those who may have encountered barriers to accessing higher education.
Virtual wound care nurses, better care for patients
Specialty nurses play a significant role in patient care. Their niche expertise is a critical part of care delivery, and wound care nursing is no exception.
“Wound care nurses are really specialized nurses who treat and prevent wounds from occurring in a hospital,” Howell says. “You never have enough of these nurses.”
Learn more in the second episode of SEE YOU NOW’s series on redesigning work. Meet Iman Abuzeid of nursing career marketplace Incredible Health, as she shares insights in building workplace cultures that serve and support nurses and bring joy back to nursing.Howell and her team came up with a new care delivery concept to improve capacity and efficiency of the nursing team supporting wound care. How it works: Wound care nurses in the UCHealth Virtual Health Center, in metro Denver, review the full scope of patients currently admitted at hospitals across Colorado and identify those at high risk for pressure injuries and wounds.
Electronic medical record data is fed to the “virtual cockpit,” where wound care nurses can remotely assess risk. The wound care nurses see patients virtually and in partnership with nurses at the bedside.
“We were able to see 38% more patients using this model,” Howell says. Not only that, but the model also gives staff options – nurses can work at the bedside one shift, and virtually the next, finding a balance that fits their needs and their lifestyle. “It’s an example of how we’re taking our nurses with expertise and giving them technology and processes so that we can make them more efficient. We can make their role better so that they really enjoy what they're doing.”
Howell and the UCHealth team continue to evaluate ways to create a more satisfying and flexible workplace. The system recently launched a “FlexSchedule” program, where nurses work four 12-hour shifts per week for 12 weeks, followed by 4 paid weeks off, providing greater flexibility for nurses who would like time off in larger blocks.
These and other scalable solutions are improving the workplace for nurses, restoring the joy in nursing and creating an environment where they can thrive.
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